IN THE NEWS
Steve Barclay’s social care recruitment drive: prudent pragmatism or fomenting the health and care divide?
In August the Health and Social Care Secretary, Rt Hon Steve Barclay MP, made headlines following an interview with The Daily Telegraph in which he argued that, to avoid a winter crisis, the health and social care sectors should significantly increase overseas staff recruitment to meet the anticipated increases in demand.
Controversially, and with regards to social care specifically, he said that the sector could benefit from bringing in foreign workers who have nursing qualifications but not a high enough standard of English for front line NHS work.
Language requirements are lower for many social care roles and are set independently of the Government by medical bodies.
A the time of his interview, nurses were required to have the same level of English regardless of whether they work in a hospital or social care setting.
The move is a desperate attempt by the Government to fill the 165,000 job vacancies in the adult social care sector.
Nevertheless, the measure has whipped up a storm. Speaking to Caring Times in response to the announcement, dementia consultant Jenny Henderson said: "The proposal by Steve Barclay to hire migrant workers rejected by the NHS for lack of language skills is ill thought out and poorly conceived. It shows a complete lack of understanding of skilled workforce necessary in care homes. Most of all it shows a complete lack of understanding of the complexities of communicating with people with dementia as the illness advances where good communication skills is essential."
The sentiment of Henderson's message is echoed by this month's contributors, Liberal Democrat Health and Social Care spokesperson, Daisy Cooper MP, and ILC head, David Sinclair. They, at best, describe the step as a sticking plaster solution arguing that the labour crisis facing the sector is a symptom of far greater structural and workforce planning issues facing the sector.
INTERVIEW
For this month's edition we interviewed Daisy Cooper MP, Liberal Democrat Health and Social Care spokesperson and Deputy Leader to hear her thoughts on Steve Barclay's solution to the labour shortage facing the sector.
Is the Health Secretary’s recommendation an effective solution to the sector’s staffing crisis?
Effective communication skills are important for ensuring good quality care and the effective running of care homes.
The government’s proposal to hire migrant workers rejected by the NHS for lack of language skills fails to recognise this. It’s a sticking plaster that at best will lead to a marginal increase in recruitment and at worst could impact vulnerable people’s care.
Instead, the government needs to recognise the value of care workers and invest time and resources in recruiting, retaining, and rewarding them.
Unfortunately, poor pay is driving care workers to the NHS, hospitality, and other sectors, leaving those in need without care packages. But, even with better pay, we will undoubtedly need to recruit care workers from abroad. In doing so, we should maintain a good level of general English language skills.
Is the skills crisis facing the social care sector a part of a broader failing of other areas of government?
Many parts of our economy are facing a labour shortage and a skills crisis, creating intense competition in the job market. However, with social care vacancies hitting a record 165,000, any responsible government would have tried to get ahead of this with serious workforce planning.
Frustratingly, the Conservative government spent months whipping its MPs against a cross-party drive to commit the government, in law, to producing annual workforce projections.
Care workers are at breaking point and quitting the industry in droves. To retain care workers they must have hope that support is on its way. Being honest and transparent about the levels of staff we will need in the years to come would be a crucial first step.
Would greater investment in nursing skills and training, as well as more effective marketing initiatives lessen the recruitment crisis?
Yes, undoubtedly, but we should also learn from what is already working well. Values based recruitment has reduced turn-over of staff, as has the provision of continuing professional development.
But the reality is that social care workers are getting a raw deal. They are under enormous strain both financially and in their working conditions. A marketing campaign won’t change that reality.
The Liberal Democrats support the introduction of a real living wage for care workers, the replication of NHS pay bands and career progression
The Liberal Democrats support the introduction of a real living wage for care workers, the replication of NHS pay bands and career progression. These are concrete ways to ensure more people are encouraged to take up social care work and continue in the sector.
Will the proposal exacerbate a two-tier system between health and social care?
Yes. Social care is a difficult and skilled profession which should be valued more highly.
Although language requirements are different between the two sectors, we should not be moving in a direction that paints social care as a lower tier to the NHS. The two are inextricably linked - one cannot function properly without the other.
We already know that delayed discharges from the NHS are in large part down to the crisis in social care. Supporting social care providers is the first step in bringing down wait times for NHS treatment.
Ultimately, it’s in the Government’s interest to do everything it can to value and reward care workers properly so that the UK can be one of the best places in the world to age and be cared for.
OPINION
This month's opinion piece comes from David Sinclair, CEO of the International Longevity Centre – UK (ILC) who argues short-term changes to immigration or NHS language rules might well be necessary, but such sticking plaster measures are seldom sustainable in the longer term.
In January 2022, the ILC’s Plugging the gap report warned that due to population ageing, COVID-19 and Brexit, the UK economy could see a shortfall of 2.6 million workers by 2030 – almost twice the workforce of the NHS.
Post-pandemic, high vacancy rates are prevalent across the whole UK labour market, but the social care sector has even higher staff turnover and vacancies. In 2018, the ONS projected that the number of people in England aged 85 or over would increase to 3.2 million by 2041 and the latest ONS Census 21 data confirmed this trend. With the oldest old more likely to have some form of disability, this demographic trend will drive a significant increase in the need for social care.
Pre-Brexit research published in November 2015 by the ILC and Independent Age highlighted the dependency of the sector on migrant workers. Moved to care: the impact of migration of adult social care warned of serious shortfalls and concluded:
“….we project that by 2037, if working in care becomes increasingly unattractive and net migration is comparatively low, the workforce could have over one million fewer care workers relative to demand than is the case today…In order to close the workforce gap over the entire period, the proportion of working age people in England, working in the adult social care sector, needs to rise from around 4% today, to around 6% by 2037”.
In April 2022, the Migration Advisory Commission (MAC) report Adult social care and immigration said the sector needed an additional 66,000 FTEs to fulfil current demand and a further 236,000 FTEs to keep up with growing care needs. Social care employs around 2% of the working-age population today and may need to employ 4% to fulfil demand by 2033. Whilst most workers were British nationals, migrant workers form a considerable part of the sector. In 2020, 1 in 4 social care workers were born outside the UK, many outside the European Economic Area (EEA).
...it would be a retrograde step if the short-term relief brought by immigration policy was an excuse not to address the more fundamental problems the sector faces
However, the ILC would agree with the MAC report, that while “immigration policy may be able to help alleviate some of the workforce problems that the sector is facing, it is not the best solution to these problems.”
Aside from the issues around poaching valuable staff from deprived countries, it would be a retrograde step if the short-term relief brought by immigration policy was an excuse not to address the more fundamental problems the sector faces.
Pay must clearly be improved, but we must better support the largely female workforce and plug the gaps. Employers must ensure healthier workplaces, offer support for those with unpaid caring responsibilities and allow flexibility. Our approach to care needs to become more preventative, more people-centred and delivered more efficiently. ILC’s latest report, The Mayhew Review: Future Proofing Retirement Living shows it would be more efficient to provide more housing with integrated care.