Care work is undervalued and underfunded. But this has nothing to do with immigration


After more than three years of speculation, the immigration proposals are finally out. The government calls it ‘a firm and fair points-based system’. Effective from 1 January 2021, the policy is aimed at reducing immigration and at boosting skills through training and automation. Points are heavily weighted towards intermediate and higher level qualifications and above average salary levels.

The points-based formula works against occupations and sectors where formal skill requirements are lower and where the proportion of migrants is high. The social care sector, where personal qualities are valued over formal qualifications, faces a particular challenge. With the sector unattractive to British workers, labour shortages are inevitable. The government has refused to make provision for the sector in its proposals, on the grounds that migration is not the answer to its staffing difficulties. At the same time it shows no signs of addressing these, which stem of chronic and long-term under-funding and failure to invest in qualifications, training and progression.

Underpaid is not unskilled

To score the magic number of 70 points, applicants need to combine essential ‘non-tradeable’ points with ‘tradeable’ ones. All applicants will need to have a job offer. The offer must be at the required skill level and they must be able to speak English. This combination scores them 50 points. To gain the other 20 they must take a job at the minimum salary threshold of £25,600, or lower if in a shortage occupation, yet to be defined.

But crucially for sectors like social care, whatever combination a prospective migrant can assemble, there is no way round the requirement to take job at an ‘appropriate skill level’ – it’s ‘non-tradeable’. It is currently set at level 3, equivalent to A-level, which currently applies to few jobs in social care.

The realisation that this requirement will prevent international recruitment to social care unleashed a justified social media outcry. Care workers, the cared for and their families praised the high level of technical and personal skills needed to care for people with complex needs, including the elderly and frail.

Narrow associations of skill with formal qualifications and pay, typically used by economists, just don’t work for the public – who value migration for work that is socially useful, rather than just for highly skilled roles. And in sectors like social care they often don’t work for employers either. In social care there is no formal qualification requirement and employers place strong value on experience and aptitude. They look for qualities such as communication skills, kindness, patience, honesty, trust, reliability, respect and above all a caring nature. These are built into guidance from the Care Quality Commission and they are all qualities we want to see in those who care for us and our loved ones. The problem is their value in neither reflected in formal qualifications or in pay. This is the result of entrenched sexism in the recognition of skills, the failure of successive governments to support regulation of social care and chronic underfunding of the sector.

Who can step in to social care?

The social care sector employs 1.49 million people, around 17% of whom are from outside the UK and 40% in London. According to the Kings Fund, workforce shortages currently stand at around 122,000. Research carried out in 2018 found that providers were already experiencing greater difficulty recruiting from within and outside the UK, having to extend the recruitment net ever further internationally.

The policy paper suggests that other migration routes might meet the needs of ‘lower skilled’ sectors, for example spouse visas connected with skilled workers and young people on youth mobility visas. Neither of these is likely to draw sufficient numbers into care homes. The sector needs motivated and experienced people, not students on a gap year. The paper also suggests that future vacancies could be filled by some of the 3 million plus EU migrants who have applied to settle. But if they’re not in social care now, it doesn’t seem likely that many will make that move.

The Home Secretary Priti Patel has argued that there are more than 8 million inactive people who could take jobs left vacant when free movement ends. Yet 2.3 million are students, 1.9 million are caring for children or relatives and 1.1 million are retired. More than one in four are long-term sick. Many of these supposedly available people are either already providing informal care or receiving the services of social care themselves.

The sector is unattractive to British workers because of a combination of pay, hours and the nature of the work. Migrants are less deterred by these drawbacks, often more able to flex their hours up or down, and are using social care work to gain a toehold in the UK labour market or as a stepping stone to other jobs. And employers report that migrants quite often have qualifications and experience in areas allied to care work, including nursing, but their qualifications are not recognised. Yet all of this will count for nothing under the new policy, which is based on the qualification of the job, not the person.

It might be argued that more motivated, higher quality workers would be attracted to the sector and also work longer hours if pay were increased, but the funding of social care prohibits pay increases of the size that would make a difference. Social care relies on local authority funding from national government on a per-case basis. According to the Local Government Association, adult social care now consumes almost 40 per cent of council budgets and faces a shortfall in funding of £3.5bn by 2025. With their funding cut to the bone, providers have very limited capacity to increase wages. Employers report difficulties paying even the National Minimum Wage.

Cutting off immigration won’t solve the social care sector’s problems

The policy paper argues that:

‘We need to shift the focus of our economy away from a reliance on cheap labour from Europe and instead concentrate on investment in technology and automation. Employers need to adjust.’

Technology and automation are not what the care sector needs. Old and sick people don’t want to be cared for by robots. The sector needs to attract skilled, capable and motivated people who take a professional approach to their work. For that to happen, the government needs to invest properly in infrastructure to regulate and professionalise social care. In particular, routes need to be opened from social care into nursing and other healthcare professional roles. But to cut off a vital supply of workers to the sector before these problems are addressed would mean the sector, and most importantly people who need social care, could cease to function.

The new policy involves using immigration restrictions to address problems which have nothing to do with reliance on overseas workers. The government’s aim of turning the UK into a higher-paid, higher-skilled and more productive economy won’t happen through keeping out migrants. Care work needs to be properly resourced, not automated. The skills of care work need formal recognition and form part of systematic training and progression. The fact that this hasn’t happened has nothing to do with immigration.

This blog was first published by LSE Brexit.