It may be the season for festive cheer but this week’s immigration white paper appears to deliver little in the way of good news for the social care sector.
Far from putting forward constructive and realistic proposals to address the growing shortfall in staff in this sector, a lot of what is in the paper risks exacerbating an already difficult situation.
The headlines honed in on the £30,000 minimum salary threshold for those with “graduate, postgraduate and intermediate level skills”. In the social care sector, this may include registered managers and social workers for example. The government says they will consult with stakeholders on the exact level for the threshold but, even if this is set at £21,000 as mooted by some MPs, a lot of roles in the sector would still fall short of it.
Further into the document is the proposal for 12-month visas for “low skilled” workers as a temporary measure (albeit one that would not be fully reviewed until 2025). This would include the majority of the care workforce. Many have, quite rightly, taken issue with the “low skilled” tag and pointed out that low pay does not necessarily equate to low skill. Indeed, the social care sector is full of highly skilled individuals doing work that delivers enormous value to society. And yet the mean salary for a care worker in the local authority sector is around £18,900; in the independent sector, it’s more like £15,700.
We are heavily reliant on migration to fill vacancies in direct care roles in particular. In England alone, 8% of care workers are from the EU and 10% have non-EU nationality. What the white paper is suggesting is that these “low skilled” workers would be welcome to come and work in our care homes and deliver vital home care, but that:
- they would have no right to extend their stay or convert that 12-month stay into permanent settlement
- they would have no right to access public funds (including health care other than in an emergency)
- they would have no right to bring dependants
- after 12 months they would have to leave, and would not be able to return for a further 12 months.
It's difficult to see how such a scheme would attract sufficient numbers of high-quality staff to fill the 110,000 vacancies it is estimated we currently have in England. And it’s unlikely that providers will be motivated to invest in development and training for staff who are going to be with them for such a short time. By taking a short-term approach to the workforce, the sector will struggle to provide the conditions that staff deserve and that enable them to provide the high-quality care we want for ourselves and our loved ones.
The high turnover in the sector – where almost one in three people leave their jobs each year – is also not likely to be helped by the white paper’s promise that “workers of all skill levels [will be able] to move between employers”. We worry that people coming to work in care will be drawn swiftly into other sectors that pay better, such as the health sector or retail. The provider market remains fragile, and building in mechanisms that drive even higher staff turnover will not secure the long-term stability that providers so badly need.
Lastly, the money. The white paper acknowledges the Migration Advisory Committee’s assessment that “wages are a critical factor in the recruitment and retention of local workers, and that low pay is often the root cause of shortages”. The implication is that the reliance on migrants could be reduced by raising wages to attract domestic workers. Assuming that raising wages is the solution (and in reality it is likely to be more complex than that), in a sector that has seen real-terms local authority budget cuts of 7% since 2010, where will the money come from to fund those wage increases?
Tidings of comfort and joy?
Underlying all these proposals is an assumption that there are queues of people wanting to come and work in the social care sector, and we just have to press a button to let some more in when we need them. We’re not alone in facing a serious workforce crisis. Our work looking at the long-term care systems in Germany and Japan have found that both countries are looking to immigration as part of the solution. That means that we will be competing with several other countries to recruit from the same pool of workers. While Germany and Japan endeavour to make their immigration policies more attractive to migrants, the UK seems to be going the other way.
Without radical reform of the entire social care system – delivery, funding, staffing – we are in for a very bleak future. The prospect of a social care green paper was providing a small chink of optimism that maybe, just maybe, this issue will finally enjoy some genuine attention. But, if reports in the press are correct and the green paper has become a casualty of Brexit no-deal preparations, it seems that we may have a long time to wait for some glad tidings.
Curry N and Hemmings N (2018) “The season to be jolly? More like a bleak midwinter for social care”. Nuffield Trust comment. https://www.nuffieldtrust.org.uk/news-item/the-season-to-be-jolly-more-like-a-bleak-midwinter-for-social-care