Dog whistle politics won’t solve the staffing crisis

The chronic shortage of suitable staff across both health and social care is causing providers significant and growing problems.

The government’s proposals to introduce a points-based immigration system have left many in the care industry frankly aghast (see page 13). The Independent Care Group’s chair, Mike Padgham is particularly candid. “This [points system] would be a devastating blow for social care and would lead to hundreds of thousands more people not getting the care they need,” he warns in stark terms.

The truth of the matter, however unpalatable, is that the Leave vote was substantially motivated by many British people’s desire to reduce immigration. Despite the evidence being against them, they feared large numbers of EU nationals were flooding into the country unchecked, taking jobs and overwhelming public services.

Mr Johnson and Ms Patel are now keen to capitalise on those fears and have produced proposals designed to allay them, however unjustified they turn out to be.

But another truth is that the UK’s health and care sector has relied on an overseas workforce for decades. 

In 1949 the Ministries of Health and 

Labour, in conjunction with the Colonial Office, the General Nursing Council and the Royal College of Nursing recruited large numbers of nurses, cleaners and other health staff directly from the Caribbean. 

In the 1950s and 1960s, Irish and Caribbean nurses were essential to the expansion of the sector, a pattern that was replicated in the early 2000s when nurses from Africa, India and the Philippines were recruited. 

A 2003 report revealed that nearly a third of NHS doctors were foreign-born and that more than 40% of nurses recruited after 1999 were born outside the UK.

But the effect of the Brexit referendum was swift and dramatic. The percentage of nurses from the EU joining the NHS fell from 19% in 2015-16 to 12.4% in 2016-17, then further to 7.9% in 2017-18 and 7.6% in 2018-19. 

It is possible that this vertiginous fall prior to any actual immigration restrictions being put in place is attributable to a perception that the UK is no longer a particularly welcoming place.

While restoring the student nurse grant and making social care a more rewarding profession will go some to way to replacing the shortfall with a homegrown workforce, we must also make it clear that we still value all those who wish to contribute to our society and play a role in providing the very best care our citizens deserve.

The dog whistle of blanket anti-immigration politics has no role to play in helping us achieve that goal. 

Time for unity

The coronavirus, or covid-19 to use the WHO designation, is wreaking havoc across the globe. The independent healthcare sector in the UK is making a considered response to the many challenges posed by this novel respiratory virus which includes limiting visitors to care homes, ensuring staff self-isolate when appropriate and offering to share resources with the NHS.

At the time of writing, the government has yet to implement measures seen elsewhere in Europe such as restrictions on movement in Italy and the closure of schools in Ireland but the situation is fluid and fast-moving and we must expect interventions to be dictated by events.

It is clear the emergence of covid-19 is unprecedented in modern times and as such there is no universally agreed way to contain its spread and limit its effects. What is certain though is that the government is taking advice from virologists and epidemiologists who are at the top of their fields. Such an approach, based firmly on scientific evidence and the latest research, is the only sensible option.

Now is not the time for political point-scoring or ideological divergence over health and social care delivery. If the UK was divided by our painful departure from the European Union, now is the time for us all to come together again for the common good.