The growth of the care sectors in Australia in the past 15 years has been phenomenal, one of the most astonishing jobs surges in Australian history.
Statistically, the care sectors are predominantly within the industry category 'health care and social assistance'. A new discussion paper from the federal government claims 'health care and social assistance' now accounts for more than 2,100,000 jobs, or 15 per cent of the Australian workforce. And the lion's share of growth in the category comes from the provision of care services rather than the delivery of formal health services.
The spectacular rise of the care sectors is taking place across all Australian regions, which is unusual. Usually a thriving economic sector has a geographical focus, think post-war manufacturing in Geelong and Newcastle, late 20th century financial services in Sydney and Melbourne CBDs, and 21st century building and construction on the edges of Australia's east-coast cities.
For the Hunter, the growth of jobs in the care sectors over the past 15 years has exceeded growth in every other sector, and by a long way. Almost one in every three new jobs in the Hunter region between 2006 and 2021 has been in 'health care and social assistance', overwhelmingly in the care sectors.
The growth of the care sectors is a profound experiment in public service delivery in Australia. The sectors are different in at least three ways compared with how public services have been delivered in Australia in the past.
First, the care sectors are run by the federal government, unlike most other major public services. Health, education, public transport, police and criminal justice, while receiving federal funding, are all run by state governments.
Second, these state-run services are delivered via state-owned institutions, such as hospitals, schools, universities, court houses, police stations, prisons, train and bus networks. Where private providers are involved, they mimic the publicly-owned ones.
Third, employment in state-run services is heavily regulated. Unionisation rates are high. The professions have a big say. Universities and TAFE control training pre-requisites and qualifications. De-skilling and casualisation are strongly resisted as a consequence.
In contrast, the emerging federally-run care sectors lack these qualities. The federal care sectors have grown on the back of three well-intentioned funding programs: My Aged Care, the National Disability Insurance Scheme (NDIS) and childcare subsidies. Mammoth levels of taxation funding are involved.
The logic behind the aged care and NDIS programs is called personalisation, where care 'packages' are 'chosen' by individuals and households. Care packages are delivered by private providers. While some providers are not-for-profits, a growing portion involve national and global corporations and their wealthy investors.
The care workforces are dominated by lowly-paid, lowly-skilled labour. Carers work in people's private homes not built-for-purpose public buildings. Union membership rates are poor. Sub-par wages and conditions are common. Highly trained professionals aren't involved. Quality assurance depends heavily on the generosity and personal skill of the individual carer, but these cannot be guaranteed.
Traditionally, Australian workers have resisted these sort of employment arrangements.
However, the newly-emergent care sectors draw on a particular pool of labour. Carers are typically women, lacking post-school qualifications, who in the past have queued, mostly in vain, for entry-level skills jobs in retailing, cleaning, packing, food processing and the like.
The explosion of the federal care programs, without traditional public sector regulations and safeguards, has created enormous demand for this previously under-employed labour market segment. And the availability of a carer job stretches from highly populated inner-city suburbs to isolated rural homesteads. The federal care dollar is highly mobile.
For childcare, the situation is more complex. Regulations in this sector are tighter, the involvement of tertiary educated professionals is mandated, direct parental supervision on a daily basis keeps providers on their toes. All this said, there are elements of the childcare sector that parallel the other care sectors, especially an over-reliance on lowly-trained staff, high rates of casualisation and the growing presence of large corporations eager for inflated profits.
The federal government's discussion paper is long overdue in sectors where the vulnerable need better protection: low-skilled workers, the elderly, the disabled, young children. You can find out more, and have a say, by searching online for "National Strategy for the Care and Support Economy".
Phillip O'Neill is professor of economic geography at Western Sydney University.
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