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

Lord Blunkett Excerpts

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Monday 7th September 2020 Lords Chamber

[Lord Green of Deddington (CB) [V]]

I had intended to withdraw from the debate, but having heard the noble Lord, Lord Lilley, I have to say that I agree very strongly with what he said. The debate so far has covered the case for a short-term arrangement to make sure that our failure to train in recent years can be made up for, but there is no justification in the medium term for taking doctors and nurses to look after people here from countries that need them far more than we do. That is our responsibility; it is time we trained our own and got a grip on it.

[Lord Blunkett (Lab)]

My Lords, I rise to support my noble friend Lord Hunt’s amendment and the brief, excellent speech he made at the beginning of this debate. I also want to reinforce points that have been made by the majority of your Lordships, with the exceptions of the noble Lords, Lord Lilley and Lord Green. Although I do not dispute for a minute that both noble Lords have a point, they have highlighted what I hope to put across this evening, which is the complete contradictions that exist in this debate.

I shall start by picking up those points made by the noble Lords, Lord Lilley and Lord Green. I am presuming that, when we reach Report, they will be moving amendments that will remove the so-called health and social care route announced in July, because under that route doctors and nurses could be recruited from across the world to fill vacancies at that level.

One of the contradictions that I want to highlight relates to young people. Young people who cannot find a job anywhere else due to the aftermath of Covid-19—the 20% drop in GDP and the knock-on effect on unemployment—might decide to go into social care. Most young people I speak to want a career and to be able to progress, and there is progression in both residential and social care. However, as things stand with the proposals by the Government, the area from which we would allow people to be brought in from overseas would be at that higher level, whereas at the lower level the vacancies that have been mentioned—122,000 in England alone—would not be fillable from outside the country. I do not know whether the Government believe that, given the crisis in unemployment that is about to accelerate, people will just take up those vacancies even if they are not emotionally and physically suitable to take up caring duties. As has been made clear in this debate, you have to be a particular type of person to take up some of the less attractive duties of caring for someone who is severely disabled or frail and has dementia.

The contradictions, also mentioned by the noble Baroness, Lady Barker, abound. We all want to see improved wages in this sector. That would not only reward people morally for what they do but help fill vacancies. But the danger of simply putting money into the sector, given the level of private equity ownership, might well be that it gets creamed off, rather than helping to fill vacancies. Or, they will simply close the homes if the money is not provided, which will cause an even bigger problem—as part of the contradictions, we would end up with older, frailer and more severely disabled people in hospital settings, which are more expensive but would allow for staffing to be brought in from outside this country. We saw that in March and April, when people who should have been in different settings in the first place were cascaded out into the residential sector unchecked for Covid-19 and ill-prepared in terms of PPE to be able to deal with it. The consequences, as the noble Lord, Lord Patel, said, are obvious for all of us to see.

The biggest contradiction of all—and I put this to the noble Lords, Lord Lilley and Lord Green—is that, on the centre-left in politics, people are generally suspicious of markets and, on the right, people generally embrace markets. But as I said on Second Reading, in the case of the labour market, the situation is reversed, and those who believe vehemently in markets are against a labour market and against being able to draw in from across the world those who have something to offer the area we are talking about this evening.

We need to sort out the contradictions. That includes the issue of austerity, which led to a bigger downturn in funding for local government services and those funded by local government than any other public service area in the country, with the result that local government has been struggling both with its own direct health provision and with funding in the market and the ability to sustain services.

I have one question—I have learned over the Covid-19 period that you do not get an answer from the Minister unless you ask them a question. My question is simple, and the Minister might be able to answer it tonight: we know what the vacancy level is, but do we have an up-to-date picture of the turnover level in the social care sector? The turnover gives you an idea of how long people can stand working in this challenging but often rewarding setting. What steps might have to be taken if the Government’s hope is that the downward pressure on job availability will help fill, in the short term, the vacancies that we have talked about?

At the end of the day, what we are talking about is the care of human beings. We are not talking about markets or political or economic theory; we are talking about the reality of caring for people in their own homes and stopping them, therefore, having to move into hospital, residential care or residential settings that are dealing with people at very difficult times of their lives. In the end, we have to care enough to get it right.

