There are several theories for why we pay care workers relatively little. Devaluation theory describes it in terms of gender bias – most care workers are women, and given decision-makers’ tendency to underestimate the contribution of female-dominated roles to the organisational bottom line, there is an inbuilt bias towards under-rewarding the work. Gender also plays a role in two other, related, theories. The ‘prisoner of love’ school holds that care workers are largely motivated by the intrinsic value for the work which they do and so they will tolerate lower pay, while the ‘love and money’ theory forms the basis of the idea that caring should not be done for pay, in order to not crowd out the sense of altruism that is thought to underpin good care.

Our own newly released research, carried out as part of the year-long inquiry into the residential care sector by JRF’s director of care services, could not find any conclusive evidence that increased pay improves care quality. Many care workers were found to be loyal to the sector because of their primary commitment to service users, backing up the ‘prisoner of love’ concept. However, the research did also show the importance of staff being made to feel valued. Chances for progression, managerial support and proportional human resource management all made a difference to whether someone would stay in post and give the best of themselves to the job at hand. The question is whether these qualities are more or less likely to emerge in a situation where the larger part of the work force are paid little, have low job security and are given few options for personal development. I would bet less.

Government has a role in breaking this circle. First, it can encourage some serious thinking within the sector about what careers in care should look like. The nature of it is changing. Residents are entering care homes at later stages in their lives than previously, often when quite ill and for shorter stays. Care workers are expected to navigate what is often a highly stressful period in the lives of residents and their families, quickly building relationships and ensuring the wellbeing of very frail people. This is emotionally and physically demanding work, but we give little thought to the toll it can take, and how to ensure that people’s skills and experiences are still being used even after they can no longer carry out certain physical duties.

Second, politicians need to be more upfront with the public about the costs of care. This is not just about wages, but wider margins also. The economics are as such that if you are working on the basis of local authority rates it is very difficult to both provide great care and to be good employers at the same time. Crucially, care homes catering to affluent families face nothing like the same dilemma. Assuming that Labour agrees that the quantum of resource put into care for the mass of the population must increase it will need to set out where between the state and care recipients (and their families) the additional burden should rest.

There are strong, well-rehearsed arguments for it to be shared, given the economic and social benefits of high-quality care. But this does not avoid the fact that the public must be made more comfortable with the idea that these are highly valuable services, generating costs to which they should contribute if able. Dilnot started this conversation, but, disappointingly, many of the ideas appeared to be shelved in the face of the media’s realisation that some people would have to pay large sums. Labour politicians should avoid the same trap when they come to unveil their own proposals by starting a discussionwith the public about its willingness to support high-quality care beforehand.

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Frank Soodeen is public affairs manager at JRF