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

Baroness Masham of Ilton Excerpts

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

[Baroness Hamwee (LD) [V]]

My Lords, my noble friend Lady Brinton has her name to the amendment moved by the noble Lord, Lord Hunt, which we support. My noble friend is indisposed at present, but I know that she will be here in spirit. I start by saying to the Minister that I will try not to moan. I generally try not to moan. It is reasonable for her to refer a Member of the House to GOV.UK; my point was that most of the public would be bemused by the reference. I think I can see on my screen that she is nodding.

There was enthusiasm for tabling amendments quickly after Second Reading, especially on what were particularly topical issues. A health and social care visa was one such. It remains topical, as does the whole operation of the social care sector, even though it is not in the headlines quite so much. I have spoken about immigration arrangements being in the rules. The scheme set out in our Amendment 47 may not be ideal—I confess I do not think it is—but it is about pinning down the arrangements into primary legislation to make them not too easy to amend.

My noble friend Lady Brinton and I also have our names to Amendment 57, on a social care visa. Many of your Lordships will have direct experience of the work of those in social care and share what the noble Lord, Lord Hunt, has talked of—the importance of proper payment reflecting the level of skill, which is very significant. As it happens, I cannot praise too much someone who recently cared for a close relative. She came from Romania.

The essential core skills are not ones that can be trained into anyone; there are the practical, technical aspects of care, but you cannot train someone to care as part of their personality. They either have it or they do not. That is why so many carers, little supported, are people who look after their spouses, children or parents at home. I mention this because, last time I mentioned care at home, the Minister thought I meant domiciliary care. That is part of the subject matter of the amendment, but I depart from the scope of the Bill for a moment to recognise the dedication and sheer hard work that family members undertake, which is inadequately recognised. Other noble Lords in the debate may know how much, in pounds and pence, that work saves the state.

The noble Baroness, Lady Masham, will explain the importance of her proposal in Amendment 66. I simply say that my noble friend Lady Thomas of Winchester added her name to that amendment, and she is very sorry that she cannot take part in today’s proceedings.

Also in the group is Amendment 82 of the noble Lord, Lord Patel, which I thought was interesting. Some of us leap in; calmer heads propose an analysis of the issue. I suspect that will not preclude some pithy points in support of progressing with analysis.

[Baroness Masham of Ilton (CB) [V]]

My Lords, Amendment 66 would provide for the creation of a fast-track health and social care visa for EEA and Swiss nationals who provide personal care for severely disabled people, after the end of free movement. The visa would be limited to EEA and Swiss nationals who, immediately prior to the commencement of Clause 1 and Schedule 1, had the right of free movement into the UK.

Subsection (1) of my proposed new clause says:

“The Secretary of State must provide by regulations made by statutory instrument for the introduction of a fast-track health and social care visa for a relevant person who provides personal care for severely disabled people in the United Kingdom.”


Subsection (2) defines “fast-track” and “relevant person”:

“In this section, ‘fast-track’ means processed by UK Visas and Immigration within three weeks from the day on which the applicant provides their biometric information, and ‘relevant person’ means an EEA or Swiss national who immediately prior to the commencement of section 1 and Schedule 1 had the right of free movement into the United Kingdom.”


The proposed new clause would provide for the introduction of a fast-track health and social care visa for a person who provides personal care for severely disabled people. The visa would be limited to EEA or Swiss nationals who, immediately prior to the commencement of Clause 1 and Schedule 1, had the right of free movement into the UK. This is a probing amendment to see what consideration the Government have given to extending their new health and social care visa to persons who provide personal care for severely disabled people in the United Kingdom.

In July, the Home Secretary and Secretary of State for Health and Social Care announced that a

“new Health and Care Visa will be launched this Summer, creating a new fast-track visa route for eligible health and care professionals and delivering on a key manifesto commitment.”

However, the Government have been criticised for excluding care workers from being able to apply for visas designed to fast-track those coming to the UK to work in the health and care sector.

