If ever there’s an issue – or a sub-section of a broader issue – that sums up the sense that the UK is broken, even eight months after a new government was supposed to set a new direction, it’s social care.
The crisis in social care has been recognised for decades, but successive governments have failed to tackle it, and it’s getting rapidly worse. This is bad enough on its own, but it has two serious knock-on effects: it reduces the effectiveness of the NHS as it cannot release from hospitals some patients who are fit to leave but have nowhere to go; and it further drags down the reputation of local government, which doesn’t have the resources to deal with social care and sinks ever lower in the public’s estimation. Add the effects of Brexit, Covid, the cost-of-living crisis and a toxic debate on immigration, and you see why the situation with social care is worse now than it has ever been.
So what do we do? Well, a lot of money would help – most solutions to the social care problem require money, but, let’s face it, the kind of public spending that just isn’t feasible at the moment. So we have to look in other directions.
There have been four major shocks to the social care system in recent years: Covid, the cost-of-living crisis, Brexit, and Britain’s attitude towards immigration. The first two are factors largely outside our control. We can’t undo the loss of so many NHS and care staff due to the impact of Covid, and the cost of living crisis, coupled with repeated rises to the Real Living Wage and NI rates for employers, has sent the cost of staff rocketing, with many care companies struggling to compete for permanent staff and often forced to pay high wages to agency personnel.
But Brexit and immigration are political. One of the less well known consequences of Brexit is that professional qualifications gained in the UK are no longer automatically recognised in the EU. This means young nurses or physiosbased in the EU, who might in the past have felt that spending some years working in the NHS would be a good career move, can no longer use qualifications gained here in their home counties. This immediately shut down a key source of keen young staff in both the NHS and care sectors in the UK. The change didn’t even benefit the EU – those workers often returned to home countries such as Romania or Portugal with new skills learned in our large teaching hospitals, a mutually beneficial exchange of skills and knowledge. Revisiting the Brexit agreement to eliminate this short-sighted lack of cooperation would make a small but significant improvement to social care.
In parallel, public antipathy towards immigrants and pressure to reduce levels of immigration mean recruiting staff from overseas is harder, as the UK is seen as a less attractive destination. While many in politics rush to emulate the anti-immigration language of the far-right, who is thanking the migrant workers who are keeping our fragile NHS and care system alive? We need to make a stand or it will become even more difficult to recruit care workers. The recent papersubmitted to the party’s policy review What would Paddy do?will no doubt attract much flak for saying the party should outwardly champion immigration, but we just shoot ourselves in the foot if we don’t make migrants feel appreciated.
This is not just principled liberalism – it is enlightened self-interest for today’s adults! Many of us will one day rely on social care. And with an aging population, if many of us want to retire at a similar time to our parents, we need to recognise the huge benefit to the country of the stream of talented young people who would love to come and work here, if only we were willing to offer them the opportunity.
We need to find the language to convince the UK public that the fact that many people want to live and work here bringsmassive potential benefits, not just for social care and the NHS, but for the economy generally. We can all benefit from the creativity and talents of the many people who want to come to these shores. Changing the narrative on Brexit and immigration is key to fixing the care crisis – and so many other problems for our country too.
* Lucy Nethsingha is Lib Dem Leader of Cambridgeshire County Council. She was MEP for the East of England from 2019-20. Her pre-politics career was in teaching, where she took a particular interest in early identification of Special Needs.