On 28 January 2020, the Migration Advisory Committee (MAC) published its report on the possible role of a points-based system and salary thresholds in UK immigration policy after Brexit. This post offers our initial reflections on the implications of its conclusions for the social care sector, based on emerging findings from our Sustainable Care: connecting people and systems study.
In the report, the MAC re-iterates its previous position on social care, namely that “the root cause of the problems there is the failure to offer competitive terms and conditions” (para. 5.67). Despite acknowledging the significant current skills gap, and other pressures, in the care sector, the authors conclude that the ‘skilled worker route’ “is not the appropriate one to use to solve the problems this sector faces for low-skilled workers” (para. 5.67). An earlier Government proposal of a temporary route for migrant workers at a lower qualification threshold, included in The UK’s future skills-based immigration system white paper, is not considered in the report; although it seems the MAC does not endorse that either.
The MAC concludes that the sector needs urgent reform to improve funding and working conditions, a view also supported by respondents to our expert (Delphi) survey (round one, 2019) with stakeholders and experts on the social care workforce, home care and immigration policy. We nevertheless believe the report underestimates the likely impact of the proposed new measures on social care, and the potentially serious consequences it would have for the care sector. Our expert panel stressed the importance of ensuring migrant workers can continue to make their contribution to this sector, at least in the short to the medium term. There are four important issues:
First, although the report takes a predominantly sectoral approach, it does not address the very uneven regional distribution of migrant workers in care. The concentration of migrant workers in care in some places means the impact of changes would be very different, for example, in London, the South West or the North East.
Second, although the report acknowledges that impact could be greater in some specific parts of the broader care sector, this deserves more serious and detailed consideration. Live-in care, a small but important and growing part of the sector, is highly reliant on migrant care workers. Our interviews with live-in care providers warn us that the proposed points-based system would potentially undermine the viability of this type of provision, which people with care needs are increasingly choosing, within a relatively short time.
Third, while the contribution of migrant care workers to the care sector has been fairly constant for several decades, the composition of this group of workers has changed since 2010. The relative share of EEA nationals has increased, particularly among new entrants, probably as a consequence of the restrictions on non-EEA migration introduced in 2012. Further limiting migrant workers’ access to the sector in the current context of worryingly high vacancy and turnover levels is likely to widen the gap in the sector between workforce supply and demand. Social care reforms tend to take time to implement, but the proposed immigration changes would have an almost immediate effect on the sector; however our recent expert survey highlighted the need, at least in the short term, for a visa system that facilitates labour mobility from the EEA and beyond.
Finally, there is the wider issue of the importance of workforce diversity and whether social care is different from other low-paid sectors. The UK’s ageing population is increasingly diverse, and includes ageing migrants. In this context, a diverse social care workforce is an asset to be valued and developed, and crucial for the wellbeing of the whole of the UK’s ageing population.
To conclude, we agree with the key assertion of the MAC report: problems in the sector are much deeper than migration. However we argue that a sensible – and a fair and sustainable – migration strategy should be part of the broader social care reform the new Government promised in the Queen’s Speech, and the PM’s recent BBC radio interview. International experience tells us that sectoral and temporary visas are difficult to get right. It is therefore paramount to start these discussions about the long term future, as well as immediate potential contribution, of migrants in social care. Failing this, we run the risk of rushed policy decisions in response to acute pressures in the sector, with significant consequences for the wellbeing of people who use social care and support, as well as for migrant care workers.
Professor Shereen Hussein and Dr Agnes Turnpenny
Professor Shereen Hussein (PSSRU, University of Kent) is currently leading a work stream researching the implications of Brexit on migrant workers’ contribution to the social care sector as part of the Sustainable Care programme. Dr Agnes Turnpenny is a research associate on the same work stream. Click the image below to learn more.