In the UK health services, where women make up 77% of the workforce, average real wages have declined by around 14% in the period from 2010 to 2017. Around 20% of nurses have had to take an additional job to survive. And the job has become more stressful, so that by July 2017 more nurses were leaving than were joining the profession, leading to a shortfall of nursing staff of about 8.9% in England, with negative effects on patient care.
The WBG, working as part of a Commission on Care, reported that the supply of non-medical care for frail elderly people has been almost entirely outsourced to private companies, who run residential care homes and services for people living in their own homes. Four fifths of care workers are women and nearly a fifth of the workers are migrants. Care workers in the private sector earn less on average and have more limited entitlements to leave, sick pay and pensions than those few workers who remain in the public sector. Tens of thousands are effectively paid below the statutory minimum wage, as they are not paid for time spent travelling for home visits and are on precarious contracts which do not guarantee a minimum number of working ours (known as ‘zero hour’ contracts). They are only allowed to spend 15 minutes on a home care visit, with negative impacts on the quality of care given. It is largely through having such poor pay and working conditions that private sector companies have managed to provide care at lower cost than the public sector.