Internationally Recruited Health and Social Care Staff: Employment Practices

Andrew Gwynne Excerpts

Wednesday 31st January 2024 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Hosie. I shall begin by congratulating the right hon. Member for Spelthorne (Kwasi Kwarteng) on securing this important debate and on the way in which he opened the debate; it was incredibly insightful and certainly chimed with a number of the issues that have been raised by Members across the House, as well as with the concerns we share about the role of an international workforce and how we look after those people who come to this country to help those in our social care service.

I also thank my friend, the hon. Member for Strangford (Jim Shannon). I know that it is convention to call him “hon. Member”, because he is from a different party, but he is my friend, because—I do not know whether I am stalking him or he is stalking me—we are always at the same debates. He made an important point about how we get workforce planning right across the United Kingdom. I am aware that if, at some stage in the future, I were to have the Minister’s job, it would be very easy to come up with a workforce plan for social care that plugs the gaps in England by pinching staff from Northern Ireland. We have to ensure that, as we go forward with our workforce planning, there are enough people in the social care workforce across the whole of the United Kingdom. We must not create a perverse situation whereby working in social care in England becomes very attractive at the cost of social care in Scotland, Wales or Northern Ireland. We must work together on this journey of upskilling and building a workforce for the future.

Likewise, the hon. Member for Westmorland and Lonsdale (Tim Farron)—I will call him a friend too as we are all friends in this Chamber—made some really important points. He spoke about the challenges—not just workforce challenges but general challenges—in delivering quality social care and other public services in sparsely populated areas such as his constituency in the Lake district, which are linked to other issues that he speaks passionately about in the Chamber, including housing and transport. We need to join up those things if we are to attract the right kind of social care workforce to meet his constituents’ needs.

I disagree profoundly with the desire of the hon. Member for East Dunbartonshire (Amy Callaghan) for Scotland to be separate from the rest of the United Kingdom. I am a proud Unionist. I have Welsh heritage, as my surname, Gwynne, indicates. I am half-Scots, as my first name, Andrew, suggests. My Scottish gran from Lochwinnoch was very adamant that I have a Scottish name. And obviously I am English—I am Mancunian—and proud of that. I see the benefits and the strength that comes from the people of the islands that make up the United Kingdom working together for the common good. I get that under the devolution settlement Scotland has the ability and the responsibility to develop, provide and plan social care services that meet the needs that are particular to the towns, villages and cities in Scotland, but migration is a reserved power. There must therefore be a relationship between the way in which the Scottish Government meet those needs and plan health and social care, and the United Kingdom Government’s wider responsibilities on migration.

We can be in no doubt that we have a workforce crisis in health and care services right across the country. Members have said that there are 152,000 vacancies in social care alone. I have been meeting providers and representatives of local authorities, and they tell me that the challenges are massive. That is why we need a proper grasp of how we build the workforce of tomorrow responsibly. It takes only the opening of a new supermarket in somebody’s area for social care to lose a whole swathe of low-paid workers because they get paid more to stack shelves, so there is something fundamental there.

We are failing to recruit the staff we need, and staff in the services are leaving. That is not sustainable. Our health and care workforce so often represents the best of Britain, going above and beyond to keep us and our loves ones safe. We cannot and must not exclude from that recognition those who come from overseas to support our health and care system. They make huge sacrifices day in, day out, and they deserve our immense gratitude and respect. They must not be used to score political points, as is too often the case.

As we have heard, overseas workers, particularly those in social care, often face very challenging environments and are vulnerable to shoddy employers, so it is vital that we ensure we have a system in which the exploitation of overseas workers is simply not tolerated. Steps must be taken to stop those who perpetrate abuse. That is not only good for them; it is essential if we are to ensure a decent quality of care. That should not detract from recognising that most workers from overseas come here to do legitimate jobs and are employed by legitimate care companies, including some that enjoy high CQC ratings for the quality of care they provide. However, those people still face abuse and exploitation in the workplace.

We must also recognise that the contribution of overseas care workers to our care economy has been, and continues to be, crucial to the functioning of health and social care. We should be deeply grateful; without them, many more care services would have closed in the last few years, leaving thousands without the support they need. Even with their contribution, Age UK estimates that 1.6 million older people in our country have some form of unmet need for care, and because our population is ageing, the demand for care is increasing all the time.

The hon. Member for Westmorland and Lonsdale referred to Beveridge and old age. An ageing population is a massive challenge to this country because of care needs and things such as pensions and the sustainability of the welfare state, but the real challenge in adult social care—this links to the issues related to our ageing population—is that in the past, people born with severe learning or physical disabilities did not live long into adulthood, if at all, and they are now living way into adulthood. Huge cost pressures are building in the system around working-age adults with disabilities, which we also need to address; it is not just about the ageing population.

We need to recruit and retain more care workers to give the sector the workforce it needs to deliver for those needing care, and we will support that. That is why we do not just have a workforce plan for the NHS; we have ensured that we have considered social care as well. The next Labour Government will introduce the first sectoral fair pay agreement in adult social care, which is testimony to the persistent battling of my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), who started her working life as a social care worker. We will ensure that pay, terms and conditions and training and development meet the needs of staff. As part of our 10-year plan for fundamental reform of the sector, which culminates in the creation of a national care service in England, we will ensure that social care is no longer a route for those seeking to abuse overseas staff and fuel the perception of care being the bottom rung of a ladder.

We must make sure that we build a career pathway that incorporates training and has parity with caring responsibilities in the NHS as part of our workforce plan, so that there is more fluidity between the NHS and social care. Somebody who starts off as a nurse should be able to have a career pathway that ultimately leads them to be the chief executive of a major care provider. Why shouldn’t somebody who starts as a social care worker have a career pathway that leads them to be the chief executive of an NHS trust? We can only do that by building a workforce that has some form of parity.

We will ensure that, in future years, comprehensive independent workforce assessments are made, so that NHS and social care staff can keep up with the demands of a growing and ageing population, rather than falling behind. I get so frustrated at the lack of progress on some of these issues. I know the Minister is trying her best, but for too long, under too many different Governments, social care has been seen as that lean-to, as the hon. Member for Westmorland and Lonsdale put it. It is time that we have a Government committed to fixing social care and to developing the services we need, built around the needs of the people who require social care services, and it is time that we have a workforce plan that drives up quality, ensures career progression and fills those gaps. We need that general election—the country is crying out for change after 14 years of this Tory Government delivering an NHS and social care system that is broken. It is time to fix that broken system—it is time for Labour.