(12 January 2023) A new report from EPSU finds that the mandatory registration of health care assistants (HCAs) is a complex exercise that must be taken in close consultation with unions – but that it can also strengthen the working conditions of those who are often excluded from key protections.
The report uses contributions from EPSU affiliate unions Kommunal (Sweden), UNISON (United Kingdom), SIPTU (Ireland), FSS-CCOO (Spain)and FZZPOZIPS (Poland) to examine the situation in five different countries. The report discusses the contexts where proposed registration schemes for HCAs are being discussed, as well as those where alternative approaches to regulation exist that do not involve registration.
The new report finds that the introduction of a mandatory register for HCAs is an important goal to raise training and qualifications, standardise roles, define a professional category and establish permanent career paths for those at the lowest tiers of the health and social care workforce. This can then promote a more stable workforce with reduced turnover, build union power and facilitate collective bargaining to raise wages and conditions to levels that are commensurate with other professional categories at a similar level.
However, if registration is introduced poorly, badly designed or inadequately timed, for example, there are risks of adverse impacts on HCAs and the sector as a whole. Such risks include imposing additional costs on low paid workers without reward, accelerating early retirements of experienced staff, and creating bureaucratic barriers that discourage rather than encourage recruitment. It is therefore important to pre-empt such outcomes and use mandatory registration as a component of a broader strategy.
The report offers a series of recommendations to policymakers considering registration of HCAs. Trade unions that represent HCAs are uniquely placed to advise on the appropriate planning, development and implementation of HCA registration schemes. It is crucial for unions to be consulted at every stage, including development, timing, implementation, and review.