Painful feeling: Care workers on zero-hours contracts talk about the strain of being too stretched to care for people properly © Getty
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Lauren Smith is the person everyone phones when they need to cry. She works for a domiciliary care company, which means she and her colleagues — most of them younger and less experienced than her — are on the road every day, often on their own, visiting elderly clients at home. “Girls are just phoning me, crying their eyes out all the time,” she says. “There’s girls doing over a hundred hours a week. They’re going home exhausted, their children are bringing themselves up basically because their mum’s on the road the whole time, or they’re having to bring the kids with them in the car.”

It sounds like a classic case of overwork, but Smith (not her real name) explains that they do not have employment contracts that specify long hours; in fact, the opposite. They are all on so-called zero-hours contracts, which do not guarantee any hours of work at all.

There are almost 800,000 people on these contracts in the UK, disproportionately young and female, and they have ignited a fierce debate over the benefits and perils of the country’s flexible labour market. But the UK is not alone in seeing a shift towards flexible work: temporary or fixed-term contracts have become more common in many parts of continental Europe, especially among the young.

Now, academic evidence is emerging about the impact of these jobs on mental health. Researchers from University College London analysed data on more than 7,700 people in England born in 1989 and 1990. They found that at age 25, young people on zero-hours contracts and those who were unemployed were less likely to report feeling healthy. People on zero-hours contracts were also at greater risk of reporting symptoms of psychological distress.

That comes as no surprise to Smith. She says the reason many of her colleagues agree to such punishing shifts is the fear that if they refuse, their hours will be drastically reduced and they will be unable to cover their bills. “One girl went off sick for a day because she was just physically utterly exhausted, then she phoned work and said ‘I’ll come back tomorrow’, and they said ‘We’ve no work for you’, so she’s having to wait a few days for them to put some work back on her. It’s a punishment for being off for a day.”

Smith has become a union representative, and so far has recruited 60 per cent of her company’s workforce to push for better conditions. Unison, the UK public-services union, which has many members in the care sector, has campaigned for “decent funding, better training and fair pay for care workers”, including tackling zero-hours contracts.

20.8%

of employees with zero-hours contracts have a lot of financial concerns

Alex Wood, a sociologist of work and employment at Oxford university, took a job in a supermarket on a “short-hours” contract, which guaranteed just 4.5 hours of work a week as part of a study he was doing into insecure work. The supermarket said this contract provided “two-way flexibility” for employer and employee. He points out, however, that employers want flexibility to reduce their labour costs, so that they can match their staffing levels closely to peaks and troughs in demand. “Which is not the same reason why a worker wants flexibility to match their work with their home life, so it’s unlikely those two things will marry up,” he says. “And if they don’t, it’s going to come down to who’s got more power in the labour market.”

Wood says the unpredictability of his shifts made it impossible to plan activities outside work that were good for mental health, such as sports or socialising. But it was worse for people with caring responsibilities: some of his colleagues were grandparents who found it “very stressful” because they could not offer reliable childcare to their working children.

It is clear some people are happy with zero-hours contracts, especially if they have the power to choose their hours, or a good enough safety net not to worry about it. But the 2017 Skills and Employment Survey, a government-funded study of about 3,300 people conducted every five years, suggests insecure jobs often have other unhealthy features too. It found people who were very anxious about fluctuating hours of work were much more likely to be in jobs that demanded very hard work, high speeds and to meet tight deadlines. Academics say relentlessly high-strain jobs like these are toxic for mental and physical health.

9.3%

of employees with permanent contracts have a lot of financial concerns

Last year, the independent Taylor Report, which was commissioned by the government, recommended that employers should be forced to pay a premium wage to employees on zero-hours contracts to reflect the fact they are not ideal for many staff, and to deter their overuse.

In the care sector, where zero-hours contracts are common, workers talk about an extra psychological strain: the painful feeling of being too stretched to care for people properly, when their compassion was the reason they went into the job in the first place.

“If you look at our advertising you will see images of carers sitting with residents, reminiscing and having fun, [but] there just wasn’t the time,” says Nicole Stanfield Caile, who used to work in a care home. “Most days we were short-staffed; that’s four people for 50 [residents]. My time would be spent making sure people were dry and fed and hydrated, and that was it.” She says many of the carers stayed late without pay because of their concern for the residents, but would end up “getting stressed out and burning out”.

Carole Easton, chief executive of the Young Women’s Trust charity, says putting too much strain on staff has knock-on costs to employers through absence and high turnover, and to taxpayers through the extra burden on health services. Official data released in October show people with “stress, depression or anxiety” now account for 44 per cent of the 1.4m people who suffer from work-related ill-health in the UK, and 57 per cent of the 26.8m days lost to work-related bad health. “Sacrificing the wellbeing of our young people is not in their best interest, and certainly not in the best interest of our economy,” she says.

Smith says that message does not seem to have reached her employer, which pressures staff to do “cram calls” — fitting six visits into an hour. “So there’s bins overflowing, there’s flies, personal hygiene is not being maintained, sores are appearing,” she says. “The girls want to do the job; they want to care for people. They’re so torn; they’re being torn in two.”

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