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

Lord Patel Excerpts

Report stage & Report stage (Hansard): House of Lords & Report: 1st sitting & Report: 1st sitting: House of Lords
Wednesday 30th September 2020 Lords Chamber

[Lord Patel (CB) [V]]

My Lords, I am pleased to have added my name to this amendment in the name of the noble Lord, Lord Rosser. The greatest risk identified for health and social care in the House of Lords report The Long-term Sustainability of the NHS and Adult Social Care was the need for long-term funding arrangements for social care and, importantly, for an appropriately trained workforce for the NHS and social care. As far as social care is concerned, the Government have not addressed either, and more than three years have passed since the publication of the report. The result is that more care homes are closed and there is a massive shortage of care home staff, as has already been mentioned.

As a nation, we are getting to a point where “shameful” is the only word that can describe our failure to look after our old and frail. The pandemic has brought hardship and pain to all our citizens, but the elderly in our care homes have paid a heavy price: 30,500 excess deaths among care home residents and 4,400 more among those receiving care at home. We have failed them in many ways. We have exposed them to greater risk from the virus, we did not protect the few staff looking after them and we did not recognise their increased risk from the virus. It seems that the only people who stood by them were nurses and poorly paid care staff, the majority of whom are from overseas.

ONS figures show that social care workers are at highest risk of Covid-19 mortality. Shamefully, the United Kingdom ranks number two in the world, after Russia, for the number of deaths among healthcare workers, and the majority of them worked in social care. Some of the poorly paid and so-called unskilled paid with their lives. Many of them were not citizens of our country. We saw on our televisions poorly paid staff, many from European and other countries, working in crowded nursing homes and living in tents in the back gardens of nursing homes so that they could isolate and protect our elderly and vulnerable, who were also isolated from their families and friends.

It is estimated that we have a shortfall of approximately 122,000 care workers. So what are we saying to these dedicated, hard-working people who want to come and willingly look after our most vulnerable? We are saying, “When your visa runs out, we want you to go back to where you came from. We don’t want any more of you to come. You will not meet the unrealistic criteria we set for salaries, and the visa and health charges will be unaffordable for you as these are now our new rules. Besides, we are going to have mass unemployment, and we are going to ask all those unemployed to staff our care homes and look after our elderly. We don’t recognise that it is a task that requires some skills, compassion and a caring attitude or a feeling of vocation, as you do.”

It is time for the Home Office to review the current proposals, which do not provide a migratory route for care workers. This is a modest amendment, in that it asks for a review. All it asks is that the Government produce evidence of the impact of the legislation on the social care workforce and social care. I strongly support it, and I hope that many others will do so. It is about people whom we need—those who want the opportunity to provide compassionate care for the elderly and the frail.

I know that my namesake leads the Home Office, and we know each other, but I say to her, “Priti, on this occasion, I do not agree with you”.

[The Lord Bishop of Durham [V]]

My Lords, I speak in support of Amendment 3. First, I draw attention to my interest, as recorded in the register, of receiving support from the Refugee, Asylum and Migration Policy project.

In Committee, I spoke to an amendment that would facilitate the immigration of highly skilled people who had been forcibly displaced by war or persecution. I am glad that the Government have responded positively to that proposal, which others in this place spoke in support of.

I thank the Minister for the helpful and productive meeting that I had with her and her colleague, the Immigration Minister. I was joined by Talent Beyond Boundaries and Fragomen. I hope that she will be willing to place on the record today the Government’s commitment to developing a pilot for health workers, possibly in the education and business sectors. I and others here who are interested will be keen for her to update the House on progress in due course. Following that positive meeting and the promises made at it, I have not pressed the amendment that I tabled in Committee because of the Government’s constructive willingness to further develop the proposal, which applies to the health and social care area.

The Government, rightly, are keen to welcome those who wish to come here with the skills to support themselves and whom businesses in the UK are ready to employ. I am therefore puzzled that social care seems not to receive the attention in immigration policy that it should.

We all know that the average pay of care workers is not high. Indeed, the figures that I have seen suggest that it is typically around £17,000 per annum. This means that such workers will not qualify for a work visa, even with a reduced salary threshold. I know that the Government wish to encourage employers to increase salaries and train domestic workers, rather than allow migration to be used as a shortcut or cost-saving measure. That is welcome, although of course it will require the Minister and her colleagues to have stern conversations with their colleagues in other departments about the necessity for a better-funded care system. Such a system will also need radically better joint working between health and social care, as highlighted, for example, in the 2016 King’s Fund report, Supporting Integration Through New Roles and Working Across Boundaries.

The Migration Advisory Committee is surely right that over the long term the solution to our care crisis lies in raising wages to attract more domestic workers, rather than using migrant workers to plug the gap. Nevertheless, the MAC was also surely right to point out this week that the cliff edge of ending free movement in the middle of a global pandemic, in which care workers are very much on the front line of safeguarding our most vulnerable neighbours, friends and family, will very much increase the pressure on the system, as the MAC puts it.

Those of us who support the amendment hardly support low wages for key workers—far from it. I believe strongly in a real living wage above the national minimum wage and in care workers being appropriately recognised and rewarded for their vital work. We are concerned that the blunt treatment of social care in the new immigration system poses significant systemic problems that could include staff shortages. The impact of those shortages will be felt by the most vulnerable in our society who rely on social care. They deserve better than “fingers crossed”, which is, I am afraid, the impression that we are left with of the current approach.

I am not unused to working within institutions with byzantine processes—I am a bishop of the Church of England, for goodness’ sake, as well as in this place. Therefore, I have some sympathy with the Government’s desire to simplify the immigration system and to resist a proliferation of special routes for particular circumstances, yet simplification is not a virtue if it becomes inflexibility or bluntness in the application of rules that will exclude from coming to the UK the very people our care sector most urgently requires. The creation of a health and care visa has, of course, been welcome news, but I know that my puzzlement that social care appears not to be adequately included is shared by others.

The amendment strikes me as modest but important. It places on the Government merely a duty to publish an independent assessment of the impact of ending free movement on the social are sector. Since international workers account for one-sixth of care workers in England, we would have to be dangerously incurious not to want to know the impact that the biggest change in immigration policy in a generation has on a sector that cares for the most vulnerable among us. Such reports as we have had already from the MAC and others only confirm that there is a knotty problem still to unravel in this tangle of issues about chronic low pay and an unnecessary reliance on skilled migrant carers. I will therefore support the amendment.