On 3rd July an official government commissioned survey found that lack of sick pay and insecure work increase the risk of carehome residents contracting Coronavirus.
The Vivaldi study1 looked at coronavirus (COVID-19) infections in 9,081 care homes providing care for dementia patients and the elderly in England. They found risk of infection was reduced by between 7-18% when staff had paid sick leave entitlement. Risk of infection almost doubled when carehomes employed bank and agency workers on zero hours contracts.
It is likely that the survey significantly under estimates the risk caused by lack of sick pay. The survey was carried out by interview by care home managers who were asked whether they offer sick pay to staff. 93% said that they did, however we know from various studies that only around 20-40% of care providers pay full sick pay.2 3 The ONS have confirmed that this discrepancy is because the authors of the study decided to group together those who pay full sick pay (ie normal wages for sickness absence) with those who just pay Statutory Sick Pay (£95.85 a week) and compared this group to the 7% who say they offer no sick pay at all (despite this being a legal requirement). The difference between full sick pay and SSP is around £197 a week for a minimum wage worker. A careworker who only gets SSP for two weeks self-isolation will lose almost £400 in income. For low wage worker that means serious difficulties paying the rent and putting food on the table. It is this financial pressure that is driving care workers into work when they have signs of Coronavirus infection.
By grouping these two types of sick pay together, the study significantly under-estimates the increased infection risk posed by workers not having full sick and isolation pay entitlement. They have found that careworkers are more likely to isolate if they only have to take a £200 a week financial hit rather than £292 a week, and this effect makes carehomes 7-18% safer for residents. But what they are reluctant to tell us is how much infection risk is reduced in carehomes where workers can isolate without suffering severe financial hardship.
While this is the first time that an academic study has found a link between lack of sick pay and risk of infection, it is not the first time the government has conceded this is a problem. The central measure in the government’s public health strategy is self-isolating those who are symptomatic and those who are in close contact with people who are symptomatic. But millions of workers – those without sick pay, on zero hours contracts, those with “no recourse to public funds” status – cannot afford to take time off work. This widespread problem increases the risk of infection in those workplaces where workers do not have these basic rights, and means Coronavirus spreads more rapidly.
Recognising this argument, in early March NHS England insisted that all workers (including bank and outsourced workers) with duties on NHS premises should be paid normal wages if they were isolating on public health advice. In fact, this has only been done in a botched and partial way4. The complexity of carrying out this instruction within a service that has been fragmented and privatised over many decades means that even in the NHS there remain many low paid workers within our hospitals without paid leave entitlement. However, in social care the problem is even more acute. A majority of care homes employ people on minimum wage with no occupational sick pay entitlement. Hundreds of thousands of workers, caring for hundreds of thousands of people who are at highest risk of dying if they get Coronavirus, are being driven into work when they have signs of infection. Despite understanding this risk back in early March and taking steps to mitigate the risk in the NHS, it was not until the middle of May that Department of Health and Social Care attempted to address the sick pay issue within care homes. Early results suggest that the way they have addressed this problem is far from adequate.5
The devolved administrations have also been slow to act, but they too have now recognised the problem. On 3rd June the Northern Irish government introduced a scheme guaranteeing 80% wages for any careworker who needed to isolate following public health advice.6 On 24th June the Scottish government took much more decisive action on careworkers sick and isolation pay providing an Enhanced Statutory Sick Pay scheme that ensures full pay for all social care workers, including home care workers.7 On 26th June the Welsh government issued advice to prevent further outbreaks of Coronavirus in food processing plants: “Employers should…ensure that employees who are required to self-isolate do not suffer a financial detriment as a result of self-isolation.”8
The UK has the second worst sickness benefit scheme in Europe (the worst is Malta). An EU report found it was “woefully inadequate” and in breach of its obligations under the international law. Most other European countries guarantee all workers can take paid time off usually paying between 70-100% wages. In Germany, for example, all workers are entitled to six weeks off on full pay. The Enhanced Statory Sick Pay scheme for careworkers announced in Scotland suggests that the UK government could act quickly to guarantee full sick and isolation pay for all. The UK government has recognised the inadequacy of SSP and casualised work since March and now has scientific proof to back up this argument. Their delay in addressing this problem will cost lives.
If you going out to work at this time, do not wait for the government to act. Organise your workmates and campaign for full sick and isolation pay for all workers in your building, including outsourced workers. Your boss has a legal duty under the Health and Safety at Work Act 1974 to do whatever is reasonably practicable to ensure that workers and others are protected from anything that may cause harm, effectively controlling any risks to injury or health that could arise in the workplace. The Vivaldi study proves that there is an increased risk of Coronavirus infection in workplaces where workers do not have sick pay and job security. Measures already taken in the NHS, in the Civil Service, on London Underground and at Lambeth Council show that it is reasonably practical for employers to address this risk.