Thursday 18 September is International Equal Pay Day which is an opportunity to pause not just to measure pay differences, but to reckon with what those differences say about how we value care, and those who give it. In Scotland’s social care sector whose workforce is overwhelmingly female, underpaid, and overworked – the day must surely be more than symbolic. It must after decades of talk set a fire under those who in political leadership have prevaricated for so long.

Recent analysis shows that in health care and social care, the gender pay gap sits at 11.2%, meaning the average woman works 41 days a year effectively unpaid compared to a man.  This isn’t about skill or hours, about professionalism or competence – it’s about value.

In Scotland, over 80% of adult social care workers are women, a figure that should inspire pride – but instead points to persistent undervaluation. Roles demanding emotional labour, flexibility, resilience, and unglamorous hours remain low paid.

That we tolerate this imbalance speaks to gender bias entrenched across public services and policy, within our political leadership and critically within society’s valuing of social care work compared to other sectors.

Scotland fares better than the UK average in headline terms – but it is simply not enough. The full-time pay gap in Scotland is around 5.5%, compared to 11.3% across the UK.  But average figures mask deep disparities within sectors – especially social care.

If we closed the gender pay gap fully, Scotland’s economy could gain an estimated £17 billion.  More than figures, this is about fairness, dignity, and economic justice for women whose work supports us all and in truth is the engine of our economy.

There is a lot more that we can do.

We could finally start to stop talking about the success of paying the Living Wage to workers who allow us all to flourish and thrive and not just to live. A decade ago the Scottish Government was ahead of the curve when it introduced the Living Wage for frontline carers. But the shine has well and truly come off that trophy. Since then we have effectively gone back as more and more, greater and greater pay awards have gone to comparative roles in for instance the NHS. The pay gap is now wider than it was a decade ago. Unless pay is fair across roles – and regularly benchmarked against NHS scales – inequity remains.

The women who do the same or similar roles in social care require parity not promises.

Sectoral bargaining offers the promise of ensuring that pay scales reflect the complex, skilled, and emotional nature of caregiving. But we need government at national and local level to follow through beyond the rhetoric with the reality of real additional resource.

It is time to lift social care out of the poverty trap.

But it goes even further. I was involved in a fascinating discussion with colleagues across the sector this past week on Fair Work and most of our discussion centred around pay, terms and conditions. But I was reminded that there is another dimension to fair work that we often forget, and that is how we value people in the roles they have. I reflected on this in a recent blog but put simply I feel that one of the reasons the system has got away with underpaying women in social care is that we continue to think of the job of care and support as low value and low skilled. We continue to think of care as ‘women’s work’ and to reward it accordingly in a discriminatory manner.

At best social care’s undervaluation stems not from indifference, but from misconceptions: that it is work that is low-skilled, replaceable, optional. We must challenge that. Women chiefly bear the burden of such work – paid and unpaid – and I cannot but detect the hand of misogyny in fiscal and budgetary choices. We urgently need as a whole society to reframe caregiving as respected, essential, and skilled.

Women disproportionately take part-time roles to manage caregiving – for children and relatives – driving pay gaps wider as they age. Indeed, women aged 50–59 can face up to 19.7% pay gaps, along with lifetime earnings losses of £400,000.

Whilst we have increasingly attractive rights in relation to flexible working we need to do a lot more to incentivise secure working, re-entry opportunities, paid family leave, and career break re-entry pathways. We need to invest in schemes that counteract the ‘motherhood penalty’ and support sustained career progression.

And there are particular challenges in social care provision because of the unethical commissioning and contracting practices of public authorities. Ad I have said elsewhere:

‘Fair work is impossible without fair commissioning. For too long, contracts have been let based on cost above all else, driving a race to the bottom where providers struggle to meet the true costs of care. Commissioning must change. It must be relational rather than transactional, valuing continuity, quality and human connection. Contracts must build in the real costs of delivering fair work – not just wages, but pensions, in work benefits, training, supervision and career development. Procurement must become a tool to enable fair work, not undermine it.’

And behind all this we must call out the unequal treatment of frontline carers where they are everyday being stripped of professionalism.

‘Workers must be involved in decisions that affect their practice… We need to start trusting the social care front line with autonomy and the ability to discern and prioritise.’

Scotland’s Gender Equality Duty remains vital. Public bodies must publish equality objectives every three years, including on pay.  This must include social care commissioning and procurement and yet I have rarely seen those critical elements included in such gender impact assessments.

