There is an inverse relationship between utility and reward. The most lucrative, prestigious jobs tend to cause the greatest harm. The most useful workers tend to be paid least and treated worst.
He then gives the example of a home care worker to make his point. “See? Medical care is undervalued by society.” But according to a 2014 list of most prestigious jobs, doctor comes in first place. And of course it’s common knowledge that doctors make good money.
So much for Monbiot’s thesis, as it were.
(As for why home care workers don’t make much money, see Econ 101.)