Post-Brexit migration plans would deepen social care pressures, say government advisers

Post-Brexit immigration proposals would shrink the social care workforce by an estimated 3% and increase pressures on the sector, the government’s migration advisers have said.

In a report for the government looking at how to implement ministers’ ambitions for a points-based immigration system to replace free movement from the European Economic Area, the independent Migration Advisory Committee (MAC) admitted its proposals would hit social care, but added that the sector’s problems were rooted in low pay, not immigration policy.

The report proposes to retain the current Tier 2 visa – which covers skilled migrants with a job offer – but apply it to EEA as well as non-EEA citizens, and to medium-skills as well as high-skills roles. It would also reduce the current minimum salary for this group from £30,000 to £25,600.

Modelling done by the MAC indicates the social care workforce would be reduced by 2.9% if the proposed changes were implemented, because of the reduced supply of EEA migrants – which would not be offset by any fall in demand for care from EEA citizens – and the fact that most jobs in the sector fell below the salary cap.

‘Failure to offer competitive terms and conditions’

While the report acknowledged its proposals would increase pressures on social care, it said these derived fundamentally from low pay and a lack of funding, rather than immigration policy.

“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,” the report said.

But while the committee’s statement on pay and resourcing was welcomed by social care commentators, they pointed out that without an immediate funding injection, the changes would worsen already deep pressures on the sector.

This reflects the lack of a timetabled plan from the government to produce and implement changes that would put social care on a more sustainable footing – though it has pledged to do so – and the fact that councils and providers are already under pressure to fund a significant rise in the national living and minimum wages in April.

‘Shutting door to thousands’

Simon Bottery, senior fellow at The King’s Fund, said: “One in six staff working in adult social care in England have a non-British nationality [and] these workers are crucial for the viability of social care services, which are struggling to cope with approximately 122,000 vacancies at any one time.

“By prioritising higher-paid workers, the [MAC] recommendations for a points-based visa system would effectively shut the door to thousands of people who are desperately needed to shore up the social care workforce.

“In doing so, the committee has batted the social care staffing problem back to government, challenging the government to improve care worker pay and conditions so more home-grown staff are attracted to the roles.”

Bottery said, however, the immediate reality was that the average hourly pay for care workers was below the rate paid in most supermarkets.

“The committee’s challenge risks being a triumph of hope over reality, unless the government provides an immediate social care funding boost, a comprehensive plan for sustainable staffing, and the prime minister delivers on his commitment to ‘fix social care once and for all’,” he added.

Home care employers said the report showed the need for government to design an immigration system that allowed care workers in.

Care staff ‘must be on shortage occupation list’

Colin Angel, policy director at the United Kingdom Homecare Association, said: “At a time of extremely low unemployment in the domestic labour market, social care employers are struggling to recruit enough people from the domestic workforce to meet demand.

“We need government to place frontline care workers on a shortage occupation list, and design a future points-based system which recognises the contribution that care workers make to UK society, rather than simply qualifications and earnings.”

Association of Directors of Adult Social Services vice-president James Bullion said the MAC’s message was clear – that migration was one of the pressures affecting the sector, but the real issue was funding.

He said thresholds of £30,000 and £25,600 were “largely meaningless in a sector where over a third earn the national living wage”.

“We must send a signal that social care staff are valued and they will be rewarded for the amazing work they do and the difference they make to our lives every day.”

‘Sector already in crisis’

UNISON assistant general secretary Christina McAnea said reducing the salary threshold by £4,400 “won’t allow a single care worker to come to the UK”.

“The sector is already in crisis, placing barriers to recruitment from overseas would cause it huge difficulties.”

In its immigration white paper in 2018, the government proposed introducing a temporary visa for up to a year, designed to help sectors such as social care which would struggle to adapt to the loss of free movement.

However, McAnea said that, under this arrangement, “by the time care staff have arrived and settled into their jobs, it’d be time for them to leave,” while people needing services would have their care disrupted and would be left anxious.

“The government can no longer duck its responsibility to reform social care, if wages were increased and training improved, people who already live and work in the UK might start to see care as an attractive career option,” she added.

The proposals also sparked concerns from NHS leaders. NHS Providers chief executive Chris Hopson said: “Health and care services are facing severe and unsustainable workforce shortages at a time of rapidly increasing demand; both the NHS and the social care sector need a future immigration system which will protect their ability to recruit staff from overseas.

“It is positive that the £30k salary threshold proposal has been pulled back in these recommendations, but we are disappointed that there are no proposals to ensure we can recruit the staff we need to ensure sustainable social care services.

Hopson said unless the government takes concerns about the viability of the sector seriously, NHS services and, ultimately, patient care would suffer.

The Home Office said the government was currently considering the report’s recommendations before setting out further details on the UK’s future immigration system.