It’s like Uber, but for Health Care Workers

Jordan Whether you have several of them on your phone and use them daily, or you view them as an unacceptable and dangerous product of late stage capitalism, you know how gig economy apps work. A customer wants something, a ride, some food, grocery shopping, handy work around the house, so they pop onto the app and request it. A gig worker looks at their app, accepts the job, gets it done, and takes the money with a healthy cut for the app, of course. You probably know that the worker doing this labor is not treated by these apps like a full time employee. Again, whatever you think of them, you know that the apps connecting these workers to jobs aren’t offering them insurance or health care or paid sick days or vacation. So you know that the people bringing you your food or driving you around are taking, by definition, precarious work. What if, though, the person drawing your blood, connecting your IV, preparing your vaccination, monitoring your vital signs, caring for you at your sickest was also a gig worker?

That is not a hypothetical question that’s already happening. And the fact that it is already happening raises a lot more questions that aren’t hypothetical at all.

I’m Jordan Heath-Rawlings, this is The Big Story. Alison Motluk is a freelance journalist who has written for Hazlitt , Toronto Life , The Globe and Mail , and others. For this piece she wrote for The Local . Hey Alison.

Alison Hi.

Jordan Thank you so much for joining us.

Alison It’s great to be here.

Jordan The first question I have to ask you is, what the heck is “Staffy”? This is something I had no idea existed.

Alison Staffy is an app for people who need workers and for people who need work. So it started in the hospitality industry to plug the gaps when, for instance, maybe a server couldn’t show up so they could quickly round up someone who could come in and do that job. So they do hospitality, they do construction, and now they do healthcare.

Jordan Tell me about how that started, because that to me, is fascinating.

Alison So what they told me was that at the beginning of the pandemic, they were already in the sort of cafeterias and restaurants of a lot of facilities, including longterm care facilities. And, of course, health care workers were suddenly in great demand because at the beginning of the pandemic, and still now to some extent, they have to do so much more. So they said, can you get this up and running and have us be able to use this for health care work as well? And it involved a little more effort, I think, because they had to find a way through the app to verify certification and vulnerable sector clearance and so on. But they did that. And towards the end of March 2020, it started working for healthcare workers as well.

Jordan And how has it been performing since then? I imagine well.

Alison Yeah. I mean, they told me it’s doing great. I think the last we spoke, they said there were 10,000 workers signed up on the app and thousands of jobs every month went through this app.

Jordan Can you just explain for people who aren’t familiar with these kinds of apps and how they work, how it works, both from the side of the worker and for the employer?

Alison My understanding from the side of the health care worker, for instance, one of the people I interviewed said he wakes up in the morning and he turns on the app and he knows when a lot of the jobs for the day are going to be advertised. So he gets up around six and starts looking around 615 and a job appears. In the case he described to me five jobs, all at Toronto General Hospital appeared. And because he had a profile already in effect, and frankly, he had a lot of work experience through Staffy and through the Toronto General at that point, he clicked on all of them actually, and he got one of them. He got it within minutes. So he saw the job, he saw where it was, what it was, how long the shift was, what he would get paid.

So I guess on their end, they saw who was applying. They probably looked at his profile and said, ‘fantastic, we know this guy. We liked this guy. He’s great.’ And they hired him through the app, I guess about an hour later, he showed up at the hospital, and started his shift.

Jordan The other folks you met who use this app, why do they use it? Why do they like it? And why, I guess if it is, preferable to them than a regular job in health care?

Alison So it’s interesting. So that particular person was a physician. Actually, he’s a trained physician, but not qualified yet to be a physician here in Canada, he comes from Eritrea. He thinks it’s great because he is studying to pass some physician exams. So he can study on the days of the week when he can’t get a shift, he goes for three shifts or so a week. It pays his bills. Pay is actually not bad, in some cases better than what they would get on an hourly rate through other means. So for him, it’s fantastic. It’s flexible. If he doesn’t get a ship that day, he studies. If he does, he works.

Another woman I spoke to, she had been working abroad. She was working in Australia, came back in the autumn of 2020. While she was overseas she had let her nursing license lapse so she couldn’t that calendar year work as a nurse. So she worked as a PSW. She got a job through Staffy working in a long term care facility, as a personal support worker. And then when the new year came, she requalified as a nurse, got another job through Staffy as a registered practical nurse and worked for four months in another long term care facility. And other people have said they work after hours at vaccine clinics. Actually, one of these people got a full time job and still plans to pick up some extra hours through Staffy.

