29/1/2020

Today, I found myself identifying with the childhood figure, Anne of Green Gables, and her potent metaphor for disappointment, namely:

‘My life is a perfect graveyard of buried hopes’

This funeral fog descended following the publication of the Migration Advisory Committee (MAC) advisory report on a new immigration system for the UK. Why the gloom? Well, for those who have seen the headlines the report does little (generous) or nothing (realistic) to support the social care workforce.

The social care workforce is in crisis. This is not a word that I would use lightly, but for any sector holding a vacancy level on any day of 122K, with a predicated growth requirement of between 580K and 800K by 2035 (dependant on demographic assumptions) then crisis seems an appropriate term.

How does the crisis manifest itself? Well it is a mix, but includes very high levels of turnover, challenging recruitment, overuse of agency staff and on occasion, closure of services.

It is against this backdrop that the MAC report recommends a salary threshold (albeit reduced in some circumstances to £25,600) that exceeds the annual salary expectations of almost all who offer frontline roles in social care, thereby effectively closing the door for care workers from outside the UK. The MAC accepts that it’s pronouncements on the immigration system will do nothing to alleviate the current pressure on the social care workforce, and in fact is likely to increase it. In addition the MAC report advises that the impact of the almost inevitable further reduction on the numbers of staff working in the care sector who are from outside the UK is likely to have a knock on impact in other areas of the economy, as the provision of care services are restricted due to workforce shortage, causing others to leave their jobs to care. In its calculations it also predicts that any potential gains brought about by reductions in demand in public services caused by immigration control, will be eclipsed by reductions in the workforce. Thereby causing further pressure on a sector which the MAC themselves recognise as an area ‘they have often singled out as being of particular concern’.

Care Minister, Caroline Dinenage, stated in May last year that:

 “Our adult social care staff deserve to be recognised and feel valued for the incredible, life-changing work they do, and I know that this isn’t always the case.”

It most certainly doesn’t feel like the case in this report, where it continues to categorise the role of frontline care as ‘low skilled’- a phrase which can only reflect the lack of understanding of the everyday complexity of the situations that care staff face.  The conflation of low pay with low skill is an insult to those care staff out there 24/7 – every single day of the year.

The MAC’s assertion that to lower the threshold further would be ‘perverse’ presents an important perspective on the need to drive upward salaries in roles where there are shortages, be that through immigration or otherwise. I agree, however, this does not reflect a reality where the core source of funding for the salaries in social care is through a commissioned income stream which has made real term cuts of £7bn over the last 9 years.

The MAC squarely acknowledges that reality facing the social care sector, by stating:

“We remain of the view that the very real problems in this sector are caused by a failure to offer competitive terms and conditions, something that is itself caused by a failure to have a sustainable funding model.”

 However, it feels as if the MAC has pointed the government towards an open goal in which to lob the long-range promise of reform. Its recommendations have denied the sector an opportunity to address the immediate and real issues around staff shortages that it faces by issuing a stern note to the government to deal with the funding of the sector. Stalwart watchers of the reform agenda will note that the current government is nigh on three years behind in its attempt to address this piece of homework!

The Conservative manifesto said cross sector talks are promised, the Queen’s speech said reforms would be brought forward in due course, Boris Johnson said on the steps of Downing Street that he will ‘Fix social care’ …….However, in the absence of anything concrete appearing any day soon – I think I am going to keep on digging in the expectation that there will be plenty more hopes to bury….. #53daysandcounting.

Follow Vic on Twitter – @vicrayner