International Equal Pay Day is more than a marker – it’s a call. In care homes and homecare across Scotland, women’s labour sustains lives, communities, and dignity. Yet pay, policy, and perception continue to fall short.

If we truly value care, then it is our actions that matter not decades of aspiration. That means we must fund pay justice, not just pay increases. It means we urgently need as media, leaders and the public to reframe care from an unskilled default to a skilled vocation. It requires us to take active steps to sustain women’s careers, not force invisible caring costs onto them. And to achieve all this we need to embed equality in every funding, commissioning, and oversight mechanism.

Until then, the hope behind International Equal Pay Day risks diminishing every year.

The African poet Adesola Oluwafeyikemi Sarah Amoo wrote these words last year in a poem she entitled:

“Equal Worth, Unequal Pay: The Struggle for Fair Compensation”

She works with vigor, heart, and mind,
Yet finds her paychecks lag behind,
Her worth, her toil, her every day,
Still shadowed by unequal pay.

With every raise, a silent fight,
For justice in the dimmest light,
A climb that’s steep, with every step,
A battle that she won’t forget.

Her voice joins others, loud and clear,
Demanding change, no need to fear,
For equal work deserves its due,
A world where paychecks honor true.

Let fairness reign in every field,
Let parity be our shared yield,
For every woman, bold and bright,
Deserves her worth in dollar’s light.

https://adesolaoamoo.medium.com/equal-worth-unequal-pay-the-struggle-for-fair-compensation-6b3c644a28f2

Donald Macaskill

Photo by Clay Banks on Unsplash

Just occasionally in a conversation or an exchange you hear a word, and it sparks imagination or memory. I was fortunate and have been now for a few weeks to be listening to the Ctrl + Care podcast – which I can thoroughly recommend – and during one of them one of the two main contributors, Michelle Corrigan spoke about how social care is about discernment and how Ai for instance can never replace the activity and the art of discernment.

I have to confess it’s not a word I have used or reflected on for a long period and certainly not outside what might be spiritual or ecclesiastical corridors but Michelle in using it made me think just what is the role of discernment in social care and I reflected further on this at a conference on social care nursing just the other day. So here are some thoughts.

At first the word discernment sounds like an ancient word – something belonging more to the monastery than the modern care home, more to cloistered silence than the daily demands of home care visits. But I want to suggest that discernment is actually at the very heart of what it means to care and support another. And indeed, it is at the very heart of the distinctiveness of social care nursing.

The word comes from the Latin discernere – to separate, to distinguish, to sift. It is more than decision-making, more than problem-solving. It is attentiveness. It is about listening deeply, weighing not just facts but feelings, not just rules but realities.

It is not simply about seeing but about perceiving, about teasing out what is important from what is secondary, what is of value from what is distraction. In the Christian mystical tradition, discernment was spoken of as the ability to sense where love and life were moving, to detect the whisper of the Spirit amidst the noise of daily routine.

In the ancient traditions, discernment was a virtue. In the Celtic world of this land, it was often linked with the idea of anam cara – the soul friend – the one who helps another see the truth of their life. In the secular and philosophical traditions, discernment was seen as a discipline of wisdom: the slow and patient art of sifting, of waiting for clarity before action.

And I think social care nursing, in its essence, is this: not only the application of knowledge and skill, but the cultivation of soul-friendship, the gift of discernment.

In our care homes and in our homecare services, discernment is what distinguishes a task-driven approach from a relationship-centred practice.

It is the difference between hearing a request for a cup of tea – and recognising the deeper thirst for companionship that lies behind it.

It is the knowledge that when someone living with dementia refuses their medication, it may not be stubbornness – but fear, confusion, or a memory of trauma.

It is the sense that when a resident is restless in the night, the issue is not simply sleeplessness – but someone in need of comfort.

Discernment is what guides a carer to pause for a moment longer at a bedside, to ask the question that was nearly left unasked, to offer dignity in the small acts of attention.

Social care nursing has always been about this art: the art of listening beyond the words, the art of noticing the unspoken. And it is so because it is profoundly about nurturing relationship which is always more than simply performing a task.

John O’Donohue, in his luminous book Anam Cara, writes:

“The heart of discernment is to listen for the presence of the other. When you listen generously to people, they can hear the truth in themselves, often for the first time.”

That is, I suspect, the gift of social care nursing. It is not only about providing treatment or attending to tasks, but about creating the kind of space where someone can rediscover themselves, where their own truth can surface.

We are not technicians of the body alone. We are companions of the soul.

