The Equal Opportunities Commissioner says she was genuinely shocked when she worked undercover in the aged care sector.
Judy McGregor did so in order to compile a report on the industry which she's described as modern day slavery.
She's found care workers in the community are paid $3 to $5 dollars an hour less than those directly employed by District Health Boards.
"I think it's easy to have an objective or theoretical view that carers are exploited, but actually doing it, and knowing it, is something else again," she says.
And she says older people feel devalued as a result.
"Older people themselves are very conscious that the people that are looking after them aren't paid well, and they equally want to do something about it."
She says at the moment the sector has a turnover of between 20 and 30 percent, even when there's high unemployment.
"Because as well as that high turnover there are many, many people who do it for a long time, and many of those people have had very little in light of monetary rewards and increases in their pay over the years in which they've been carers."
Dr McGregor says there's also an urgent need for career progression in the sector.
She says many of the major private aged care providers acknowledge that the pay of carers is unequal.
Dr McGregor told Newstalk ZB's Mike Hosking they're concerned the funding model they're using from the DHBs perpetuates inequality.
"I also think some of the private providers could step up and as well as returning good profits to their investors and shareholders they could equally return better wages to the carers and nurses that they employ."
Grey Power president Roy Reid agrees the low pay rate in rest homes and for home carers means people don't stick with the job.
"I know from experience that there's many receiving home care who get very upset when they get different people."
Mr Reid says the organisation also wants care workers to be trained to a minimum standard.
Mr Reid says he understands privately owned rest homes need to make a profit, but "paying their staff less is not a good way to achieve their profits."
Associate Health Minister Jo Goodhew says a number of moves are already underway to improve conditions.
She admits it's a difficult and challenging job.
"There is diversity of pay rates across the sector, and so rather than generalise one amount, it's a difficult financial time now for the Government, we have managed to increase it each year."
Ms Goodhew says she's fully considering the report, but is urging people to remember the Government's spending $1.4 million on aged care this year.
"I certainly can tell you that in some respects we feel we're making some progress on some of the recommendations as they come out. We've been doing some work in those areas, but I'm certainly not going to preempt a response."
John Key says equal pay for the aged care sector would be costly for the Government.
The Prime Minister has told Newstalk ZB's Mike Hosking if the Government decides to fix the issue, it'll have to give DHBs an extra $140 million a year.
"If we were in conditions where we had lots and lots of money, would we move in that area? Potentially yes, but we're not in those conditions.
"Frankly it's a problem we also inherited from the previous Labour Government, despite the fact that they're currently saying well we should now pay it, then where's the economic position they had when they were in office?," Mr Key says.
A Wellington home care provider believes DHBs and private companies are dragging down the aged care sector.
Elder Family Matters general manager Lawrie Stewart says he pays his workers between $17 and $18 an hour.
"It's still not as high as we believe they're worth but it's significantly higher than what the carers that operate either in publicly funded homes or in residential care access," he says.
Labour's concerned pay and conditions in the aged care sector will only get worse under planned employment law changes, rather than better.
National's planning to make further changes to collective bargaining and other laws that Labour MP Darien Fenton says will further undermine workers' rights.
She says aged care workers fell behind in the 1990s due to changes to employment law.
"They lost their rewards, they lost their weekend rates, they lost their penal rates for working overtime, their sick pay was reduced and so on.
"They've never been able to regain it, because they've never had the collective power to stand up to their corporate employers," Ms Fenton says.