EDITORIAL – 21st Feb 2020


In the James Bond film ‘Skyfall’, 007 is asked by the typically doomed beauty to who he is romantically attached “what do you know about fear?” to which Bond replies “all there is”.

I am far from sure that he accurately summarised the full gamut of fear before giving his answer.

To a frail, elderly person, sitting from day to day in a care home, seeing out their final weeks/ months/ years in unfamiliar domestic circumstances, supported entirely by the skill and empathy of dedicated care workers, Bond’s understanding of fear is perhaps under called. Why?

Because in an extraordinary piece of government policy making, new immigration rules orientated to a points-based accumulation of right to work risk the entirety of the care system as we know it. Moreover, it’s been headline news across the media and you can be certain that those same frail older people have added it to their existing worries and anxieties.

And so have their families.

And so have most of the rest of us who have ever looked at a population demographic chart of life expectancy.

The National Audit Office (NAO) advises that in 2016-17 the care workforce in England consisted of 1.34 million jobs in the local authority and independent sectors. This excludes another nearly 250,000 jobs taken by personal assistants for people with personal budgets and self-funders, as well as some who work in care but are contracted to the NHS.

There are around 20,300 organisations providing care in a care sector that is fragmented and complex.

And into this massive ecosystem of care provision, the Government announces that in order to qualify for the required 70 points, immigration applicants (from Europe as well as the rest of the world), will need to have a job offer from an ‘approved employer’, speak English and earn at least £25,600. They can circumvent the salary requirement, if they are applying for a job in which the UK has a shortage.

Note – Care workers are not listed as a job in which the UK has a shortage.

Overall, in my opinion, this takes ‘fear’ to a whole new level for millions of people. The care system is already creaking under years of Government cuts to the local authority budget. Despite numerous assurances, and even promises over the last 18 months, there is still no sign of a health and social care green paper, so we do not know how Government thinking is evolving in respect of how we will access care for frail, older people in the next 5-10 years.

Back to that NAO report and the revelation that staff turnover in the care sector is nearly 28%. It is estimated, that vacancy rates are at least 7%, which equates to a demand for nearly 95,000 to fill the sector completely. The CQC has advised that the sustainability of the care sector is precarious.

So, how does a policy which will inevitably reduce the ability of EU and international workers interested in moving the UK to pursue a career as a care worker make sense?

The government argues that the new immigration rules are designed to raise the quality of labour by improving standards and encouraging employers to invest in training. Well, the primary resource and government partner for enabling training for workers in social care is ‘Skills for Care’. In the most recent data available, the Government provided this organisation with £23.5m of funding to provide that training – I’ll leave you to do the maths in respect of how such a paltry sum filters down to the front line.

Yes, I am fearful and terribly concerned, as to the effect that this move will have for our relatives and even you and I in the coming years, as care homes are brought further to their knees, good quality care staff are rare as hens teeth, the frail older population multiplies and the Government is invisible and silent in respect of how we will design a new system fit for purpose. Because, anybody who is experiencing the care system at present, knows perfectly well that for a huge number of brilliant staff caring for their loved ones, the UK is not their country of origin.

What do I know about fear? Not even the half of it.

Enjoy a super weekend.

Jon Wilks
Chief Executive