Immigration and Social Security Co-ordination (EU Withdrawal) Bill Debate

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Department: Home Office

Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Baroness Jones of Moulsecoomb Excerpts
Baroness Williams of Trafford Portrait Baroness Williams of Trafford (Con)
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The noble Lord asked about the lead-up to 2025 and the ETA. It is a new immigration system—there will be a pragmatic approach to people coming in and out of this country, because it is a whole new system and will take some time to bed in. The ETA will give both security and certainty on people coming in and out of this country.

In terms of data sets, we obviously now use exit checks; if someone has a visa, it will be on their visa how long they are able to stay. The noble Lord talked about the person who literally went in and out of Lille in one day in order to update their boarding card. He makes a very good point.

This system will take some time to bed in. I will write to the noble Lord about some of the very specific supplementary questions he has asked; I am just giving him the answers that I know off the top of my head. As for sanctions for someone who has not complied, obviously it is easier for someone with a visa, and less easy for someone doing a series of short stays.

Baroness Jones of Moulsecoomb Portrait Baroness Jones of Moulsecoomb (GP)
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I am very sorry to correct the Minister, but she made a statement earlier that was incorrect. In response to my noble friend Lady Bennett, she said of retaining—or not taking away —freedom of movement that it was the will of the people and what the people voted for with their Brexit vote. That is absolutely not true. We voted—I voted—for Brexit for many different reasons, and freedom of movement did not particularly come up as a reason. Quite honestly, none of us understood that the Government were going to make such a shambles of it. We could not have predicted that it could be so badly handled. So please, it is not the will of the people, and it was not what people voted for with Brexit. They voted for a variety of reasons.

Baroness Williams of Trafford Portrait Baroness Williams of Trafford (Con)
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My Lords, we did vote to leave the EU, and I do not think anyone can be in any doubt about some of the reasons. People voted for a variety of reasons, but the noble Baroness will totally understand that I am not going to get into a debate about why people did or did not want to leave the EU. I will leave it there.

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Lord Patel Portrait Lord Patel (CB) [V]
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My Lords, before I speak to my Amendment 82, I want to support strongly the noble Lord, Lord Hunt of Kings Heath, who spoke with his usual passion when presenting his amendment. I hope the Minister will respond to that.

Amendment 82 can be taken in the context of the Covid-19 pandemic which has highlighted the exceptional contribution and sacrifice made by our health and social care workers every day in protecting and caring for people in the community. It has also made clear how much we depend on our international workforce. Around 29% of doctors working in NHS hospitals and almost 14% of healthcare workers overall in the United Kingdom are from overseas. International workers account for approximately one-sixth of care workers in England.

The pandemic has had a profound impact on all aspects of our health services, but I draw the attention of the House to its impact on the all-too-often overlooked sector of social care. Between March and July this year, there were 30,500 excess deaths among care home residents as well as 4,500 excess deaths among people receiving care in their home. Figures from the Office for National Statistics also show that social care workers are among the occupational groups at the highest risk of Covid-19 mortality. The United Kingdom recorded the second highest number of deaths among healthcare workers in the world, second only to Russia, and a significant number of those deaths were among social care workers. These figures highlight the immense sacrifice and heartbreak that these workers have faced while trying to do their job in a system that was already overstretched. The vital contribution they make to the health system has been overlooked and undervalued for too long.

Adult social care is facing stark recruitment and retention challenges, with an estimated 122,000 vacancies, while the demand for social care workers is expected to rise in line with the UK’s ageing population. The CQC’s State of Care report concludes that workforce shortages in adult social care are

“affected by the lack of value given to social care by society and disproportionate levels of pay.”

The pandemic should serve as a wake-up call that we need to value our social care workforce more. In a sector where one in six of the workers are from overseas, any changes to the UK immigration system that could deter or prevent those who want to work in this country are of deep concern. There is a risk of significant implications for the staffing of health and social care services, as well as the quality of care and patient safety in the future. While measures to help recruit doctors to the NHS, including the fast-track NHS visa, are welcome, the lack of any route into the UK for social care professionals is extremely concerning. The average salary for a care worker in England is between £16,400 and £18,400, which means that individuals would fail to meet even the lower salary threshold of £20,480 to enable them to trade points to be eligible to work in the United Kingdom.

The current proposals for new immigration controls risk exacerbating the current social work workforce shortages and, as a result, putting some of the most vulnerable members of our society at risk, as already mentioned. Social care staff play an integral role in the efficient and safe running of the health service, and it is vital that any future immigration system recognises this. We owe our overseas health and social care staff a huge debt of gratitude. We should do all we can to keep these dedicated workers and ensure that there are no barriers to future recruitment.

It is important to grow our domestic workforce to help to meet workforce challenges, and to improve working conditions, pay and training as part of that. However, we must also provide an entry route for overseas staff who want to join such a vital part of a healthcare system that would struggle to cope without them. There is a consensus across healthcare organisations, as well as growing support for the idea from parliamentarians right across the political spectrum, that social care needs a long-term, sustainable solution that includes better funding. In the short to medium term, the immigration system must include a migratory route that meets the needs of the social care sector, which is facing severe challenges. We now need the political will to act and reverse this public policy omission.

