Ki-hyung Park

					Presentation on actual conditions of home care service workers

Home care services means a kind of work that provides certain services by visiting someone’s home. Home health care service workers, home gas safety check workers, social work case managers, home tutors for immigrants, electronic appliances workers such as installers of water purifiers, air conditioner or internet are included.

We need to pay attention to the fact that these various works are essential services to society. Since these services are provided directly to homes or individuals, workers visit homes where service clients  live and meet them, and its goal can be made by visiting the client’s house. In this regard, home care services become the norm of the essential services within our society.  Furthermore, even though there is a difference of degree, it can be a point where publicity among people’s relationship is formed.

However, is publicity being guaranteed for various services with home care services’ form? And, what kind of relationship does guaranteeing publicity exist  in  workers’ safety and health? How can we start our conversation about  female home care service workers’ safety and health? In order to find the answer to this question, <Ilteo (The Workplace)>, KILSH’s monthly magazine’s April issue will focus on the changes of care workers’ sector out of various home care services.

Care labor in the social welfare sector out of various home care services, is most prominent, but the way care labor was provided has been far from publicity. Korean society began to enter the aging society in the late nineties. Since going into the transition to neoliberalism, privatization has processed in many sectors, and private consignment in social welfare services has spread too. While there was rapid processing of the aging, large family culture has changed into nuclear family or one-person family culture. The rapid economic growth shifted the  way each family deals  with welfare problems while the government keeps up with economic development. Therefore, there was the vacuum in the system in the caring labor sector, and the necessity to solve this problem has increased. But, in the privatization process flow, the government did not prepare enough capability and throw administrative resources into. Instead, the government tried to fulfill the demand of social welfare services with private outsourcing.In spite of the original intention which was to   increase the quality of service through market competition, but the arrears of wage, wrongful dismissal and even illegality and corruption such as fiscal corruption were widespread. Therefore, the quality of services worsened and the  safety and health of  home health care service  workers ended up being threatened.

A care worker working for a center talked about her experience. “I made a home visit to a man in his late sixties. . He tried to make unpleasant physical contact with me a couple of times. I was in a closed space with him for work, so I always feel nervous whenever I work. Furthermore, I feel that I was not fairly assessed about my work.rk. Sometimes I was being verbally abused by  female clients or client’s caregivers. They even refer to me as a just random person or ajumma(the middle aged married woman) over the phone when I was there in person.

But, the centers did not address the workers’ concerns, but, rather, chose to change clients assignments.  One of the worst cases, when clients  ask to change their assigned workers, the centers would not even consider if there was any legitimate reason for the request, but they accept the request without any investigation to the fear of losing their clients.   When a worker brought a problem up, the employing center responded “it is just the same as exchanging a product at a department store”. When a worker’s shoulder was injured, , the worker could not receive any industrial accident compensation or rehabilitation treatment. Care workers always suffer from job insecurity, too. Besides a lack of their job security, it is difficult to find a new job among the middle aged women given that there is a small labor pool. Hence, they are reluctant to voice their concerns and issues about working conditions.

It is not just a problem for care workers which will also affect the quality of care delivered to clients. Jeong-ah Kim Director of Organization of Home care strategic project team, Korean Public Service and Transport Workers’ Union(KPTU) said as follows.

“Since centers were run as a report system, centers were founded easily. It was not reviewed if such centers had enough finance and proper systems. For example, there were a lot of cases that centers were built in Incheon but have clients  registered and provide services in Joongnang-gu, Seoul. Even though social welfare workers are supposed to come and check, checking clients’’ circumstances were not properly assessed.. There was no such thing as systematic maintenance from the beginning.  But the centers tried to make clients stay anyhow because the profit came from clients In order to win a competition for attracting clients the centers used expedient means such as cutting client’s own charges, then to meet the difference they took money from care workers’ wage. Even using expediency centers would not provide case management to consider what a client would need and which service should be provided for each circumstances.”

Communications among a center, a client  and a care worker is only made to make and maintain a number of cases, but not made for the process of providing actual services. The Centers are just the same as ‘outsourcing companies’ that just connect care workers and clients. Controlling service quality is just regarded as the responsibility of  care workers, but workers were not able to cope  with this for themselves. Threats of sexual violences such as sexual abuse and job insecurities even made workers shrunk of fear. Since clients  and their guardians did not receive any guidance about care workers’ roles and position, they treated care workers as they just could just use for whatever they wanted. Care workers were isolated from any relationships, and they were blamed for care service.

As criticism continued on this, there has been a change on system, acknowledging publicity of care work. The representative case is Seoul Public Agency for Social Service(SPASS). The SPASS is a public institution founded by the government where they can directly provide the care service. The government tries to strengthen publicity and improve the quality of service through this institution. After city mayors or governors of provinces found public corporations, they consign from local governments and run public institutions for social service, and directly employ service workers. Even though it is a pilot program, Seoul, Daegu, Gyeonggi-do, and Gyeongsangnam-do are running this program. The SPASS has a lot to solve such as issues of transportation and providing transportation fees, and preparing preventative measures for safety and health. Nonetheless, there is a big change compared to private consignment. Hyemi Kim, the branch leader of Seoul SPASS branch, KPTU has shared her past work experience at  Eunpyeong Home Care Center, Seoul SPASS.

“One worker used to care for one client before, but now two care workers work together. We feel comfortable for sure. Clients are  more careful with their behaviors. . When we visit our clients for the first time, our manager would come together. Managers would not simply check the client’s condition by making a phone call, but thoroughly check the condition and circumstances of clients. . If clients  have questions or complaints, they would contact centers through managers. On the contrary, when you work  for private centers, care workers give their personal phone numbers to clients , and they would get phone calls even at midnight, weekends or holidays and get even unreasonable requests. But now, care workers do not contact clients  directly but have processes as social services that are provided by centers. Communication is made well among centers, clients  and care workers, and this helps build trust with one another.  Now, we can assess personalized care needs and provide care services tailored to their needs promoting safety and the quality of services.

Furthermore, increasing job security after direct employment, the recruitment, and obtaining compensation and treatment from industrial injury are our particular focus areas. In addition, it is crucial to highlight the fact that workers can collectively discuss safety and  raise the health issues such as providing masks and hand sanitizers dealing with the COVID-19 Now they have an opportunity that individual workers’ status change to collective labor relations.

The critical change is that investing finance by the local governments is connected to public responsibility, and centers manage cases. These are the conditions that acknowledging the status of care workers and managing the quality of service can be made. This is why the government should not use indirect management methods to collect part of the premiums of the Korea Health Insurance Corporation as long-term medical insurance and provide them as subsidies, but they should make a direct investment in the centers to strengthen transparency in the investment, and public responsibility.

However, after the trial of SPASS,  private centers’ resistance is severe for the reason of violation of private property rights. Nonetheless, Hyemi Kim, the branch leader and Jeongah Kim, director of organization both emphasized this point as this.

“Care work is a public one as a social welfare service. You cannot rely on the self-sacrifice efforts of one’s kindness. It is critical to our society  so it should be solved collectively. In this sense, it is necessary to strengthen publicity for home care as a whole including care work.