“Those of us who have the luck to enjoy good health forget about this vast parallel universe of the unwell – their daily miseries, their banal ordeals. Only when you cross that frontier into the world of ill-health do you recognise its quiet, massive presence, its brooding permanence.”
We all hope for good health for ourselves and our loved ones. But in times of need, this quote from the author William Boyd should serve as a warning to us all about the perils of failing to create an effective care system that treats our most vulnerable with compassion and dignity.
For Scotland’s care sector, the White Paper announced by the Prime Minister on Monday is notable not for what it says, but for what it does not say.
The headline change is an end to the recruitment of international care workers. Only those already in the UK on the Health and Care Worker visa route or those switching from other visa routes will be able to apply, providing they do so before 2028. This change does not affect existing sponsored workers.
Recruitment restrictions are UK-wide
Care providers in Scotland should note that these new rules will apply in Scotland. This is in contrast to restrictions on care sector recruitment introduced earlier this year, which only applied to England. This will be unwelcome news for Scottish care providers who had expected to be able to recruit international workers to meet demand – particularly in rural and coastal communities with ageing populations and a limited number of local workers.
It seems that the UK Government’s latest offering on immigration has focused on numbers instead of the needs of businesses and the public. In its current form, what the White Paper proposes is likely to bring very significant recruitment challenges to Scotland’s care sector. With only 12% of payrolled workers in Scotland being international citizens – compared to 21% in England – many businesses will be asking why this change is necessary.
The risk is that this will seriously impact people in Scotland who are most in need of care – and the families left to pick up the slack by providing unpaid care.
Valuing international care workers
For care providers and people receiving care, international staff have been a lifeline. During the pandemic, international key workers were applauded. Many will remember Boris Johnson’s effusive praise of the international nurses who cared for him when he had a near-fatal brush with Covid.
In fact, in recognition of the role international staff played during the pandemic, the last UK Government introduced a policy which exempted healthcare workers from paying the Immigration Health Surcharge (IHS). The IHS is an upfront fee that all international workers pay as part of a visa application. This can be a huge cost, with a family of four, for example, paying around £15,000 for a five-year visa.
My team and I regularly help healthcare businesses in pharmacy, dental and care obtain sponsor licences to recruit and retain international staff. While the media headlines around the White Paper give the impression that the UK Government is now making it harder for employers to hire international staff, the reality is that recruiting overseas staff is already challenging under the current system.
Significant barriers already exist
To employ international staff, employers have to pay a fee to obtain a sponsor licence and then pay a charge of £364 (or £1000 for medium or larger firms) for each worker each year. Under the White Paper proposals, the Immigration Skill Surcharge will increase by 32% in line with inflation, which will mean an increase of £480 per year for small companies and £1320 for medium/large companies.
Even once an employer has a licence, they risk losing it if they do not comply with hundreds of pages of guidance which changes regularly – including two significant changes so far this year. This is especially onerous for small businesses with no HR function. I have been advising on sponsor licences since 2008 and have yet to meet a business owner who would put themselves through the current process if they could fill their recruitment needs from the local workforce instead.
For those care sector businesses who do make the investment, I find that the feedback is universally positive. The benefits that international staff bring vastly outweigh the costs and time of obtaining and maintaining a sponsor licence. In my experience, business owners praise international workers as being “highly qualified”, “reliable” and “hard-working”. In the care sector, where businesses frequently deal with high staff turnover and absence issues, my clients tell me sponsored workers stand out as lifting morale due to their willingness to do extra shifts and stand in at short notice.
The harsh reality of staff shortages
The challenge that many care sector organisations face is that if they cannot recruit international staff, they cannot deliver on contracts with local authorities to provide care to those most in need in our communities. In some parts of Scotland, care providers operate in depopulated rural and coastal communities where there is simply no pool of local workers to draw from. In these communities, the UK Government’s plan for local incentivisation schemes and higher pay will not address the problem.
The proposals in the White Paper therefore place a further unwelcome strain on an already overburdened sector. The Home Secretary told Laura Kuenssberg recently that there were 10,000 overseas care workers, who had come to the UK on false promises. While this is a significant number and there has been exploitation in the sector, it is important to remember that far more international workers come to Scotland to take up genuine roles with reputable care providers.
The UK Government could have responded to the exploitation issue by adopting more robust pre-licensing and post-licensing monitoring. It is worth noting that this exploitation of care workers took place during a period when more than three quarters of sponsor licence applications were granted.
Instead, they have chosen to go down a route that some will see as being extreme.
We would strongly recommend that care providers in Scotland who have been considering applying for a sponsor licence do so now if they want to have the opportunity to bring in international staff.
For legal advice, contact Immigration Law specialist Jacqueline Moore or a member of Thorntons Immigration team on +44 3330 430350 or complete an online enquiry and a member of the team will contact you.