I therefore hope that my amendment will be supported. It is supported from outside very strongly—by the Royal College of Nursing, the British Medical Association, UNISON, Independent Age and the Royal College of Physicians. It places a duty on the Government to report on migratory options for health and social care workers ineligible for the skilled-worker route.

The amendment would require the Secretary of State to lay before Parliament a report setting out in detail the options for overseas workers excluded from the skilled-worker scheme, within a period of 30 days beginning on the day on which this Bill is passed. It would need to specify a migratory route for care workers, home workers and healthcare support workers. It is time we recognised the vast contribution of the social care workforce to our community. Showing that there is a migratory route into the UK for them would be a step towards achieving this. They have demonstrated that in low-paid jobs they provide good social care, and even die for us, as shown by Covid-19.

I had not indicated that I intend to divide the Committee today, but I look forward to the Minister’s response and I will reserve my judgment. All I can say is that the support for this amendment outside and from all sides is immense, and I hope the Minister will respond to that.

Baroness Jones of Moulsecoomb Portrait Baroness Jones of Moulsecoomb (GP)
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My Lords, I shall speak in favour of my Amendment 93. It is obvious that many of the amendments in this group are heading towards the same sort of thing, which is protection for people of all kinds as well as holding the Government to account for what they do. I support several of the amendments that have been spoken to, and I have been moved by some of the speeches from noble Lords.

My amendment is supported by over 50 organisations from all the devolved nations, including the Health and Social Care Alliance Scotland, Macmillan Cancer Support, UNISON and the Association of Camphill Communities. Amendment 93 would require an independent evaluation of the impact of the effects of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill on the health and social care sectors across the UK. This would be made after consulting the Secretary of State for Health and Social Care, the Scottish Ministers, the Welsh Ministers, the relevant Northern Ireland department, service providers, those requiring health and social care service and others. One would hope that this would be automatic with any measure that a Government introduce as they really need to know whether it is working or not.

Proposed new subsection (1) would require the Secretary of State to lay a copy of the report before both Houses of Parliament no later than one year after this Bill is passed. Proposed new subsection (8) would require a Minister of the Crown to make arrangements not later than six months after the report has been laid before Parliament, for the report to be debated and voted on in both Houses.

My amendment is necessary to safeguard the interests of the many people who rely on the contribution of EU citizens and non-EU citizens for the provision of health and social care across the four nations. This of course includes disabled people, children and young people, older people, unpaid carers and those with long-term health conditions. I should perhaps declare an interest in that I am getting older and this might apply to me in a decade or two.

Prior to the UK leaving the EU, a number of studies had highlighted the significant adverse impact of Brexit on the health and social care sectors across the UK. These studies, and the initial information about the points-based immigration system provided in the Home Office’s policy paper, The UK’s Point-Based Immigration System: Policy Statement, suggest that the ending of freedom of movement and the introduction of a points-based immigration system will potentially have a major adverse impact on the health and social care sectors across the UK. I think every speech so far has highlighted that fact.

The proposed independent evaluation that would be introduced by Amendment 93 could play a key role in supporting the health and social care sectors across the UK, helping them to address a range of concern about the proposals. These include concerns that many health and social care workers from other European countries, and from non-European countries, would not meet the proposed income threshold under this system, and that the requirement to have a job offer is unnecessarily restrictive, and will create addition administrative burdens and cost for health and social care organisations trying to recruit staff from abroad. As we have heard, there is a lack of recognition of health and social care specific skills, experience and professional qualifications in the proposed points-based system. As a result, it does not recognise the skills and experience of the workers from across the EU, and from non-EU countries, to enrich health and social care support and services here. Nor does it value the sector and its growing importance as a result of demographic changes.

There is much wrong with the Government’s immigration policy, but health and social care will feel a particularly brutal impact. This independent analysis is required so that the Government can think properly about the needs of health and social care and develop policy accordingly.

Baroness Finlay of Llandaff Portrait Baroness Finlay of Llandaff (CB) [V]
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My Lords, I declare my interest as chair of the National Mental Capacity Forum. I speak to Amendments 2 and 66, to which I have added my name, and I strongly support Amendment 82, tabled by my friend Lord Patel.

The current proposals will exclude a group of workers we desperately need: carers for those with physical and/or mental disabilities, especially, as my noble friend Lady Masham highlighted, those with spinal injuries and similar severe physical constraints, and those with severe impairments of mental capacity for a wide variety of reasons. Many of these people are at a high risk of Covid and some will have been on the official shielding list. They wish to remain in their own homes and need care around the clock. For them, a live-in carer is the best option, but the annual salary of such a carer will fall below the level to accrue points in the system. That workforce just does not exist here. UK residents are not coming forward to train as live-in domiciliary carers.

Those carers already here are fearful that they will not obtain leave to remain. UNISON is calling for key workers to remain here and be eligible for NHS care—that is, to be exempt from the “no recourse to public funds” criteria—during the pandemic. Around 17% of the social care workforce is made up of migrant workers, with 115,000 European nationals and 134,000 non-EU nationals.