The gig economy isn't always exploitative – it can be a genuine force for good, as HomeTouch's Dr Jamie Wilson is proving

Elliott Haworth
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Source: Greg Sigston (City A.M.)

The gig economy has been dealt endless flak in recent months.

Whether it’s the working conditions of Deliveroo riders or debates over Uber drivers’ employment status, platform-based companies have had a turbulent ride.

But admonishing the bigger players tarnishes all firms in the sphere with the same brush.

Many, like HomeTouch, are a genuine force for good.

Home care for the elderly has been a cause celebre in the UK for some time – it often costs families an exorbitant amount of money, and yet, in many circumstances, the carers are grossly underpaid. The agency model is outmoded, exploitative, and in desperate need of reconstitution.

Jamie Wilson, a dementia doctor turned chief executive, founded HomeTouch in 2015; a platform based on the principles of the gig economy, which pairs carers with patients.

Principally, it offers those in need of care choice, while ensuring carers are fairly paid, by cutting out agencies.

HomeTouch is different to other gig economy models, in that carers set their own price. The more experienced command a real premium, and Wilson says to earn 75 per cent more than one would through an agency is under-egging it.

“There are some customers who have high care needs, who are willing to pay a premium for the best carers. They’d rather have that relationship. And they’d probably be paying the agencies higher than that amount, but the carers get almost nothing – the agency getts the vast majority of what they earn. In our case, we’re taking a much lower cut, and carers are far happier in their work.”

HomeTouch offers those in need of care a genuine choice, while ensuring carers are fairly paid (Source: HomeTouch)


It’s an uncommon move, I suggest to Wilson, from doctor to entrepreneur. “I really like it,” he says. “I think I was probably always more of an entrepreneur than a doctor. But I do think the training that I had over that 10-15 year period... it’s very difficult to shake that off. This is a business about helping people’s health, particularly when they’re at their most frail and vulnerable. And so, I have a pretty deep understanding of what those customers are going through.”

Wilson worked across various parts of the NHS, principally at memory clinics – referral centres from GPs for people with early dementia. What he witnessed awoke him to the stumbling blocks many face when trying to organise home care.

Thousands of people pour through the doors, naturally concerned about the diagnosis – but often more so about finding reliable home care. The experience of carers coming in and leaving after a week piles another burden on families at an already sensitive time.

“So that was one experience, and the other – which is more well known about – is on the acute wards, where people had been admitted to hospital for pneumonia or something. It was just impossible to get people home from hospital. They would come in, they would have a treatment, and then it was impossible to find a home care provider to get people discharged – it’s one of the primary causes of bed-blocking.”

Rather than wishfully hoping the NHS would solve itself, Wilson decided to take up the mantle, and act upon the issues at hand. As he started digging for information about home care, it became clear that the incumbent agency model was not fit for purpose.

“The existing 7,000 agencies providing home care were not doing a great job. And when I looked into that, what I found was that the carers were underpaid, they were leaving their jobs after a few weeks, and so, what I wanted to do was create a model whereby the carers were brand ambassadors – and it would really transform their experience.”

Acquired taste

Already, after setting up in 2015, the platform is around 20 times the size of a normal agency, covering about 25-30,000 hours of care a month.

While the firm started in London, it has rolled out nationwide following an asset acquisition of – Europe’s, and perhaps the world’s, largest database of live-in carers. Wilson says it has been transformative.

“Platform businesses, particularly where there’s a human component to it – whether it’s taxi drivers or delivery drivers or whatever – will have some constraint on either the supply or demand side. In the home care sector, it’s absolutely about supply. There aren’t enough good careers to meet the demand that’s out there.”

More people are opting for live-in care – but there is a constraint on the supply side (Source: HomeTouch)

In the home care sector, there are two primary segments. There’s either hourly, or live-in care. For the former, carers need to live within a small radius of the client, due to the frequent trips. For the latter, live-in sector, where the carer is from matters not, as they will be at the client’s home on a semi-permanent basis.

The live-in sector is proliferating, as medicine keeps people alive longer, and fewer people want to go into residential care.

A good gig

With 25,000 people on its system and exclusive access to a huge repository of live-in carers, I question the vetting process. After all, knowing that loved ones are in safe hands is paramount, and with a gig economy model, scare stories around Uber drivers might make some uneasy.

But, says Wilson, vetting is a “massive, essential part of our business – we take each carer through a 46 point vetting process – starting with filling in a form, checking qualifications and other criteria. Then they go through a telephone screening process, in which we’re asking them more questions: personality traits, constancies, and interpersonal skills. And by the time they’ve been through all that, they then have to go through criminal bureau checks, and background references from previous clients. Then they come in for a morning session, in which we check for a cultural fit with our model.”

I stand wholly corrected. The notion that the gig economy is somehow immoral or exploitative is dangerous. In the same way Uber shouldn’t be regulated in the same way as black cabs, HomeTouch shouldn’t be regulated in the same way as Uber. To force HomeTouch to employ all of its carers defeats the point of the model, I suggest to Wilson.

“It does,” he says. “And I think it would be grossly unfair. One of the big bees in my bonnet I have about this whole topic is that there’s a lot of misrepresentation. I think there’s a lot of unions saying all these people are being forced into self-employment, but the point is that people make an active choice. All we’re doing is giving people something that they want. People want more flexibility, they want to be able to work on an ad hoc basis.”

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