The MAC Report Notes The Looming Social Care Crisis - Then Recommends We Make It Worse

If we stop social care workers coming from the EU, and there’s no extra money, what happens next?
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The Migration Advisory Committee report is undeniably a formidable piece of work. The range and depth of its analysis is impressive, and it will undoubtedly serve as a reference point for years to come.

However, when it comes to the MAC’s recommendations there is a structural problem at the heart of the report which holds it back. For political reasons, it pretends that immigration policy can be decided in isolation from the ongoing Brexit negotiations. And yet it acknowledges - rightly - that “the impacts of migration often depend on other government policies and should not be seen in isolation from the wider context”, pointing - again, rightly - to the need for solutions that go beyond immigration reform to deal with the current crisis in social care. To sum up: immigration policy should be addressed in isolation except where it very definitely should not be.

The MAC have refused to engage in scenario planning, presumably in order to avoid upsetting the government, yet still produced a series of recommendations ripe to be misconstrued – as they have been – because of the planet sized caveat that they are only relevant in a world where they can be viewed in isolation, which of course does not exist.

Back in the real world, however, ducking social care is no less a sin. The MAC has recommended (in a world in which immigration policy happens in isolation of course) that we end low-skilled immigration, except possibly for seasonal workers. Today’s news is full of British businesses large and small setting out the many problems this would cause them.

But a bigger issue has been missed. Our social care sector faces a staffing crisis – and if implemented the recommendations in this report would make things an awful lot worse.

The social care sector is already finding it impossible to find enough workers to look after our loved ones. In a time of almost full employment and in a sector offering low pay, hard work and often little prospect of progression it’s no surprise that the sector has been left with almost 100,000 unfilled positions.

In fact, you may wonder why it’s so few. The answer, as Global Future research shows is an army of migrant workers. One in five of those who care for our elderly and disabled people come from overseas – more than 200,000 of them.

In the last five years, the total number of overseas workers in the adult social care sector has stayed more or less constant. But this masks a huge shift in where these workers come from. In 2012/13, non-EEA workers made up 72% of all the overseas workers in the sector, with EEA workers making up the remaining 28%. By 2016/17, non-EEA workers had fallen to 57% of the total, and non-EEA workers had risen to 43%.

So in short, low skilled workers from Europe are filling the gaps because non-Europeans can no longer come here to work in low-skilled jobs, and those already here are slowly leaving the profession.

Now, if we stop these people coming it doesn’t take a genius to work out what happens next. And nor does it take a genius to find a solution: if the problem is low wages and poor conditions then the answer is obvious – pay people more and improve their conditions. In isolation, the problem looks simple.

In the real world, social care budgets already face a funding gap running into the billions which of course itself operates within the wider local government funding gap. Increasing adult social care workers’ pay to a level where it would have a substantial impact on recruitment and retention might well be the right thing to do, but it would require very significant additional money.

Furthermore, while improvements in pay and conditions could be expected to have a positive impact on recruitment, stopping the recruitment of overseas workers would not in itself push wages up – because the downward pressure on wages comes from a central government-imposed squeeze.

Which brings us back to the MAC’s suggestion that we don’t view social care recruitment in isolation. Fine – but if we stop social care workers coming from the EU, and there’s no extra money, what happens next?

Low-skilled migrant workers are easy targets. In a world where a self-defeating net migration target calls for ever more downward pressure on immigration perhaps an all-out ban on low skilled migration looks a smart thing to do – in isolation. But in reality our research suggests social care faces a near future in which it cannot fill 400,000 positions. What then for our older and disabled people? Isolation.

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