When the new state-run nursing-care insurance system was launched in April, many of its planners predicted it would lead to better working conditions and salaries for home helpers.
Yet the opposite has occurred. Many of the home helpers who provide care to the elderly say they have seen their hourly wages dwindle by as much as 30 percent.
The home-helper program is a key element of the public nursing-care insurance system. Under the system, workers provide nursing-care services to people aged 65 or older at home if such care is deemed necessary.
People between the ages of 40 and 65 who need nursing care due to age-related ailments are also eligible for the service.
Regarding home helpers’ shrinking incomes, several factors are at play. One concerns the type of tasks they are being asked to perform. Many elderly care recipients are requesting housekeeping services rather than “physical care” — such as assistance in taking a bath — which earns a higher hourly wage.
Furthermore, the workers are often called to provide care for only short periods of time, sometimes for as little as 30 minutes. Many complain of exhaustion from spending large amounts of their working day traveling from household to household.
Workers at Yasashite, a Tokyo-based care provider, have apparently seen their work hours increase by around 20 percent with no corresponding increase in overall income.
“The main reason is that we receive only a few requests for physical care,” a senior company official says. “At this rate there soon won’t be any people who are willing to do the job left.”
Moreover, some providers have cut home helpers’ hourly pay rates since the program’s launch.
A social welfare corporation in Tokyo, for instance, used to pay 1,800 yen an hour for physical care. The amount is now 1,600 yen. Similarly, the rate for housekeeping has fallen from 1,500 yen to 1,100 yen.
Some companies have also started to employ their helpers on part-time rather than regular full-time contracts. The new contracts typically offer few, if any, benefits.
Therefore, it comes as no surprise that the Tokyo Care Union, a labor union created by home helpers, is dealing with a rising number of complaints about falling incomes.
Some claim that the new insurance program emphasizes only the rights and interests of its care recipients, while ignoring the workers’ plight, according to the union. Some are also irked over becoming little more than maids.
Yet home helpers are qualified professionals. They are classified into three grades, depending on training. First-grade workers spend 230 hours learning their trade, second-grade workers 130 hours and third-grade workers 50 hours.
In fiscal 1998, about 170,000 home helpers were qualified nationwide.
If the home helpers’ conditions continue to worsen, says a senior official at a major care provider, “The services will stagnate, and the public nursing-care insurance system itself will crumble.”
That could entail a deterioration in the quality of services, many fear. Employers would find it increasingly difficult to hire and keep helpers due to the job’s diminishing appeal.
Care recipients would consequently be unsettled by the developments, and trust in the system would break down.
An official at a private care provider in Tokyo says the number of home helpers giving up their profession for less demanding part-time jobs is already “conspicuous.”
“People become helpers because they are drawn to the high hourly pay rate. However, transportation time and costs are not paid, so the situation becomes costly,” the official said.
Another problem has to do with the tendency of many helpers to work only for short periods of time. Most helpers are housewives, who aim to work only until their tax exemption for family dependents runs out.
Thus, the short-term and temporary nature of the staff makes it difficult for the system to maintain safeguards that would, for instance, ensure that users are not given illegal medical treatment.
“Right now, we are desperately working to avoid having the quality fall, but at this rate, I don’t know if it’s going to work,” a veteran home helper says.