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Care workers: The forgotten heroes in the fight against Covid-19

Written by
Nilmini Roelens
Date of Publication:
20 April 2020

Over the weekend, The Daily Telegraph announced that Covid-19 deaths in care homes could be as high as 7500. In an era where care workers in private institutions are sacrificing their lives but do not have the same recognition as NHS workers with automatic extensions of visas for a year, our minds should turn to the contribution made by migrant workers in these stalwart institutions. A recent article in the Independent highlighted this issue.

The recent announcement from the Chancellor recorded that there is no change to the deadline for end of the transition period which ends free movement on 31 December 2020 and the decision to press ahead with a new immigration system from 1 January 2021 alongside a simplified set of Immigration Rules, might be a tall order at the best of times. To do so without taking into account the impact of the Pandemic, we could be inflicting serious self-harm upon ourselves.

Pursuing the same pre-Pandemic agenda whilst thousands of people are dying in hospitals and care homes around the country, whilst several sectors were already in crisis, makes one wonder whether the UK Government is in a state of pre-Covid-19 stasis.

The Government should pay heed to the needs of UK businesses and sectors that will be struggling to survive (literally). A co-ordinated response will be required by the Government, with meaningful consultation with stakeholders, during the current crisis as well as in the aftermath of anticipated economic recession, or at best in the big UK economic downturn, as foretold by the FT.

MAC (Migration Advisory Committee) reporting back in May 2019 on the shortage occupation list stated: "The labour market is very different now from the last SOL review in 2013. Unemployment is lower, vacancies higher and free movement no longer providing the ready supply of workers it once did for some employers. In addition, there is considerable uncertainty surrounding Brexit and the future immigration system".

The pre-Pandemic CIPD's labour market outlook report for Winter 2019/20 found on average, 40% of total vacancies were proving hard to fill although few organisations have in fact turned to migrant labour, including 15% from within the EU and 10% from outside the EU.

The post-Pandemic landscape will be so disparate and would have been so unimaginable a year ago, that when drafting the Covid-19 exit plan, we must visualise as far as possible the post-Brexit economically downward turned landscape before designing the new immigration system. The Government must take the time to consult and listen to the needs of businesses for migrant labour and acknowledge that we live in a global village and are part of a bigger picture, to aid in the economic recovery of the country.

The MAC recommended the abolition of the Tier 2 annual cap and the RLMT; the Government took these on board in its vision for the post-Brexit immigration system.

In the same report, MAC stated that in medium-skill jobs such as science and technology technicians, construction workers, social care professionals, "shortages may be emerging but specific recommendations should wait until nearer the time when the new immigration system is clearer and about to be implemented".

Whilst all businesses will be facing serious challenges in these unprecedented times, the above sectors stand out for special consideration. More economic harm could be inflicted if we do not on the one hand react rapidly to some needs but take carefully reflected, measured steps on the other.

Care homes in crisis – shortages

Although in an economic downturn, the level of unemployment will be high, the UK has always struggled to recruit care workers from the resident labour force.

The new immigration system has not catered for lower skilled workers.

Unless care workers are placed on the shortage occupation list, the possibility of trading low wages against a relevant qualification in the proposed system will be of little comfort for the social care sector. Even so, the minimum salary level set at £20, 480 may prove to be too high, particularly as businesses in many sectors struggle to get back on their feet post-Pandemic and post-Brexit.

Age UK fears that Brexit could worsen the crisis in care for older people:

"We think this is a huge mistake. Care workers are low paid, but not low skilled. And our care workforce is in no position to withstand the loss of good, willing care workers, wherever they come from. We're worried things will only get worse after Brexit. The care system in the UK is in no fit state to withstand the loss of EU workers, now or in the future. If care workers based in the EU are no longer able to work as live-in carers in the UK, care companies will find it hard to meet rising demand.

"It's expected that there'll be 14.5 million people aged over 65 by 2035. That's 44% more than there were in 2017. To cope with that rise, around 650,000 extra care jobs will be needed".