On 13 July, the Home Office released details of the UK points-based immigration system, which will come into effect from 1 January 2021. Under the new system, the health and care visa will allow people working in eligible occupations, who speak English and have a job offer, to come to the UK. Under this visa route, workers and their families will gain fast-track entry to the UK, with reduced application fees and dedicated support, the Government said. Those who are eligible to apply and their dependants will also be exempt from paying the immigration health surcharge—a move that has been welcomed by doctors. But applicants must meet a salary threshold of £25,600, which is €28,200 or $32,000, to be eligible to apply for the visa, unless they are entering a shortage occupation, such as nursing and medicine. The NHS workers’ union, GMB, said that this threshold would mean that many NHS cleaners, porters and support staff will not qualify for the visa.

The Government have faced a backlash because social care workers are not eligible to apply for the visa, although the Migration Advisory Committee, on whose advice much of the new system is based, recognised the workforce shortage faced by social care in its most recent report and did not recommend that care workers be added to the list of shortage occupations. I cannot understand this. Perhaps the Government can tell us why. Instead, the committee said that it hoped the Government’s forthcoming Green Paper on social care would provide more clarity on the future of the sector in the UK and contain concrete proposals to improve terms and conditions for care workers. Waiting is not acceptable. There is a crisis.

Critics have said that the exclusion of care home staff from a post-Brexit, fast-track visa system for health workers could prove to be an unmitigated disaster and may increase the risk of spreading coronavirus. Professor Martin Green, the chief executive of Care England, which represents the largest private providers, has said that the decision amid the pandemic in which 20,000 people have died in UK care homes has the potential to destabilise the sector even further, with disastrous consequences, confirming that there could be no special treatment for carers coming to the UK from the rest of the world.

The Government have said that they hope that Britons will fill the shortfall of around 20,000 workers, equating to 10% of all posts. Currently, 17% of care jobs are filled by foreign citizens. In the debate on Second Reading, I drew attention to this when I said:

“There is a danger that people who cannot get work of their choice are pushed into doing care work, with such horrifying results as happened at Whorlton Hall near Barnard Castle, Thors Park in Essex and Winterbourne View near Bristol, where patients were abused and bullied. This cruelty was exposed by ‘Panorama’. We must surely try to prevent this sort of thing happening again. I hope the Government will listen before it is too late.” —[Official Report, 22/7/20; col. 2251.]


The health and care visa has been designed to attract the brightest and best from around the world. It has been criticised for excluding front-line care home workers and contractors. It has been pointed out that the minimum salary threshold means that many cleaners, porters and other support staff will not qualify. This will discriminate against severely disabled people living in their own home who need paid carers. The Government are discriminating against any care workers.

Vic Rayner, the executive director of the National Care Forum, has said that in London, where around 38% of care workers are non-British, the policy could be “an unmitigated disaster.” She said:

“‘We have 122,000 vacancies, growing demand for our services, and then the tap is turned off like this … It is not good news at all. What you need for good care is a stable, skilled and plentiful workforce. And in the context of Covid-19, where you are trying to minimise movement of staff, any shortages might increase movement of staff and use of agency staff, which we are trying to avoid.’”


Robin Hall, the secretary of the Hampshire Care Association, has said that a shallower pool from which to recruit could drive up wages, which, without greater public funding, would mean fewer staff employed per resident. She said:

“‘That will damage the quality of care we can deliver … You also may have to get less choosy about who you employ, and that’s a dreadful thought. A lot of our EU staff are highly skilled. They are smart, articulate and speak three or four languages. We don’t get that quality of applicants from the UK because of the status the profession has.’”


With the advances in medical treatment made over the years, many severely disabled people are living in the community in their own home. Many of them need live-in or daily carers. We also have an increasing elderly population. A bright young man called David who broke his neck in a rugby accident and was paralysed from the neck down had been cared for by his mother. As she got older, her arthritis became worse. David was fearful that he might end up in a care home, which was something he could not accept. David lived in a comfortable bungalow with a garden and a lily pond. One day he was found drowned in that pond. In desperation, he had driven his electric wheelchair into it to end his life. Surely we do not want more cases like that.

Good care workers who work in people’s homes must be dedicated to the job, get satisfaction from it, be honest, skilled, compassionate and flexible. Caring for severely disabled people is not for everyone, but those who undertake these positions are special and they should be valued, not treated as “also rans”.

I look forward to hearing the Minister’s comments on Amendment 66, and I hope that it will be taken seriously.