A Labour Strategy for Personal Support Workers

Veronica tells us why.

September 2020

We call them heroes, but that’s not how they feel. They care for seniors and other vulnerable people, and COVID-19 called government and public attention to those who suffered and died because of their work. Most of that attention went to people working in long-term care homes, but that’s only part of the story. The people who work in clients’ homes are part of the same system. It’s a system that needs fixing, and fixing it takes a broad strategy and commitment.

Personal support workers provide a large part of home care, and we need a labour strategy for them and for those who also work in homes. We hear that they have to work too hard, are paid too little, and don’t get the support they need to do their jobs safely. Veronica tells us what that looks like.

Veronica’s story

“I’ve been doing this work for 10 years, ever since my husband and I arrived with our two small children from the Philippines. Mario is a mining engineer, and the only work he could get was on overseas operations, so he’s gone for months at a time. He sends most of his earnings home, but we still need my job to survive.

“I was trained as a chemical engineer, but the only job I could find here was as a personal support worker. My home care agency isn’t too bad as employers go. I get the mandated minimum wage, but no sick leave and practically no other benefits, because I’m still a contract worker. If I complain, I could lose my job. Employment insurance wouldn’t cover rent and food for very long, and I don’t want to go on social assistance.

“I usually look after at least six clients in a day. With travel time in between, there is only an hour to spend with each one, and that’s just not enough for all their needs. Even worse, I don’t have time to visit with them when they are lonely, and so many are so very lonely, unable to see their friends, kids, or grandkids. 

“The pandemic has made things worse. My agency gives me one surgical mask per day and gloves for each visit, but no gowns. I tried to buy my own supplies, but it was almost impossible to get them, and I don’t know how I would pay for them. I bring my own hand sanitizer, but the cost has doubled, so I use it sparingly. I used to do an evening shift at a nursing home, but the government now says I can’t mix health care settings. I understand, but don’t know what to do. I could go back to cleaning hotel rooms, but that would be just as risky. Some of my clients asked me to stop coming for a while. I have children and take public transit to work, so they worry about cross contamination. I’m just as worried. My son has asthma, so infection would be very dangerous for him. I could expose him without even knowing it. I share my apartment with my sister’s family, so it’s always crowded. If I get sick, who will look after my kids or my clients? Most would be all alone. I also feel alone. These days, I haven’t been sleeping too well, and I don’t know how much longer I can keep going.”

Veronica’s story isn’t unusual, and it didn’t start with COVID-19. Our approach to caregiving has been inconsistent and sometimes dismissive, often because of society’s view of the people who do this work.

The Canadian Women’s Foundation tells us that our primary and long-term care systems are staffed largely by women. More than 90% of nurses, 90% of personal support workers in long-term care and community care, 80% of medical lab staff, and 75% of respiratory therapists are women. Women also make up more than two-thirds of those cleaning hospitals, schools, and office buildings. Additonally, a large number of these women are racialized.

During the pandemic, Ontario deemed personal support workers essential, but didn’t give all of them the compensation and benefits to go with that status. Premier Ford more recently called these workers “grossly underpaid” for what they do, while acknowledging he might be opening up a “can of worms.” Our government has turned its attention to workers in long-term care homes, but that can of worms affects home care workers as well. While government is investing in long-term care, making the shift from warehouses to actual homes, home and community care will take on even more responsibility.

We need to attract dedicated and qualified people and keep the ones we have. Improving pay, benefits, and working conditions are necessary steps, but personal support workers and the people they serve need more. Care Watch has long advocated for a strategy to bring together and coordinate efforts to:

  • Recruit people, both current and new Canadians, to personal support work. The supply of personal support workers is decreasing, and turnover is high. People new to Canada have often replenished a dwindling pool, so we need to keep making that possible.
  • Provide and require consistent professional education and certification. All personal support workers need common skills and expertise. Some newcomers to Canada are already highly qualified. A consistent educational plan would let them build on their qualifications to meet Canadian requirements.
  • End precarious work. Full-time employment lets workers earn a decent living without having to move between sites and expose themselves, their clients, and their families to infection.
  • Establish standards for pay, pensions, benefits, and working conditions that recognize value and promote respect. When staying at home is the healthiest and safest choice, a worker with paid sick leave doesn’t have to fear losing needed income.
  • Explore models that replace a piecework, hourly task approach to home care with consistency and continuity. A provider with fewer clients can give each one more attention, with fewer chances for infection.

No one government department, no one ministry, can develop and establish a labour strategy. It will take the commitment and cooperation of ministries responsible for health, long-term care, labour, education and training, and citizenship and immigration. Working together, they can develop a labour strategy that will serve workers and clients now and protect them in the future. They need our encouragement and support.

What can you do?

  • Learn as much as you can about the workers who care for seniors and other vulnerable people.
  • Advocate for a labour strategy that will give us the people we need to do this work and treat those people fairly.

Advocacy can take many forms:

  • Talking with people and raising awareness
  • Attending meetings, signing petitions, and writing letters to newspaper and magazine editors
  • Asking your provincial and federal representatives what they and their parties are doing. Are they consulting with personal support workers, their unions, and their employers? What are their positions on wages, benefits, and working conditions? Are they prepared to advocate for and support a labour strategy?