The most fundamental right of the worker is to be paid. Separate from fighting for higher rates, better conditions, or wider measures to fight inequality—or even demanding the full value of one’s work, including the surplus extracted for profit—this is the basic expectation in the system under which we live. But for one group of key workers who have been tirelessly working to keep hospital patients, nurses, and doctors safe from infection during the pandemic, even that most fundamental of rights appears to be under threat.

Privately outsourced cleaners and porters working at NHS hospitals across the UK have reported repeatedly going without pay or getting underpaid by the giant companies that employ them. Tribune has been speaking to some of those cleaners and porters and the trade unions that represent them about the issue and the devastating impact it’s having on already low-paid and overworked employees.

‘I live month to month. I get paid every four weeks and I’m normally skint by about two and half weeks,’ explains John*, who has worked at a hospital in Surrey for nearly two decades, where facilities are currently managed by Mitie. ‘The one thing you should get right as a company is people’s pay. It’s the thing people come to work for.’

John says short or missing pay is a constant occurrence at his workplace, and it’s leaving most of the staff there, particularly those on fewer hours, at risk of destitution. ‘You’re playing with people’s livelihoods here,’ he says. ‘If they’ve got rent to pay, they can’t tell their landlord, “I didn’t get paid this week, but they’re gonna pay me next month.”’

John is far from alone. At one South East London hospital, where the cleaning contract is run by Danish outsourcing giant ISS, the problem is allegedly endemic. Organisers for GMB trade union tell me that it’s pushing workers there into heavily deepening poverty. They report that on past occasions workers have ended up with no wage at all on payday after errors meant none of their work was logged.

One worker at the hospital was forced to walk multiple miles to work each day after his pay was mistakenly cut to the point that he couldn’t afford public transport. Cleaners and porters working there are often unable to pay their gas and electricity bills for them and their families, even in the middle of winter.

‘I’ve even had to post food bank information onto their WhatsApp group because they’re so desperate,’ explains Helen O’Connor, the GMB organiser who looks after facilities staff. The problem is so bad GMB has had to help members who have been left unable to even pay the few pounds needed to remain a member of the union.

At another East London hospital, one of the worst hit during the pandemic, Tribune has heard that cleaners were left tens of thousands of pounds out of pocket when their wages were entered into payroll incorrectly. At a location in South London, the problem is so desperate that an on-the-ground rep is reportedly being given extra authority to handle the huge groundswell of cases. GMB organisers have said they are now considering protests and strike action after both Mitie, which manages facilities there, and the NHS Trust itself said they couldn’t guarantee that more mistakes won’t be made in future.

The issue is said to be systemic. ‘Every single company in every single hospital in my region do it,’ says Lola McEvoy, London regional organiser for GMB. ‘It’s the first thing that cleaners say, If I ask them what’s wrong.’ O’Connor agrees on the scale of the problem, telling Tribune that to affects most if not all the hospitals in her region.

The impact of this problem across the workforce is predictably huge. At the very least it can mean going into debt with friends and family or payday loan companies, or missing bills, failing to pay rent, being unable to eat. Often this means people end up having to spend more—for example, on interest—for the crime of not being paid your fair wage that month. As the old adage goes, there’s nothing more expensive than being in poverty. Neither of the outsourcing companies Tribune reached out to for this piece said they offer any form of reimbursement or compensation for even the most extreme pay mistakes.

The problem is worsened by an alleged culture of bullying within hospitals using outsourced services. Tribune has heard claims of physical assault, intimidation, and managers sending staff home mid-shift as punishment. According to O’Connor, all of this creates a culture where even just speaking up when you aren’t paid your fair share is a struggle for outsourced employees, who are scared of being informally disciplined by losing vital overtime if they do.

It’s not absolutely clear why this is happening. Those Tribune spoke to speculated that it could be due to understaffing in accounts, underdeveloped IT systems, a lack of care from companies, cashflow problems, or even a combination of all of the above. But those affected suggested that at the core it’s driven by one thing: the pursuit of profit.

ISS told Tribune that they were ‘not aware of any current pay issues’ at John’s hospital, and said they have an ‘open culture’ that encouraged underpaid employees ‘to speak to their onsite management teams’ about any problems. They did not give any explanation as to why this has allegedly happened in the past. Mitie also said they are ‘are not aware of any current outstanding pay issues at the Trusts where [they] operate’, and that ‘should a pay issue occur, [they] have processes in place to ensure that employees can get a same day BACS transfer.’ Both responses are appended to this report.

Poll after the poll rates the NHS is rated as the thing that makes people proud to be British. The contradiction at the heart of that is that for some of its most overlooked staff—those that keep wards clean, hospitals functioning, and patients fed—it can also be the site of some of the direst exploitation in our economy. As John put it: ‘Cleaners, porters and caterers work tirelessly in these hospitals doing long hours, and it feels like there’s no appreciation whatsoever.’

That cuts to the core of the issue. According to those on the ground, company decision-makers don’t have the will to solve the issue. ‘They don’t care… There’s just a lack of empathy there for people, about what it means for their lives,’ explains O’Connor. ‘No-one would like to be treated like that – having to argue just for their own money. But for outsourced workers, it’s increasingly common.’