Posted on April 22, 2020 at 6:02 AM
By Doug McConnell and Dominic Wilkinson
Post originally appeared on the Journal of Medical Ethics Blog
While the general public enjoy the relative safety of social distancing, key workers are at a higher risk of both contracting COVID-19 and transmitting it to their families. This is especially the case for ‘frontline’ workers who are frequently exposed to the virus and may not have access to adequate personal protective equipment (PPE). Tragically, many key workers have died of COVID-19 around the world already, including over 100 in the UK.
Although it is relatively rare for key workers to die from COVID-19, the risk of death is obviously much greater than one would usually expect in these roles and key workers clearly have good reason to be anxious. For ‘frontline’ workers, the distress is compounded by working in harrowing conditions where so many are dying alone. Furthermore, frontline workers have to take on the burdens of ensuring they do not transmit infections to their families, by moving in with patients, living in hotels, or maintaining rigorous social distancing in their own homes.
These atypical costs, risks, and burdens suggest that key workers are owed compensation in addition to their usual pay and a few instances of nationally coordinated applause.
There are currently at least three forms of compensation under consideration in the UK.
- The Liberal Democrats are calling for NHS workers to receive per diem hazard pay equivalent to the Armed Forces’ ‘Operational Allowance’ which they receive while on deployment (~£30/day).
- A cross-party group of MPs is calling for a scheme to compensate the families of key workers for funeral costs and lost earnings if those workers die of COVID-19. This is also modelled on the system used for the Armed Forces.
- Another cross-party group of MPs is calling for foreign nationals in the NHS to be offered indefinite ‘leave to remain’, i.e. the option of becoming permanent residents without the usual 5 year waiting period and application costs. Interestingly this measure also has a military precedent when Gurkhas were offered indefinite leave to remain.
A method for working out whether these forms of compensation are justified is to assume they are justified in the case of the Armed Forces and then assess the strength of the analogy with key workers during the COVID-19 pandemic. So, are key workers analogous to the Armed Forces in the relevant ways?
One reason to compensate the Armed Forces with public money is that they are doing a job that benefits the public. On this count the analogy is strong. In fact, the benefit provided by key workers during the COVID-19 pandemic is probably greater than that provided by the Armed Forces in many of their overseas deployments. Without the efforts of frontline staff and the support of other key workers, thousands more would die of COVID-19. To deliver public benefits of a similar value, the Armed Forces would need to be fighting a defensive engagement in the UK.
Another reason justifying compensation in the case of the Armed Forces is that certain, significant costs, risks, and burdens are unavoidable aspects of the work. Again, the analogy is strong. The greater risk to key workers from COVID-19 is an unavoidable consequence of providing treatment, selling groceries, et cetera.
There are two disanalogies between key workers and members of the Armed Services that make the case for compensating key workers stronger than the (already strong) case for compensating the Armed Forces.
First, the risks and burdens of working in the Armed Services are more obviously inherent to that work than the risks of pandemic are to key workers. Members of the Armed Forces cannot claim they were unaware of the possibility of being deployed to dangerous areas. But when supermarket workers and hospital porters accepted their roles, for example, they did not plausibly consent to working in the conditions created by COVID-19. Even physicians who recognize their duty to treat during a pandemic, are working in much rarer and unexpected circumstances than members of the Armed Forces when deployed overseas. So most key workers and even physicians have a case for claiming that their contracts fail to fairly remunerate them for working in these conditions.
Second, the compensation for members of the Armed Forces is based on the assumption that they are adequately trained and equipped. If they were not, then a further claim of compensation would be justified. Therefore, key workers who have had inadequate PPE have a stronger claim to hazard pay and compensation for any harm suffered as a result.
On the basis of this comparison, key workers have a strong claim to public compensation for working during the COVID-19 pandemic. Exactly how much compensation is owed relative to the Armed Forces is a different matter, however. We address that issue and expand on the above arguments in a forthcoming article.