Gender discrimination in care:  a reflection for International Women’s Day.

Tuesday sees the celebration of International Women’s Day, 8 March, 2022. This is an annual event which raises the profile of the experience of women and girls around the globe. The theme for 2022 is “Gender equality today for a sustainable tomorrow.”  Regular readers of this blog will know that I have written often about the strong female influences in my personal and professional life, so I want to spend a bit of time this week reflecting on some connected thoughts from those insights.

1.

It was as far back as 2017 that I appeared before the Scottish Parliament’s Economy, Jobs and Fair Work Committee and gave evidence relating to the Gender Pay Gap in Scotland. A few months later the Committee issued its thorough report ‘No Small Change’  which identified that gender segregation was a real phenomenon within the care sector in Scotland. Indeed, Scottish Care in its evidence to the Committee argued that there existed systemic gender discrimination in the way in which we treated the predominantly female social care workforce in Scotland. Sadly, some four or five years later despite all the rhetoric about reform and reconceptualising care services we are still faced with clear gender discrimination in the way in which we prioritise social care and its largely female workforce. I am more and more convinced that we will not address the dis-ease afflicting social care provision unless we call out the gender discrimination which is so characteristic of the way in which social care in general and its workforce in specific are treated sector. At the risk of personal repetition, I said five years ago that were this a workforce which was 86% male and not 86& female then we would not have had the travails of unequal pay nor the ludicrous terms and conditions which are deemed acceptable by contracts from local authorities. Indeed that latter point was forcefully and cogently articulated in the Fair Work in Scotland’s Social Care Sector Report in 2019. It stated:

‘The evidence suggests that the undervaluing of care work is, to a significant extent, linked to the predominance of women workers in the sector. 11 The view of the Social Care Working Group was that part of the failure to value social care comprehensively is due to its status as women’s work. Women face systematic labour market disadvantage, including occupational segregation, workplace discrimination and lack of flexible working. Institutionalised undervaluation is common in highly feminised jobs and occupations, contributing to the gender pay gap (of 15% in Scotland). Social care work is also less visible than other work, taking place in service user’s homes rather than workplaces, with implications for skills recognition and for collective organising.’ (page 14)

Calling out gender discrimination in social care requires us to continually underline the reality that gender segregation is a fact which requires attention. Part of the reason we fail to value social care as a whole is that it is still seen by and large as ‘woman’s work.’

2.

At the heart this gender segregation challenges our understanding of what care itself is and the value that we put on the art of care. In the last few years, we have seen the offensive articulation of a belief that care is ‘low skilled’ and I cannot help but believe that such an assessment is in part because of both the fact it is undertaken predominantly by women but also that care itself is deemed to be of lesser value and import to society than a technical set of skills or attributes. Such pervasive gender stereotyping must be challenged not just for what it says about the workforce but just as importantly for what it conveys about social care.

It will come as no surprise that for me social care and our ability to prioritise it and value is both the bedrock and heart of our society and should be valued because it evidences a priority which captures the essence of who we are as a society and as communities. But clearly despite the fact that social care is a massive economic contributor to the overall economy wider society still perceives it in negative terms, in language of cost, burden and deficit. Take for instance the much heralded launched of the Scottish Government’s National Strategy for Economic Transformation report ‘Delivering Economic Prosperity’ in the last week. Except for mentions of support for the Living Wage in Adult Social Care and a passing reference to technology in care, social care doesn’t merit a mention.  I am utterly dismayed that despite the travails of the last two years and the heightened awareness of the intrinsic and fundamental importance of social care that this document fails to prioritise social care and its workforce, businesses, and employers. Instead of a nation considering that part and parcel of economic prosperity is a prioritisation of a social care system and supports that potentially becomes the engine of that prosperity there is a complete failure to think radically and creatively with people at the heart. Gender bias and the pay gap are mentioned as is the need for radical childcare, but the contribution, entrepreneurship and creative potential of the largest female workforce (outside of the health sector) is ignored.

3.

But the systemic gender discrimination we witness isn’t just to be found in the way we treat our social care workforce, or fail to recognise its economic value and ingenuity, it has also been sadly the experience of our response to the global threat which has bene the pandemic.

As the United Nations in various reports in 2020 and 2021 has underlined the pandemic has highlighted the way in which as modern societies, we are so reliant upon women both in the frontline of care and health services but also at home.

But as the United Nations Women report on Covid19 states:

‘In times of crisis, when resources are strained and institutional capacity is limited, women and girls face disproportionate impacts with far reaching consequences that are only further amplified in contexts of fragility, conflict, and emergencies…

Despite these numbers [in health and care], women are often not reflected in national or global decision-making on the response to COVID-19. Further, women are still paid much less than their male counterparts and hold fewer leadership positions in the health sector. Masks and other protective equipment designed and sized for men leave women at greater risk of exposure. The needs of women frontline workers must be prioritized: This means ensuring that health care workers and caregivers have access to women-friendly personal protective equipment and menstrual hygiene products and are afforded flexible working arrangements to balance the burden of care.’

4.

Lastly any consideration of International Women’s Day and a reflection on social care has to also face the challenges posed by the unequal treatment of women in terms of their health and social care. It is not just the social care workforce which is predominantly female and the victim of gender discrimination it is also sadly the fact that the majority of those supported and cared for are also themselves women. It is estimated that in the United Kingdom that 61% of people with dementia are women and 39% are men. Accepting that this is in part because women live longer than men it is not that difficult to evidence discrimination behind the data. There is relatively little research focus on the specific genderised characteristics of the disease that may impact upon women. Indeed an earlier report by the Alzheimer’s Society rightly stated that women and dementia are the ‘marginalised majority.’ The fact that dementia is the major cause of death of women across the United Kingdom is a reality that few consider or talk about. I cannot be the only person who having marvelled at the unified scientific community which brought about such astonishing breakthroughs in the discovery of the Covid19 vaccine, has pondered what would happen if equal focus and priority was given to finding treatments and interventions for dementia. Is it too simple a leap to suggest that both age and gender discrimination has a contribution to such relative lack of fiscal priority?

International Women’s Day is an opportunity for us all to focus on the contribution and creativity of women in our communities; it should also be a call to address the systemic discrimination that treats women and girls less favourably and equally, whether in social care, economic opportunity or in disease management and research.

Donald Macaskill