Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Debate between Baroness Jones of Moulsecoomb and Lord Patel

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Monday 7th September 2020 Lords Chamber

[Lord Patel (CB) [V]]

My Lords, before I speak to my Amendment 82, I want to support strongly the noble Lord, Lord Hunt of Kings Heath, who spoke with his usual passion when presenting his amendment. I hope the Minister will respond to that.

Amendment 82 can be taken in the context of the Covid-19 pandemic which has highlighted the exceptional contribution and sacrifice made by our health and social care workers every day in protecting and caring for people in the community. It has also made clear how much we depend on our international workforce. Around 29% of doctors working in NHS hospitals and almost 14% of healthcare workers overall in the United Kingdom are from overseas. International workers account for approximately one-sixth of care workers in England.

The pandemic has had a profound impact on all aspects of our health services, but I draw the attention of the House to its impact on the all-too-often overlooked sector of social care. Between March and July this year, there were 30,500 excess deaths among care home residents as well as 4,500 excess deaths among people receiving care in their home. Figures from the Office for National Statistics also show that social care workers are among the occupational groups at the highest risk of Covid-19 mortality. The United Kingdom recorded the second highest number of deaths among healthcare workers in the world, second only to Russia, and a significant number of those deaths were among social care workers. These figures highlight the immense sacrifice and heartbreak that these workers have faced while trying to do their job in a system that was already overstretched. The vital contribution they make to the health system has been overlooked and undervalued for too long.

Adult social care is facing stark recruitment and retention challenges, with an estimated 122,000 vacancies, while the demand for social care workers is expected to rise in line with the UK’s ageing population. The CQC’s State of Care report concludes that workforce shortages in adult social care are

“affected by the lack of value given to social care by society and disproportionate levels of pay.”

The pandemic should serve as a wake-up call that we need to value our social care workforce more. In a sector where one in six of the workers are from overseas, any changes to the UK immigration system that could deter or prevent those who want to work in this country are of deep concern. There is a risk of significant implications for the staffing of health and social care services, as well as the quality of care and patient safety in the future. While measures to help recruit doctors to the NHS, including the fast-track NHS visa, are welcome, the lack of any route into the UK for social care professionals is extremely concerning. The average salary for a care worker in England is between £16,400 and £18,400, which means that individuals would fail to meet even the lower salary threshold of £20,480 to enable them to trade points to be eligible to work in the United Kingdom.

The current proposals for new immigration controls risk exacerbating the current social work workforce shortages and, as a result, putting some of the most vulnerable members of our society at risk, as already mentioned. Social care staff play an integral role in the efficient and safe running of the health service, and it is vital that any future immigration system recognises this. We owe our overseas health and social care staff a huge debt of gratitude. We should do all we can to keep these dedicated workers and ensure that there are no barriers to future recruitment.

It is important to grow our domestic workforce to help to meet workforce challenges, and to improve working conditions, pay and training as part of that. However, we must also provide an entry route for overseas staff who want to join such a vital part of a healthcare system that would struggle to cope without them. There is a consensus across healthcare organisations, as well as growing support for the idea from parliamentarians right across the political spectrum, that social care needs a long-term, sustainable solution that includes better funding. In the short to medium term, the immigration system must include a migratory route that meets the needs of the social care sector, which is facing severe challenges. We now need the political will to act and reverse this public policy omission.

I therefore hope that my amendment will be supported. It is supported from outside very strongly—by the Royal College of Nursing, the British Medical Association, UNISON, Independent Age and the Royal College of Physicians. It places a duty on the Government to report on migratory options for health and social care workers ineligible for the skilled-worker route.

The amendment would require the Secretary of State to lay before Parliament a report setting out in detail the options for overseas workers excluded from the skilled-worker scheme, within a period of 30 days beginning on the day on which this Bill is passed. It would need to specify a migratory route for care workers, home workers and healthcare support workers. It is time we recognised the vast contribution of the social care workforce to our community. Showing that there is a migratory route into the UK for them would be a step towards achieving this. They have demonstrated that in low-paid jobs they provide good social care, and even die for us, as shown by Covid-19.

I had not indicated that I intend to divide the Committee today, but I look forward to the Minister’s response and I will reserve my judgment. All I can say is that the support for this amendment outside and from all sides is immense, and I hope the Minister will respond to that.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I shall speak in favour of my Amendment 93. It is obvious that many of the amendments in this group are heading towards the same sort of thing, which is protection for people of all kinds as well as holding the Government to account for what they do. I support several of the amendments that have been spoken to, and I have been moved by some of the speeches from noble Lords.

My amendment is supported by over 50 organisations from all the devolved nations, including the Health and Social Care Alliance Scotland, Macmillan Cancer Support, UNISON and the Association of Camphill Communities. Amendment 93 would require an independent evaluation of the impact of the effects of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill on the health and social care sectors across the UK. This would be made after consulting the Secretary of State for Health and Social Care, the Scottish Ministers, the Welsh Ministers, the relevant Northern Ireland department, service providers, those requiring health and social care service and others. One would hope that this would be automatic with any measure that a Government introduce as they really need to know whether it is working or not.

Proposed new subsection (1) would require the Secretary of State to lay a copy of the report before both Houses of Parliament no later than one year after this Bill is passed. Proposed new subsection (8) would require a Minister of the Crown to make arrangements not later than six months after the report has been laid before Parliament, for the report to be debated and voted on in both Houses.

My amendment is necessary to safeguard the interests of the many people who rely on the contribution of EU citizens and non-EU citizens for the provision of health and social care across the four nations. This of course includes disabled people, children and young people, older people, unpaid carers and those with long-term health conditions. I should perhaps declare an interest in that I am getting older and this might apply to me in a decade or two.

Prior to the UK leaving the EU, a number of studies had highlighted the significant adverse impact of Brexit on the health and social care sectors across the UK. These studies, and the initial information about the points-based immigration system provided in the Home Office’s policy paper, The UK’s Point-Based Immigration System: Policy Statement, suggest that the ending of freedom of movement and the introduction of a points-based immigration system will potentially have a major adverse impact on the health and social care sectors across the UK. I think every speech so far has highlighted that fact.

The proposed independent evaluation that would be introduced by Amendment 93 could play a key role in supporting the health and social care sectors across the UK, helping them to address a range of concern about the proposals. These include concerns that many health and social care workers from other European countries, and from non-European countries, would not meet the proposed income threshold under this system, and that the requirement to have a job offer is unnecessarily restrictive, and will create addition administrative burdens and cost for health and social care organisations trying to recruit staff from abroad. As we have heard, there is a lack of recognition of health and social care specific skills, experience and professional qualifications in the proposed points-based system. As a result, it does not recognise the skills and experience of the workers from across the EU, and from non-EU countries, to enrich health and social care support and services here. Nor does it value the sector and its growing importance as a result of demographic changes.

There is much wrong with the Government’s immigration policy, but health and social care will feel a particularly brutal impact. This independent analysis is required so that the Government can think properly about the needs of health and social care and develop policy accordingly.