Jordan Maybe this is just me, but you can tell me what the reaction to this piece has been. Why do you think it feels so strange for nurses and health care professionals, people we trust to intimately care for us, are hired on this app the same way we would hire an Uber driver or somebody to come over and clean your eaves?

Alison The truth is, I think an Uber driver is a pretty intimate process, too. They’re putting you in their car sometimes late at night. They’re taking you to your home. They’re driving you on a highway. I don’t actually think it’s that different. I mean, these guys have all been vetted, they all have the qualifications that they would have, had they been hired through the hospital directly as a full time employee. No one’s cutting any corners.

When you’re a patient in a hospital, the nurses are the nurses that the hospital provides.

Jordan Yeah, you’d never even know.

Alison Yeah. I don’t know what their status is. They’re good or they’re bad because of who they are, not their qualifications. I imagine it’s not from their employment status. So I think people may be surprised, but maybe they shouldn’t be surprised.

Jordan Who is concerned about this then? Labor groups? Professional associations?

Alison Sure, I think they are. And so the Registered Nurses Association of Ontario, the President said she thinks it’s terrific that they can earn money and find work in their part time and so on. But she is worried about the profession changing. And certainly I think one of the things we can say is what’s happening now during a pandemic, may be different after the pandemic. Maybe there won’t be as much money. Maybe people will opt out of full time jobs and then find they can’t get enough work. I spoke to someone at Gig Workers United, and they are the ones who are working with Uber drivers and probably other gig workers, to try to make the profession more stable. And one of the things she said to me, and I think this rings true. She said ‘they’d rather turn around and let us walk away than pay us more.’

I’m a Gig worker. I’ve been a freelance writer for more than 20 years, and I can tell you, yes, that’s the strategy. She’s right. Let’s get someone younger who’s not so demanding. Let’s get someone who can work for a quarter of that. What do we care? Right. So I think that’s a worry. It’s a completely legitimate worry. I don’t know that it’s the apps fault. That’s a problem of the way our employment system is set up, in the way our laws are set up.

Jordan Well, that’s what I was going to ask. We’ve talked on this show before about gig workers taking on these apps to be considered more fully workers, and whether that’s benefits or insurance or whatever it is, that’s an ongoing fight. Health care, especially right now, is an industry in which I would think all these things would be offered. But instead, what I’m hearing is that even hospitals and places that are supposed to be not for profit in our country are looking to use apps that don’t give workers as much as they would get had they been normally hired.

Alison I think they would argue that it’s always been hard to find people to work these odd shifts. And, ‘oh, we just need a few extra people at some times, but we don’t need them all the time. We’re just being lean.’ The people I interviewed were very happy with the situation, so I don’t have anything terrible to report. But the reality is they have no paid holidays, they have no sick days. So for a health care worker, this is important. We want them to have incentives to stay home if they’re sick. They have no overtime pay. So a lot of these people can work many, many shifts. They have no employer portion of EI or CPP paid, and they have no pension.

So if you do this your whole career, you might find that nursing and healthcare work is very demanding work, you might find that at 75 you can’t really do that work anymore. So what do you do? Because you haven’t contributed to a pension the way you would have had you been employed.

Jordan What does the Labor Ministry think about this?

Alison Well, there was one case, actually. There was one case that said that if a person is employed and using all of your equipment and you are setting the wage and you are setting all of the parameters, then perhaps they will be considered employees. And then, of course, there’s the Uber case right now, which my understanding is it can go ahead, that they are going to be looking at this question like, are they employees or are they independent contractors? What does it mean to be an independent contractor?

Jordan Do we know what cut the app takes from the pay?

Alison So they told me the minimum is, I think they said 25% is their minimum. And I think it goes up from that. But there’s a long history in health care of agencies, health care agencies. And my understanding is that their cut is even bigger. So the app itself probably represents a reduction of the overhead cost. And I think they would also say, well, we’re actually saving your health care dollars because because we’re being very lean and we’re only hiring people when we need them, and we’re hiring them very efficiently. And it’s very hard to argue with that last point. They are hiring them very efficiently. They’re not wasting the healthcare workers time, and they’re not wasting their own. And I think that’s a reasonable comeback.

