When Adam Smith wrote his books on economics and society where he identified the effects of people actions that could be either beneficial or detrimental, he couldn’t have possibly envisioned Brexit and the situation in which both the UK and Europe now find themselves. Were he to fast forward to 2019 he would be perfectly justified in saying “I did tell you this might happen; you should have read my books”.
Many events turn out very differently from what was intended and couldn’t have been foreseen but that certainly isn’t the case with Brexit. Neither the right nor the left, obsessed as they were with what they believed to be the larger questions, as they saw them, of sovereignty and an ever-expanding overarching and authoritarian superstate on the one hand, and quasi-fascist, xenophobic and racist nationalism on the other, paid very much, if any, attention to what was going to happen in terms of the changes to the everyday lives of people. The rest of us, who actually have to deal with the day to day effects of leaving the EU, are now facing and dealing with these “consequences” one of which is staff for the NHS and caring for the elderly and long term sick and disabled.
It is a myth that we have always relied on foreign-born staff to run our health services. Traditionally this country had an extensive recruitment and training programme of nurses and other paramedic staff. What happened was that, gradually, as the economy improved rapidly after the Second World War, nursing and the ancillary professions became less attractive for a variety of reasons some of which were unsociable hours, lower than average wages and the often demanding task of dealing with the sick and dying.
Even before our entry into the EU nursing and care staff were arriving in this country to plug the leaks opened up by an ever-expanding NHS and care sector and an increasing unwillingness of young Brits to enter those fields. And it wasn’t just the EU that kept the boat afloat, countries like The Philippines and India have created a whole industry to train medical staff for export. This was then followed, if unintentionally, by countries whose economies were failing and who needed the foreign remittances that were provided by the doctors and nurses they had trained. What we face now though is something totally different. Besides the need for all EU staff, who previously had the right to enter without restriction, now losing that privilege, we now have yet another hurdle for all to jump.
In response to various loopholes in the raft of immigration legislation on the statute books, the barriers to entry into this country have been both raised and made more difficult by, amongst other things, the lower limit on earnings of £30 000. How this figure was arrived at is a mystery but it would seem to be a completely arbitrary one based on a figure grabbed from thin air. What may have been brought in to prevent spurious marriages and employment, and worked in that respect, is now a serious barrier to the employment of a whole range of indispensable NHS and care staff and urgently needs to be reviewed.
In the Evening Standard (13TH Feb 2019) an article drew attention to this approaching crisis and stressed the £30K limit should be reviewed by the Home Secretary. The response was predictable waffle. A government spokesman apparently said “We hugely value the contribution of the 104,000 EU national in social care jobs and we want them to stay working here in the UK after we leave the EU. The Government is now consulting on the measures that were recommended in the Immigration White Paper, asking for options on the salary threshold”. In other words, we’re not going to do anything until it’s too late and when there is a real crisis we’ll muddle through.
This isn’t rocket science, or is it? In the short term, we need to create or rather re-create the visa scheme that had always existed for skilled workers in the health care sector before the free movement of the EU. Under that scheme, we saw people from Spain, Portugal, Greece and other European countries living and working in the UK. Then, simply reduce the lower limit of earnings to, say, £20,000 which would bring thousands of skilled health professionals under the earnings umbrella. There is however one last paragraph in The Evening Standard article which brings us back to where we started and the title of this article.
The writer of the article, Nicholas Cecil, says this and it should give cause for concern. “An extra 650,000 more social care workers will be needed by 2035 due to an ageing population”. Think about that in yearly incremental terms from now and take into account all of the other factors such as their families, where those families will live, go to school and work, and it’s not too long before the Law kicks in. A back of the envelope calculation is up to two and a half million more people merely to stand still. We have to do something.
In the longer term the answer is simple and staring the politicians in the face, train the young school leaving population of this country in the caring professions. At the moment caring is regarded as unskilled and menial work when in fact it is complicated and demanding. As a matter of urgency, a future Labour government should create a professional body for the recruitment and training of care workers. This training scheme can be based on the existing health authority network for simplicity of administration and will be responsible for the training and licencing of all future care workers. This will apply to all non-UK workers in the same way that nursing standards do. The object is to raise the status of the caring professions to that of State Registered Nurse and to do so with three to five years.
The present system of partial or full privatisation can never accomplish this, so one of the tasks of a Labour government will be to restructure the whole service, bringing most of what has been outsourced back in the house but especially the Care Sector. The situation is serious and there isn’t much time to fill a gap that is already beginning to appear. As the former Communist satellites of Eastern Europe, Poland being a prime example, begin to raise their standards of living and prosper, their younger citizens will no longer want the jobs they formerly filled in construction and care. We are facing a staffing crisis of huge proportions but no one can use the excuse when it happens that we weren’t warned.