Increase in overseas social workers poses ethical questions for councils

The success of the NHS in recruiting nurses from developing
countries has led some to ask why the overstretched social care
sector does not look to import skills from these countries.

The General Social Care Council issues a letter of verification to
certify that a person from a non-EU country has completed a
recognised social work qualification in their own country. The
number issued rose from 1,175 in 2001-2 to 1,390 in 2002-3
-Êan 18 per cent increase. Significant, perhaps, but the
numbers are tiny compared with those of the health sector.

More than one in three nurses registering with the Nursing and
Midwifery Council are now from overseas. The council’s figures for
2002-3 show that nearly 14,000 overseas nurses joined its register
out of total of 36,000. Most were from non-European Union nations.

These statistics only confirm what most people already know: that
the NHS, and our hospitals particularly, are being propped up by an
influx of foreign nurses. Most come from the Philippines, India and
South Africa, with Nigeria and Zimbabwe not being far behind. Only
one in 10 were from the traditional areas of recruitment:
Australia, New Zealand, Canada and the US.

Unlike the NHS, a large proportion of overseas social workers are
from antipodean countries. Of the 6,261 verifications issued since
1990, a third have been to Australians and New Zealanders.

NHS recruitment from developing countries took off four years ago
as a result of the government’s focus on bringing down hospital
waiting lists, and a drop in the number of UK citizens going into
the nursing profession. What helped was the Home Office decision to
classify nursing as a priority occupation, fast-tracking visa
applications within four weeks. But social work has the same
priority status, so why are there not more overseas social workers
being recruited?

Recruitment agencies believe that if councils provided more initial
support for overseas workers the recruitment crisis could start to
be addressed (news, page 9, 29 January).

Lawrence Perry, who runs Dolma International Placement, an
employment agency that recruits social care staff from the
Philippines to the UK, says there is a large surplus of trained
social workers in the Philippines who could be recruited. However,
Perry says there has been little interest in the UK because of the
difficulty in finding overseas workers affordable accommodation.

Richard Bloom, who runs, can testify to
the difficulties of integrating employees from the developing world
into UK society. Two years ago, he recruited 70 social workers from
Zimbabwe to work in London boroughs and Birmingham Council.
Although the move was a success – “they are very hard working,
loyal and high quality people” – it has proved an organisational

Bloom had to lend many of the workers between £1,000 to
£3,500 so that they could pay the upfront costs such as
accommodation, transport and clothing.

“Some have paid the money off but others are paying it back at
£50 a month because they are under serious financial pressure
to help family members caught up in Zimbabwe’s economic and
political problems. At that rate they will still be paying it back
in another two years. I have had to employ another person just to
keep on top of the payments.”

He normally charges councils 17.5 per cent of a worker’s salary as
commission for handling the recruitment, but had to charge 25 per
cent because of the higher overheads. “Most authorities aren’t
prepared to pay that,” he adds.

But Bloom says the arrangement worked best where local authorities
tried to support their new recruits. He singles out Southend on Sea
and Birmingham Councils for offering financial support to buy

Bloom says the complexities of recruiting from overseas has put him
off repeating the exercise. “I have 200 CVs sitting in my filing
cabinet from Zimbabwe and India but I don’t bother offering them
[to authorities] because we won’t get the interest,” he adds.

Despite Bloom’s experience, there are signs the care sector is
starting to look to the developing world. According to the GSCC’s
figures, South Africa and India are the two countries from which
social workers are most likely to be recruited.

Richard Smith, of social care recruitment agency BBT, says it is
planning to open an office in India. And Bournemouth Council is the
first in the UK to obtain the backing of the Filipino government to
begin recruiting social workers from the south east Asian

Some agencies are sceptical about the amount of post-qualifying
practice experience social workers in the Philippines have, but a
spokesperson for the Filipino embassy says that there are a lot of
social work graduates “working in government agencies, NGOs and

It has also emerged that local authorities in London and Greater
Manchester are holding discussions with regional officers from the
NHS Workforce Development Confederation about what they can learn
about recruiting overseas from the health service’s experience.

Jane Worsley, international recruitment project manager at Greater
Manchester Strategic Health Authority, says the talks aim to give
social services advice on “orientation procedures as employees need
a period of adaptation”.

The local government Employers’ Organisation has developed a
checklist of things local authorities should do to ensure overseas
social workers settle in smoothly.

“Cultural issues have to be considered,” says Katherine Kelly,
recruitment consultant at the Employers’ Organisation. “Even for
workers from developed countries, coming to work here is very

Kelly says councils are already aware of the need to invest in
their infrastructure, such as finding workers temporary
accommodation, opening bank accounts for them and providing
information on doctors and schools.

Hampshire Council recruited six Australian and New Zealand social
workers last year and is in the process of recruiting home care
workers from India. Helen Dunn, recruitment adviser at the council,
says it would consider looking at developing nations for recruiting
social workers.

She knows of a local authority that has had “a very good
experience” of recruiting social workers from South Africa and of
another that is recruiting in India. “It is working with centres of
excellence at the University of Delhi where students are gaining

Agencies solely dedicated to helping overseas workers settle in the
UK are also beginning to be set up, adds Kelly. “They do everything
from meeting workers at the airport, helping them understand an A-Z
and how to get from their home to work,” she explains.

However, there are questions over whether it is right for one of
the wealthiest countries in the world to systematically recruit
workers who poorer countries have trained.

The Home Office issues guidance on which countries have a surplus
of professionals, and the NHS and most councils abide by that. But
this is not a new issue. In 2000, South Africa’s minister for
social development criticised the UK of “robbing” it of its social
workers and nurses when it was “desperately short of both”.

In the Philippines private institutions have been set up with the
sole aim of training people to become nurses abroad because there
is a perception that it has an excess of nurses. However, health
consultant Tom Bolger says: “The reality is that it has an excess
of nurses compared to the number of jobs available to them, not to
the number of nurses needed for its society.”

Ian Johnston, director of the British Association of Social
Workers, agrees. “We have serious concerns about recruiting from
countries that might need social workers more than us.”

Johnston says the GSCC should look at whether overseas social
workers’ qualifications are compatible with UK working practices.

The GSCC says this will be addressed when the letter of
verification is replaced by the social care register in late April.
It will mean an individual’s “qualification, personal character and
health” will need to meet certain standards.

But with not enough home-grown social workers it seems likely that
councils and the government will increasingly be looking to
developing nations to fill the void.

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