Discernment, in this way, is not a luxury. It is not an added extra. It is the very texture of good care and support. It is what makes social care nursing distinctive – grounded in skill, yes, but rooted in presence, in patience, and in the kind of listening that allows another to become more fully themselves.

The art of discernment in social care and social care nursing is one which I think needs to be rediscovered.

And perhaps today, more than ever, discernment is an act of resistance.

It resists the reduction of care to cost.

It resists the temptation to make relationship secondary to efficiency.

It resists the belief that rules and procedures can ever replace the lived moment of encounter.

Discernment insists that every decision is contextual, every encounter is unique, and every person is worthy of time and thought.

We have not lost this need today. Indeed, in a world of information overload, where care is often reduced to metrics and measures, discernment calls us back to something deeper. It asks us to resist rushing, to question the easy answer, to attend to the fragile humanity in front of us.

This is the distinctiveness of social care nursing. It is not simply about doing for another. It is about being with another. It is about the ancient art of wisdom rooted in the everyday acts of attention.

This is not to dismiss the necessity of policy, procedure, or system. But discernment reminds us that no rulebook can ever replace the lived moment of care, the eye contact, the listening ear, the intuitive sense of what is right in this unique situation.

So let me close with a poem, offered as a meditation, echoing the Celtic soul-tone that John O’Donohue so often gifted us:

 

In the stillness between sea and stone,

where the wind carries whispers of ancient hills,

discernment walks softly,

like a pilgrim listening for the soul of the land.

 

It is the knowing of tide from wave,

the hearing of truth in the hush of a pause,

the sight of light breaking through cloud,

revealing what lies hidden, tender, and true.

 

To discern is to sit by the hearth of another’s being,

to hear the music beneath their silence,

to cradle their story as one cradles flame,

protecting it from the gust of indifference.

 

And in this gentle seeing,

this soul-friendship born of presence,

we remember that care is not duty alone,

but the ancient art of belonging,

the blessing of one heart recognising another.

 

Donald Macaskill

In the aftermath of the Scottish Bereavement Charter Conference on the Future of Bereavement in Scotland – held a couple of days ago and which gathered a very thoughtful range of participants and a range of workshops, including the inspiring contributions of Debbie Kerslake of Birmingham – the growing intersection of AI and grieving deserves I think some wider consideration and reflection.

In my previous writing on “synthetic resurrection,” I invited readers to consider how emerging digital technologies reshape landscapes of memory and grief. At its heart, this practice asked: How might we hold the dead? And how might technology both support and challenge the dignity of that process?

Now, the News Agents piece “Would you use AI to talk to your dead relatives?” and an intriguing phone-in conversation on LBC just last week – brings that philosophical question into the everyday. It introduces Reflekta, an AI-driven service that enables families to create digital avatars of loved ones – fed by their memories, voices, and texts – and engage in ongoing conversation for a subscription fee. Some find comfort and continuity in this, especially those wishing to preserve stories (as Reflekta’s founder Greg Matusky does, using the voice of his WWII veteran father.)

Yet others, like reporter Lewis Goodall, warn of potential exploitation – cautioning that grief is not a product to be monetised, and that synthetic voices may hinder the natural process of letting go. I would tend to agree with Goodall because while Reflekta’s founder hopes to preserve family stories, there are obvious critics concerned about the ethical and emotional risks: worried that simulating a person risks substituting reality with “fiction” – a phantom that may hinder natural grieving and closure.

At this week’s bereavement conference, Debbie Kerslake joined me to explore AI and bereavement, placing technological innovation within a broader human rights and community context. She is also the Director of Brum YODO’s whose work- organising creative, communal events like A Matter of Life & Death Festival– underscores the power of shared ritual and story to process loss, foster connection, and honour forms of grief that resist digital reanimation.

Brum YODO’s ethos reminds us: talking about death, creating spaces for remembrance, imagining communal memorials- those are the foundational practices for healthy bereavement. They resist loneliness, stigma, and commodification of grief. Yet many of these accepted approaches including our own excellent Good Life, Good Death, Good Grief programme in Scotland, asks a basic yet fundamental question: Can Ai support healthy grieving?

The short answer is probably that Ai may provide narrative preservation, but cannot replace relational, embodied grieving.

The emerging scholarship on deathbots or AI-driven chatbots that emulate the presence of the deceased- so-called Interactive Personality Constructs of the Dead (IPCDs)- highlights a troubling concern: they may replicate some sense of presence but miss the profound intersubjectivity of real relationships, risking unresolved grief or emotional confusion.

