Human Rights Commission equal employment opportunities commissioner Dr Judy McGregor says all New Zealanders should be upset at the low wages paid to aged care workers.
Dr McGregor says residential carers, who are predominantly women, are being discriminated against and lack of action to pay them fairly would be a fundamental breach of human rights.
The Human Rights Commission report Caring Counts says carers in residential facilities or providing home care earn on average $14.50 an hour while healthcare assistants doing similar work in hospitals can earn $3 - $5 an hour more.
In January, Dr McGregor worked for several days at a residential aged care hospital facility, choosing one outside Wellington so she would not be recognised.
"When I did the job myself I realised the immense emotional labour that goes into it - the skill, the technique, the fatigue," Dr McGregor told Radio New Zealand's Sunday Morning programme.
"I think it's a vastly undervalued and underpaid sector that's immensely important to New Zealand, and of growing importance given the ageing demographic.
"I think all New Zealanders should be emotionally upset about the very low wages that are paid to these saint-like women who are working in the community and residential age care facilities and in hospitals."
She says the sector has relied on the dedication of workers to their patients, but industrial action will increase. "We've got to the end of being able to exploit the emotional labour aspects of this work."
The report says fixing pay inequality between healthcare assistants and residential carers would cost $139 - $149 million a year, less than 1% of the health budget.
Among the report's 10 recommendations is that the Minister of Health directs district health boards to develop a mechanism to achieve pay equality and implement it over a three-year period.
It also proposes a five-star quality assurance rating system of rest homes to be developed.
The report also points out that some care workers in the community are paid less than the minimum wage when their time worked, wages and payment for travel between clients is looked at as a whole.
Higher Cabinet ranking not needed for aged care - PM
The report urges Prime Minister John Key to ensure the minister with responsibility for older people has a top 10 Cabinet ranking.
Currently, Jo Goodhew, who is Minister for Senior Citizens and Associate Health Minister with responsibility for aged care, is ranked 22nd and is outside Cabinet.
But Mr Key says there is no correlation between Cabinet ranking and the emphasis on particular issues.
He says if an issue is important, it will be given priority, no matter whether it is a junior or senior minister putting it forward.
The report says that by 2036, New Zealand will need 48,200 paid carers for elderly people but current trends show there will be only 21,400 paid carers available.
Labour force predictions see the health and disability sector workforce needing to grow by 40 - 69% by 2021 to meet demands.
The report gathered evidence from 886 participants over a one-year period.
Union backs call for action on pay
A union representing rest home workers is backing calls for immediate action on low pay rates.
Service and Food Workers Union spokesperson Lyndy McIntyre says private employers must be held to account for how they spend taxpayer money.
At present, she says, those employers could choose to return profits to shareholders or use the funding to expand their business.
Associate Health Minister Jo Goodhew says there is no regulation or legislation in place that dictates what private providers pay staff. Government funding is passed to DHBs which then allocate it to private providers.
Ms Goodhew says the Government will consider the commission's recommendations, though she says the aged care sector is already making good progress with much more auditing and a better qualified workforce.
Labour's aged care spokesman Kris Faafoi says says the Government should launch a wide ranging aged care strategy to permanently address problems in the sector.