[Lord Hodgson of Astley Abbotts (Con)]

My Lords, I listened carefully to the powerful opening speech from the noble Lord, Lord Hunt of Kings Heath, who is very experienced in this field, and to the speeches that have followed.

Who can argue about the need for a properly skilled, staffed, trained social care workforce? “Skilled and settled”, I think, was the phrase used by the noble Baroness, Lady Masham of Ilton. That is why the issues in subsections (3)(a), (3)(b), (3)(c) and (3)(d) in the noble Lord’s proposed new clause seem entirely appropriate questions to ask. But when they are tied back into an immigration Bill, I begin to get nervous. The noble Lord, Lord Blunkett, talked about contradictions, and I listened carefully to what he said, but the fact is that the issues in subsections (3)(a) to (d) are issues for the sector not linked directly to the immigration matter we are discussing this evening.

I recognise I am probably swimming against the tide, but it is important to realise that workplace psychologists will tell you that you go to work for three reasons. First, you go for the money, and let us not be precious about that. Secondly, and equally importantly, you go for what they call self-actualisation —to improve and increase your life skills, work with decent people, have career progression, have a good performance that is noted and rewarded and, hopefully, operate in an atmosphere of good team spirit. Those are the internal desires most people have in going to work.

The third area is external reputation. When you mention where you work, what do people say in the saloon bar of The Dog and Duck or around the table at a dinner party?

It is worth taking those three yardsticks and applying them to the social care sector. First, there is the money. There is no getting around it: £8.70 an hour is clearly not good enough when compared with £9 for stacking shelves in a supermarket. However, money is not the only motivator here, and when we turn to self-actualisation —the second of the criteria that I mentioned—the situation is quite serious. I have had the privilege of serving on the boards of many companies in my career. When I join one, I often say, “Tell me about your staff turnover.” No staff turnover is not an attractive thing; very often it means that the company has got a bit complacent and is not at the cutting edge, and that the service is not as good as it could be. You want some staff turnover—5%, 10%, that sort of level—to provide the dynamic but, if it rises above that level, it is operationally destructive, distracting and expensive, and the quality of the service starts to fall away.

I understand that in 2018-19 there was a 32.2% turnover in directly employed staff in the sector. Worse, among care workers the turnover was 39.5%. Further evidence of a lack of considered career progression is that half the workforce—excluding registered professionals —have no relevant social care qualifications, which seems to me a question not of money but of managerial grip and organisation, and of making the sector better managed.

Lastly, on the external reputation, one of the great advantages and developments of the pandemic is that people have begun to see how useful, worthwhile and attractive social care can be. People have begun to think about it. Long may that continue but, historically, we all must accept that its reputation has not been that good.

This is a system under acute stress, as many noble Lords have said. The danger of amendments such as these is that they will result in new arrivals, and that immigration will be used as a crutch to maintain what is close to being a broken system. I cannot believe that this is the right approach. More importantly, if the sector believes that it has a “get out of jail free” card, to use the inference that the Minister made when winding up at Second Reading, then there is no pressure on the sector to make any improvements or changes to how the businesses are run or operated, nor indeed is there any pressure on the Government to do likewise. We must find ways to improve the operational performance and the financial performance.

I have two final points. First, on the issue of morality, referred to by my noble friend Lord Lilley, the noble Baronesses, Lady Barker and Lady Meacher, and the noble Lord, Lord Patel, recruitment in this area is a zero-sum game. What we have, other people lose. Maybe one could say that within the EU there is sufficient prosperity for us not to worry about it, but the noble Lord, Lord Patel, mentioned the wider recruitment. This is a very serious issue. We must look ourselves in the mirror and decide whether it is right and fair for us to be recruiting doctors, nurses and care workers from less- developed countries. It may be serious within the EU, but it certainly is serious around the world.

I will give just one example. When the Ebola virus struck Sierra Leone, there were 136 doctors there, one for every 45,000 people; in this country, the equivalent figure is one for every 300 people. At that time, there were 27 Sierra Leone doctors working in the NHS. If we had not employed those people, we could have given a 20% boost to Sierra Leone’s health facilities. It is not the answer but when we set out our stall for the future we must consider our attitude towards the less developed world, and whether we will, as the noble Baroness, Lady Barker, said, take ourselves out of the international market for health and social care workers.