Age UK estimates that, pre-Pandemic, there were 130,000 new care workers needed each year.

The May 2019 MAC report acknowledged:

"Recruitment and retention in the social care sector continue to be worse, extending beyond those roles known to be challenging to fill in the social care sector such as nurses into all categories of care staff, management and domestic and ancillary worker" (Scottish Care, response to the MAC Call for Evidence)

"Social care wages remain relatively low, which can make it an unattractive industry for UK-born workers to join. In 2018, over 500,000 jobs in social care were paid below the real living wage. Low pay inevitable results in the sector struggling to recruit and retain workers. It leads to a dependence on migrants who may have fewer work opportunities". (Independent Age, response to the MAC Call for Evidence)

Pre-Pandemic, Independent Age UK examined the impact of migration on the adult social care workforce and found that the adult social care sector in England will have a shortage of 200,000 care workers by the end of this Parliament and longer term, the sector could face a shortfall of 1 million workers in the next twenty years due to migration restrictions:

"- 1 in 5 of the adult social care workforce (18.4%) in England was born outside of the United Kingdom, which includes 150,000 working in residential care homes and 81,000 working in adult domiciliary care.

- Non-EU migrants account for the greatest proportion of migrants working in adult social care – approximately 1 in every 7 care workers (191,000 people)

- Greater London is particularly reliant on migrant care workers with nearly 3 in 5 of its adult social care workforce (59%) born abroad".

Best form of applause

If all skilled workers from overseas and EU workers are to be recruited via a Tier 2 style sponsorship scheme, the costs involved in hiring via the new immigration system may remain prohibitive for essential workers unless the Government removes certain costs and makes the system more accessible. Such workers should be exempted from the Immigration Skills Charge and from the Immigration Health Surcharge which is due to double to £624 per annum on 1 October 2020.

As we clap for the NHS, the best form of applause we can offer these hitherto forgotten heroes who have taken the same risks as our NHS workers to care for our seniors is to ensure that there is no differential treatment in the offer of automatic extensions of visas and to make things more pain free in the post-Pandemic world. "Employers need to adjust" to not being able to source EU low skilled workers may not be the right rhetoric in these circumstances.

One wonders also whether the heavy-handed approach taken by sponsor licence compliance officers in the 2010-2016 period under Tier 2 for care homes and Tier 4 for international colleges, would sit comfortably in today's Pandemic world.

Whilst one would always advice clients to be assiduous on PBS compliance, one wonders if the "high index of suspicion" and "light trigger" that the Home Office officials were permitted in R (The London Reading College Ltd) v Secretary of State for the Home Department [2010] EWHC 2561 (Admin), or the superlative language of "infraction" used back then, would still be appropriate. Destroying or damaging businesses such as the care home in Raj and Knoll Ltd, R (on the application of) v The Secretary of State for the Home Department [2016] EWCA Civ 770) who were considered not to "deserve the trust" of SSHD, for example for failing to update the current work addresses of employees or for keeping inadequate records of the RLMT, may appear somewhat heavy handed today, given the contribution care home workers are making in the "war effort". Light trigger presumably would no longer mean being "trigger happy" when it comes to PBS enforcement action in the sponsor licence context today.

The need to reconstruct an ailing economy in a post-Pandemic, post-Brexit world will mean the Government should urgently re-evaluate the needs of businesses for migrant labour and neither neglect nor mistreat key sectors that will need support in the aftermath of the crisis.

Opening up the long-forgotten Tier 3 in any new style immigration system, to secure (regrettably) lower paid but essential workers with valuable skills, could perhaps be part of the solution. Making the same gesture for automatic visa extensions as for front line NHS workers to recognise the contribution made to the "war effort" in fighting the virus, urgently commissioning a reassessment of needs of industry and placing care workers on the shortage occupation list immediately, may present some relief in the exit process from the Covid-19 crisis.

An NHS which was already under resourced now faces greater hardship, the loss of EU subsidies in the future and a severely depleted Treasury after the crisis, will mean we will need all the support we can get from the private sector to rebuild the economy.