Brexit – and the Prime Minister – are currently at their most tumultuous point to date. While Theresa May faces a vote of no confidence this evening, the final decision on how the UK leaves the EU is in severe jeopardy. Yet regardless of who steps up to the podium to lead the UK, the final Withdrawal Plan must reach Parliament’s approval. Without doing so, the UK faces departing from the EU without a deal come March 2019, rousing further concern over what is already an unprecedented staffing crisis for the NHS and the UK’s care sector.
Care workers in shortage
The Institute for Public Policy Research (IPPR) thinktank claims that care workers are “exploited” by working “excessive hours” on insecure pay and job contracts.
Years of austerity cuts and “chronic underfunding” to public spending has resulted in stifled and unrewarding pay for carers who work tirelessly around the clock. According to the IPPR, carers should receive the living wage of £10.55 an hour in London and £9.00 an hour for carers working outside of the capital which is a significant rise from the current £7.76 average hourly rate the Care Workers Charity has found.
The pay problem is a growing issue in the care worker community. Low pay coupled with increasingly poor working conditions are driving valuable workers away and, despite a growing demand for workers in the sector, near 900 carers quit their jobs a day between 2015-16. Three years later and little has improved for the industry: thousands of carers took to the streets in Glasgow to protest against years of unresolved disputes over equal pay just this October.
As a result of severe budget cuts and stifled, stagnant pay, rota gaps are common and staff are stretched so thinly that patient care and the quality of care is suffering. Staffing shortages across the NHS are now so dire that the NHS is being described as in the midst of a “national emergency”. The Office of National Statistics estimate the 1.34 million adult social care workforce is in shortage of 90,000 members of staff – a vacancy rate three times higher than the UK’s labour market average. However, with the number of over 85s requiring 24-hour care expected to double to near half a million by 2035, recruiters are becoming concerned for the future.
Increasing the Immigration Health Surcharge
In a bid to tackle underfunding and gaping holes in the NHS’ budget, the Home Office announced that the current Immigration Health Surcharge imposed upon migrants when applying for entry into the UK will double beginning this December. The charge is implemented for migrants so that they are medically covered throughout their time in the UK and will receive treatment in the same way as UK citizens. Although the charge is publicised at an increase from £200 to £400, for migrants on a Tier 2 Visa lasting five years, the charge has increased from £1,000 to £2,000. According to the UK government, the Immigration Health Surcharge has brought in over £600 million to the economy since it began in 2015 while the doubled amount is expected to bring in a further £220 million.
The impact of Brexit and visas
Exacerbating an already underfunded and short-staffed industry, the UK government have confirmed that EU citizens will no longer “jump the queue” to enter the UK after Brexit. This means that carers who are EU nationals will also need to apply for a Tier 2 Work Visa and, unlike doctors and nurses who are featured on the UK’s Shortage Occupation List, receive no financial aid and no visa discounts when applying.
According to Skills for Care, currently 104,000 workers originate from the EU while a further 130,000 hold a non-EU nationality. However, after Brexit, many carers would be ineligible to work in the UK since many will fall short of the £30,000 a year minimum income threshold. Even those who do bypass the salary requirement, Tier 2 visas are capped annually at 20,700 total per year. This means that not only will EU carers face forking out thousands in visa fees and the doubled Immigration Health Surcharge, but they could be refused altogether based on their salary or the cap already being reached. If the UK government decides to restrict its access to European talent pools, experts predict the care industry could be in shortage of 380,000 workers by 2026.
The UK government still has time to implement an alternative immigration system for EU settlers and workers. For the IPPR, this would mean putting social care workers on the UK’s Shortage Occupation List as this would incentivise care roles in the UK. However, much more is needed to aid the growing crisis. Not only would a pay increase be welcomed in keeping the industry afloat, but dropping the increased charge alongside a revised immigration plan for EU migrants after Brexit are both also desperately needed. Without these changes, critics warn that the mountainous paperwork and high visa fees – now coupled with the doubled health surcharge – will only deter social care providers from taking up a job in the UK entirely impacting on rota gaps, growing staff shortages and even patients’ quality of care.