Scoping the Workforce of the Future: The Role of Personal Support Workers in the Healthcare Division of Labour

Globally the capacity of health professions to deal with healthcare issues in modern societies is rapidly being outrun by such factors as the development of new health knowledge, an ageing population and changing patterns of illness. Accordingly, there have been a variety of responses to this resource strain, from online communications as a means of obtaining health care knowledge, to the growing role of informal carers and volunteers – often under the supervision of health personnel. In the healthcare division of labour, doctors themselves have also devolved many tasks to less well paid health professionals through increased interprofessional collaborative working. In utilizing lower paid workers, both financial and resource strains in terms of time provided by more expensive professionals can be reduced. By far the largest body of workers involved in healthcare is the fast-expanding group of generally low paid personal support workers who typically outnumber health professionals like doctors and nurses and play a key role in coordinating and delivering care in many settings. From contemporary data presented from Canada, though, it is clear that this group is largely operating not only in precarious conditions – with, amongst other things, low pay, zero-hours’ contracts and short-term working – but also in a heavily unregulated environment, with limited educational requirements. If utilization of these workers to address limited health care resource capacities continues to increase, as projections suggest, then the need to consider policies that allow for better conditions for these workers is paramount. Drawing on the experience of Canada, this paper considers how the role of personal support workers in the future might be enhanced further in terms of power and justice through policy change in order that they can become an even more effective workforce in supporting users and serving the public interest alongside other health care personnel.