Immigrant workers and home care

Hey there, time traveller!
This article was published 31/07/2023 (826 days ago), so information in it may no longer be current.

Manitoba’s senior care is in serious trouble.

Ravaged by the pandemic, it is dangerously understaffed and woefully under-resourced to serve Manitoba’s aging population. Home care — provided outside of hospitals and residential nursing homes — is in high demand, yet we know little about the workers providing it, nor the most effective ways to retain its predominantly immigrant workforce. Our recent report Justice for Im/Migrant Home Care Workers in Manitoba, published by Canadian Centre for Policy Alternatives — Manitoba (CCPA-MB), explores these challenges and makes pressing recommendations.

Home care services include medical and non-medical care provided to people in their private homes instead of residential nursing homes. Currently, more than 18,000 Manitoba residents can access a range of essential home care services such as assistance with bathing, toileting and medication reminders, through Manitoba’s regional health authorities or the Self and Family Managed Care program.

Like other care systems however, years of government underfunding combined with the strains of the pandemic have ravaged the system, leaving critical gaps in care delivery and workers burned out. Lack of publicly funded home care options mean that seniors are forced into nursing homes rife with scandalous neglect. The government is paying dearly (up to $300/hour) for temporary staffing agencies to provide “just-in-time” health-care staff to shore up the hemorrhaging workforce. Chronic reliance on temporary direct care workers has been proven to erode the conditions of care.

The most powerful and effective solution to this problem is to increase wages and improve working conditions in public home care and this solution can’t be ignored any longer. With a workforce that is heavily dominated by immigrant workers (well over 60 per cent), we need to better understand and meet the needs of home workers who are new to Canada.

Our report explores the challenges experienced by immigrant home care workers employed across government-funded programs, private agencies, and hired privately by individuals. We highlight four key areas of concerns: poor working conditions such as low wages, and lack of vacation time and formal contracts; widespread experiences of racism and violence; exclusion from pandemic-related income supports; and inadequate settlement services.

We can’t afford to let the private sector manage this problem. Workers have told us that experiences of racism are more pronounced in the private sector, and lack of job security and employer accountability in private jobs make it difficult for workers to stay in these jobs for more than a few years. In short, privatization is creating a revolving-door health-care workforce, something that will negatively impact all of us as we age and require these services ourselves.

The government can act now by:

1. Improving working conditions for home care workers in Manitoba. Basic provisions like living wages, legislating 10 paid sick days, vacation days, job security, and benefits will help recruitment and retainment.

2. Curbing the expansion of privatized home care in Manitoba. The public sector needs to look at why workers are leaving public jobs for temporary agencies. Temp agencies are currently offering higher wages, more time off and control over the number of hours they work. Yet these workers are not categorized as employees and have very little protection under the Employment Standards Act or Workers Compensation Board of Manitoba. Workers will not stay in these positions long. We need to strengthen the public home care sector and further regulate the private sector to decrease its expansion and the associated erosion of working conditions for immigrants.

3. Enhancing and guiding the development of formal government supports and entitlements by ensuring that immigrants (who are mostly racialized women) working in private residences have the same government supports as other workers. Migrant workers also need to be regularized and made to feel welcomed, safe, and supported in their new homes.

With the upcoming election, we are at a critical juncture. We need a government committed to a strong high quality care system for Manitoba seniors and disabled people. But immigrant care workers also need broader com­munity support. Unfunded migrant justice groups, like our community partner Migrante Manitoba, have been doing the heavy lifting, supporting immigrant care worker communities during the pandemic. We urge those receiving home care services, as well as family caregivers and organizations representing them, to support these recommendations and advocate for a more socially just home care system that prioritizes justice, security, and safety for immigrant home care workers in Manitoba.

Mary Jean Hande is an Assistant Professor in Sociology at Trent University and project lead for the SSHRC-funded Justice for Im/migrant Home Care Workers in Manitoba project and Leah Nicholson holds a SSHRC MA graduate scholarship in Political Science at Dalhousie University.