Productivity and pressure: Social services get an unhealthy squeeze

The Women’s Policy Action Tank recently published a special issue of the Good Policy newsletter, exploring three areas of policy with a gender lens: women and the criminal justice system, Indigenous women, and women’s experience of employment. Each topic is explored using a dialectical approach, in which two authors approach a topic from a different angles. We will be publishing the paired articles on our blog over the coming three weeks. This week we publish the last two articles, exploring women and work. This article is a companion piece to Precarious work and the health cost to women, by Susan Maury.

Dr Fiona MacDonald, School of Management, RMIT University

Public policy reforms in social services are often directed to increasing productivity and efficiency. Intuitively this seems like a good idea but what does increasing productivity actually mean in practice, who does it benefit and what are the costs? For the social services workforce, comprising mainly women working in generally low-paid direct care and support roles, the costs of the pursuit of productivity improvements can be high.

Workforce or labour productivity refers to the ratio of output (e.g. services provided, goods produced) to labour input (number of workers and hours worked). Increased productivity can be taken to be a measure of worker efficiency and it can be achieved in a variety of ways. For example, one way of driving productivity growth can be by investing in infrastructure and in worker skills. On the other hand, productivity can also be improved by increasing the intensity and speed of work to increase workers’ output.

In social services in Australia and elsewhere, the adoption of so-called New Public Management models since the 1990s has seen the spread of performance-based contracts, increased competition and outsourcing of publicly-funded care and other human services. An incessant search for productivity improvements in services has resulted and this has also been driven by a tightening of public funding, even though demands on many services have been growing. In this context, the imperative to maximise employee efficiency can amount to pressures for workers to do more with less time and fewer resources.

'Efficiency' is not the answer to everything. Putting social services employees under pressure reduces outcomes and creates stressed staff.

'Efficiency' is not the answer to everything. Putting social services employees under pressure reduces outcomes and creates stressed staff.

Such efficiency-related pressures have implications for care workers’ job quality and for service provider organisations. Standardisation of services, breaking down of roles into tightly specified tasks, fragmentation of jobs into time-based tasks and increased performance monitoring all potentially undermine worker autonomy, increase stress and lead to less meaningful and rewarding work. Work intensification increases the likelihood of work spilling over into non-work time and impacting on the ability of workers to combine work and life as they would prefer or need. While the part-time nature of much of this feminised work has been attractive to the mainly female workforce combining work and their own unpaid care responsibilities, increasingly this part-time work is characterised by unpredictability and fragmentation of working time. Tighter specification of jobs around specific tasks and the reduction of ‘downtime’ have been achieved through increased casualisation of care jobs.

While appearing to increase productivity in the short term, these types of measures are also likely to have deleterious impacts on organisations’ recruitment and retention of workers with negative longer-term outcomes for productivity and for the quality of care provided to service users. The relational aspects of care work that underpin care quality are undermined where workers have little autonomy and work is routinised and performed under tight time pressures. With reduced job quality driving higher rates of worker turnover, continuity of care is also undermined.

‘Innovation’ is now lauded as an important key to high quality service provision in social services.[1] We might hope that this focus – combined with the greater emphasis on user choice – could provide the impetus for finding better ways to organise work for quality care and for quality jobs for care workers. However, if innovation is simply another code for economic efficiency through market mechanisms,[2] this shift may turn out to be simply about cost saving, not quality.


[1] Productivity Commission (2016). Introducing Competition and Informed User Choice into Human Services: Identifying Sectors for Reform. Study Report, Canberra.