Jordan When we talk about efficiency in the context of these apps. And here I’m again now referring to the gig apps that I have experience with, which is like Uber and the like. They feature surge pricing in an attempt to make sure that you can get an employee, but you have to pay a ton more for it. Does that work the same way with health care workers and personal service workers?

Alison Yeah. Apparently it does. Apparently, if they’re desperate, they absolutely have to have that health care worker, that nurse or whatever on the floor. 5 hours before they need the person maybe they’ll offer $40 an hour. It’s pretty good. And then 3 hours before they’ll raise it, 2 hours before it’ll go up, and then an hour before they desperately need this person, you know, I was told it could be $100 an hour. I have mixed feelings about that. On the one hand, I feel like well, supply in demand. Why shouldn’t the nurse get $100 an hour? But on the other hand, you look at that and you think, how is it that a hospital with a CEO earning who knows how much can’t figure out how many workers they need and plan for that in a reasonable way? And why would you want to ever encourage people to wait to the last minute before they say they’re going to come in? I don’t know. I mean, it doesn’t smell like the best planning.

Jordan Well, and I’ll be honest with you when I read the story. You know, one of the things that I was thinking from a perspective of somebody who might be a patient, is that I want the nurse who’s treating me, who’s helping me, to not be fretting about their next gig, to not be crazy from three straight nights of overnights because they’re trying to get as much work in as they can to not be running around from one gig to another, to know where things are in the hospital that we’re in. And that’s the kind of stuff that makes me nervous when I hear stories like this.

Alison I think that’s fair. I think that’s what we all want. We want our healthcare workers to be treated fairly, to be paid fairly. But I think a lot of health care workers right now would say that’s not really happening anyway. And so this is a great option. So it could happen that this actually puts more pressure on the province to treat its healthcare workers in a better way. I don’t know. But yes, we we want our health care workers to feel comfortable in their setting, not to be worried about their job. Not to wonder, am I employed tomorrow or ever? How will I pay my mortgage this month?

Jordan Yeah. Do I have benefits? Can I take time off if I’m sick? These are the things that shouldn’t be in the back of the mind of somebody who is trying to keep me healthy.

Alison I agree. But I would say I personally wish all workers worrying about those things, not just the people who are fully employed. I want everyone to have that, my grocery store workers to have those benefits and that peace of mind.

Jordan what’s the feedback been like from this piece? Am I the only one that’s kind of a little squicked out this way? And like I said earlier, I think that could be totally because of my own bias in terms of how we view different kinds of work in this society. I feel like that might be a common refrain.

Alison I mean, people are retweeting it and so on. I haven’t had a lot of direct feedback. Are they retweeting it because they think ‘great’, or are they retweeting it because they’re thinking, ‘wow, this sounds precarious’? I mean, I know from people I’ve spoken to, they were surprised, as I was when I first started looking into this, like, ‘really, this is happening?’ We are used to, to some degree, the gig economy. We’re quite used to it. We’re quite used to apps for hiring our workers. So maybe it’s not a big leap.

Jordan What happens next with this? What will you be watching for? I guess if this phenomenon disappears, as hopefully the pandemic does.

Alison Yeah. It’ll be very interesting to see if it lasts. And I can’t imagine why it wouldn’t to be honest, because I think there’s always people who—maybe not as many people—but there are always people who prefer to have irregular work. But I think for the vast majority of health care workers, of course, they would prefer full time work, and probably hospitals would prefer that, too. So I will be watching to see after the pandemic are as many people interested in this and also, of the ones who are interested, do we start to see the wages being bid down? That would be not surprising to me. So here we have all these people who are depending on this as their way of finding work. And suddenly we don’t have enough jobs or we have too many workers and not enough jobs. And so now we can really go to the bottom. I mean, I’m curious. Maybe that won’t happen, but, boy, I hope not.

Jordan Alison, thank you so much for this. It’s fascinating.

Alison Thank you.

Jordan Alison Motluk writing for The Local. That was The Big Story. For more from us, head to thebigstorypodcast.ca find us on Twitter at @TheBigStoryFPN. Talk to us via email thebigstorypodcast@rci.rogers.com [click here!] You can find us in your favourite podcast app. We don’t do gig work. We’re all full time employees here, have no guilt when you rate and review and tell your friends.

Thanks for listening. I’m Jordan Heath-Rawlings we’ll talk tomorrow. Back to top of page