Boris Johnson’s plans for fast-track “NHS visas” will do nothing to head off an impending post-Brexit staffing crisis which threatens to cripple social care in the UK, with catastrophic consequences for hospitals and other services, health chiefs have warned.
The Independent has obtained a document written by NHS Employers, the organisation responsible for recruitment across the entire health service, in response to a consultation on government immigration proposals due to come into force by 2021.
It sets out strong opposition to the Home Office’s planned points-based immigration system and new salary thresholds, pointing out many social care staff earn as little as half the proposed minimum of £30,000 per annum needed to obtain entry to the UK.
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Mr Johnson’s announcement this week of the so-called NHS visa was explicitly intended to address fears that the health service will struggle to attract the staff it needs from abroad post-Brexit. Under the scheme, the cost of a visa application for health professionals would be halved from £928 to £464 and a decision would be guaranteed within two weeks. Applicants coming to work in the NHS would receive preferential treatment with extra points under the points-based system, and no cap would be placed on numbers entering through the NHS route.
However, it makes no provision for people working in social care – prompting NHS and care leaders to call for an urgent rethink to avoid devastating consequences for vulnerable people.
The NHS Employers consultation response warns that if the social care sector is prevented from attracting staff, the NHS will face knock-on effects as elderly patients are taken to A&E as a last resort, or end up stuck on wards unable to go home.
One senior national NHS leader told The Independent: “We are all agreed that social care is the biggest risk to the NHS and the biggest risk to the health and welfare of the country.”
The government’s new immigration rules were described as “naive and deluded” by Nadra Ahmed, the executive chair of the National Care Association, who told The Independent: “This exclusion of social care in the visa announcement feels like a deliberate act of sabotage from government.
“It epitomises the lack of will to address the issue that is staring everyone in the face. It’s not rocket science to realise the social care sector will be impacted in a way that is unrecoverable if these proposals are not moderated.
“It will mean acute medical care will be compromised because hospitals will be caring for people stuck in hospital beds when they could be at home.
“The needs of vulnerable people will go undetected and people will have to go without care.”
The document has been sent to the Migration Advisory Committee, which was asked to review the government’s proposals in time for them to come into force by January 2021.
Ministers want a £30,000 salary threshold and tougher visa requirements for overseas workers once the UK has left the EU and free movement has come to an end. They also want migrants to be earning £35,800 after five years.
If this is imposed, NHS Employers chief executive Danny Mortimer warned in the document that social care jobs “simply don’t attract the levels of pay required” and the new system would “would cut off overseas care worker supply”.
He added this would be “[to] the detriment of the NHS, impeding patient flow and adding further strain to services and staff”.
The median hourly wage for an adult social care worker in March this year was about £8.10 an hour, equivalent to a salary of just over £16,000, but a quarter of staff were paid even less at just £7.83.
The adult social care sector, which includes home care for elderly and vulnerable people, already has about 122,000 vacancies and is heavily reliant on EU and non-EU workers.
The latest statistics suggest about 134,000 staff working in adult social care are from outside the EU, about 9 per cent of the workforce.
NHS Employers said the government should abandon an arbitrary salary threshold and instead use existing NHS pay scales for a points-based system.
Alternatively, it said the government should recognise the social value of roles such as care staff.
Councillor Kevin Bentley, chair of the Local Government Association’s Brexit taskforce, told The Independent social care was “now one of the sectors most vulnerable to changes in migration rules”.
“The next government needs to bring forward substantive proposals for the future of adult social care as soon as possible, to reassure all those who use and work in this vital service,” he added.
A Home Office spokesperson said: “The UK immigration system is designed to help attract the brightest and best talent from around the world.
“In June 2019, the Home Office asked the independent Migration Advisory Committee (MAC) to advise on potential future salary thresholds in the context of the future system, including how thresholds could be calculated, the levels of salary thresholds and whether there is a case for regional variation across the UK and exceptions.
“The MAC is expected to report back in January 2020.”