For me at a very practical level at the heart of such griefbots lies a fundamental limitation: every response is based on static, past data- the recorded voice, texts, anecdotes of the person who has passed away. These AI reproductions cannot account for the reality of change – a loved one’s voice, attitudes, or advice would inevitably evolve if they were still alive- facing new world events, personal growth or even shifting relationships. They ignore the truth of personal development. Growth and wisdom occur continuously. We expect differently from those who remain with us. Ai chatbots cannot simulate these future selves of the deceased – they are frozen in time.

Thus, what such technology offers is not an evolving, relational presence, but a nostalgic snapshot- a memory preserved, not a relationship nurtured.

While Ai might help preserve memories- even offer solace in loneliness- its limitations lie in the lack of authenticity – a digital proxy cannot truly feel, respond, or evolve as the real person did. They risk dangerous dependency and overreliance on an AI persona may inhibit moving forward in a healthy way. And they also raise profound ethical concerns.

There are, also, other associated psychological risks with griefbots which the literature increasingly highlights – simulating a continuing bond may prolong the liminal state in which the deceased feels not fully gone. Grief is a process; transformation involves internalising the memory not preserving external echoes. Researchers also warn of technological “hauntings” – unsettling, unregulated presence of simulated voices that disrupt mourning and could induce emotional harm.

These AI systems often come with subscription models and algorithmic designs that reinforce emotional dependency, not healing. The bots optimise for engagement, risking manipulation of grief for profit. Monetising grief, misrepresenting the dead, and blurring lines between memory and fiction are very real risks. What happens, for instance, if your money runs out and you cannot continue the monthly subscription?  Whilst Reflekta have indicted there are use limitations and safeguards, they cannot guarantee against the risks of dependency. Such dependency may reduce the bereaved individuals’ emotional autonomy. If removing the bot means losing a vital connection, users become bound to the technology rather than free to grieve naturally.

More worryingly are the risks of anthropomorphism and what is called the ELIZA effect. This is where users inadvertently project human traits onto the chatbot, conflating simulation with sentience, which can deepen confusion and emotional reliance.  At its worst level this can be quite damaging. The well documented recent case of where a man in New York threatened to jump off a building after a recent divorce created intensive dependency upon a bot is a case in point.

So up till now I have been very negative and cautionary about the use of Ai in grief and bereavement support – but there are some, I would suggest, potential areas of use and benefit, if properly framed and boundaried.

AI might support archival storytelling – capturing memories, organising testimonials, preserving stories for future generations- but must not aim to replace the dynamic relationship or the evolving self. Such memory archives are not chat bots but rather act as the repositories of multimedia memories. There is also potential use in legacy tools and in encouraging reflection, encouraging families to remember together- without ongoing simulated interaction. But all of this has to be framed within ethical design and all practice, I would suggest has to ensure transparency, autonomy, consent, and ideally an “off button.”

AI in bereavement occupies a fragile tension between preservation and potential disruption. It can store voices and stories- but cannot embody relational depth. Communities like Good Life, Good Death, Good Grief and others remind us that grieving is not about simulation, but about shared humanity, ritual, and respect. Ai can support healthy grieving but only if held lightly, ethically, and sacrificially- subservient to the human, not the other way around. I am not at all convinced the bots we have seen and the products currently on the market are achieving that to date.

I leave you with the sage words of the great Mary Oliver, in ‘When Death Comes.’

When death comes

like the hungry bear in autumn;

when death comes and takes all the bright coins from his purse

 

to buy me, and snaps the purse shut;

when death comes

like the measle-pox

 

when death comes

like an iceberg between the shoulder blades,

 

I want to step through the door full of curiosity, wondering:

what is it going to be like, that cottage of darkness?

 

And therefore I look upon everything

as a brotherhood and a sisterhood,

and I look upon time as no more than an idea,

and I consider eternity as another possibility,

 

and I think of each life as a flower, as common

as a field daisy, and as singular,

 

and each name a comfortable music in the mouth,

tending, as all music does, toward silence,

 

and each body a lion of courage, and something

precious to the earth.

 

When it’s over, I want to say all my life

I was a bride married to amazement.

I was the bridegroom, taking the world into my arms.

 

When it’s over, I don’t want to wonder

if I have made of my life something particular, and real.

 

I don’t want to find myself sighing and frightened,

or full of argument.

 

I don’t want to end up simply having visited this world.

When Death Comes | Library of Congress

 

Donald Macaskill

Photo by Steve Johnson on Unsplash