On 19th February, Government announced its proposals for a new points-based immigration system post-Brexit, which it intends will come into force on 1st January 2021.
This, the Government says, ‘Sets out how we will fulfil our commitment to the British public and take back control of our borders. We are ending free movement and will introduce an Immigration Bill to bring in a firm and fair points-based system that will attract the high-skilled workers we need to contribute to our economy, our communities and our public services. We intend to create a high wage, high-skill, high productivity economy.’
The proposals have caused dismay across the social care world – including amongst providers of care and support, those who receive care and support, those who work hard on the front line to deliver care and support, and those who commission care and support.
We must take all opportunities to shape these proposals to support the care sector, rather than allow them to hinder us. It’s quite simple; we need a system that will:
- Use the points-based system to award extra points for care worker roles.
- Create a three-year visa for care workers.
Why? Because the occupation is in national shortage and the sector is facing growing demand for labour, in a time of full employment. If Government does not enable recruitment from outside the UK there will be real, human consequences – care facilities will close, homecare services will be reduced and the people who need the services will suffer, and, whilst there is a lot of work going on to recruit more care workers in the domestic space, that is simply not going to fill the shortage.
Let’s have a more detailed look at the Government’s stated aims, why they pose such a challenge for social care, and how they hinder a system already under pressure.
Government’s stated proposals for the new system are:
- ‘The points-based system will provide simple, effective and flexible arrangements for skilled workers from around the world to come to the UK through an employer-led system.’
- ‘All applicants, both EU and non-EU citizens, will need to demonstrate that they have a job offer from an approved sponsor, that the job offer is at the required skill level, and that they speak English.’
- ‘In addition to this, if the applicant earns more than the minimum salary threshold of £25,600 then the individual would be eligible to make an application.’
- ‘However, if they earn less than the required minimum salary threshold of £25,600, but no less than £20,480, they may still be able to come if they can demonstrate that they have a job offer in a specific shortage occupation, as designated by the MAC, or that they have a PhD relevant to the job. In effect, applicants will be able to ‘trade’ characteristics such as their specific job offer and qualifications against a salary lower than the minimum salary or the ‘going rate’ in their field.’
For social care, the proposed system seems to deliver entirely the opposite to, ‘Simple, effective and flexible arrangements for skilled workers from around the world’ and ‘A firm and fair points-based system that will attract the high-skilled workers we need to contribute to our economy, our communities and our public services.’
Identifying the issues
Good care workers, wherever they come from in terms of nationality, are highly skilled – they bring compassion, care and resilience to supporting and caring for some of our most vulnerable citizens, across lots of different settings, including people’s own homes. They work with people to live the best lives they can, with choice and dignity and independence.
The focus on formal qualifications in the new system entirely misses the point for social care as it fails to recognise the value and skills that care workers do truly contribute ‘to our economy, our communities and our public services’. Compassion, care and resilience rarely accrue a PhD – but they are hugely valuable in helping us provide care and support for those who need it most, when they need it most. Surely we all want to encourage skilled care workers to come to the UK to support us and our loved ones?
Salary thresholds are also not helpful. Whilst Government has taken on some of the advice in the MAC report in terms of reducing salary thresholds, this is of little help to social care. The £25,600 threshold hugely exceeds the annual pay of front-line care staff – Skills for Care data tells us that, for adult social care, estimated average salaries in the UK range between £16,400 and £18,400.
Equating levels of pay with levels of skill is highly misleading in the context of social care. Low pay and low skill are in fact very different things. Those with experience of working in care, receiving care, or commissioning care will mostly tell you that it is very misguided to equate skill with pay.
The main reason care staff are not paid as highly as staff in other sectors is that pay levels within social care are directly constrained by the level of funding received from the state to pay for people’s care (be that from local authorities or clinical commissioning groups). The state has huge purchasing power in this market, so social care providers are not operating in a traditional free market system, but rather they are stuck in a pseudo-market situation.
The MAC recognised this in its recent advice to the Government, where it acknowledges that a move away from free movement to a points-based system, with the salary threshold of £25,600, will increase pressure on social care. However, it does not think that the post-Brexit immigration system should have a role in relieving that pressure, stating, ‘We remain of the view that the very real problems in this sector are caused by a failure to offer competitive terms and conditions, something that is itself caused by a failure to have a sustainable funding model.’
At present, there are no reassuring signals from Government that funding for social care will increase any time soon, although the Budget may surprise us all. The National Care Forum – and much of the sector – has been calling for a three- to five-year funding settlement now, to protect the provision of care, as part of the start of a long-term funding solution and a long-term vision for social care shaped by those who use it now, and those who will in the future.
It seems extraordinary that Government is advocating free market conditions to correct the problems of wages in the social care labour market and, at the same time, has presided over ten years of reductions in the very budgets that essentially set the price for that labour market.
The reality of the numbers
Skills for Care data (the best we have on this topic) tells us that there are currently 122,000 vacancies on any one day in social care (a vacancy rate of 7.8%); there is also a turnover rate of 30.8% (44,000 leavers in the last 12 months), and there are 115,000 workers in care who hold EU nationality (8%), as well as a further 134,000 who hold a non-EU Nationality (9%). Hopefully all those who hold EU nationality have achieved EU settled status or are applying for it now. The sector has been actively encouraging this for many months.
The social care workforce is estimated to be 1.62 million people strong. The projected growth of the population aged 75 and over highlights that, by 2035, the number of adult social care jobs needed in England could rise by 800,000.
We cannot see how this projection can be met by the UK labour market alone, despite the suggestion that the eight million economically inactive people might come to the rescue (note: 2.3 million of them are students, two million have long-term conditions or disabilities which hinder or prevent working, 1.1 million are retired, and 1.9 million are already at home, many of them caring for family). And while digital technology has a significant role now and in the future of care, it will not replace the human touch – compassion, care and resilience cannot be automated.
Shaping future thinking
Work was going on in earnest to ensure that whatever immigration proposals were formulated by Government did not cause untold damage to the health and care workforce. The locus of this work has been with the Cavendish Coalition, of which NCF is a member. This health and care coalition has been working since the outcome of the EU referendum to build a strong understanding of the importance of the international workforce for the whole care and health system. Together, we have formed a number of key asks from Government. These include the solutions I mentioned previously: using the points-based system to award extra points for care worker roles and creating a three-year visa for care workers.
Whilst we were not optimistic that the new immigration system would favour social care after having read the runes in the MAC report, we had hoped that the Home Office would take more time to consider and respond to the issues for social care in any future immigration system. It seems that this is not the case.
This means that there is much work to be done to shift the outlined system. We will be working with partners across the sector to think about how to challenge the Government’s approach and build a points-based system that hits the mark for social care.
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