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Moved to Care launch presentations

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This presentation includes the ILC-UK's Ben Franklin and Cesira Urzì Brancati presenting a summary of the Moved to Care report; a response from Dr Shereen Hussein, Senior Research Fellow at King's College London; and a response from Madeleine Sumption, Director of the Migration Observatory.

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Moved to Care launch presentations

  1. 1. Migration and Social Care Report Launch Thursday 19th November 2015 This event is kindly supported by Independent Age
  2. 2. Welcome Professor Martin Green Chief Executive: Care England DH: Independent Sector Dementia Champion Chair: ILC-UK This event is kindly supported by Independent Age
  3. 3. Presentation of research Cesira Urzì Brancati Research Fellow: ILC-UK Ben Franklin Head of Economics: ILC-UK This event is kindly supported by Independent Age
  4. 4. Moved to care: The impact of migration on the adult social care workforce Ben Franklin and Cesira Urzì Brancati, International Longevity Centre follow us on twitter: @ilcuk @bjafranklin
  5. 5. What will we be covering?  Key research questions  Policy background  Migrants in the care workforce today  Why migrants are so prominent in this sector  Potential long-term implications of public policy  Policy recommendations
  6. 6. Key questions 1. To what extent is the adult social care workforce currently dependent on migrant workers and in what ways? 2. How might current and future public policies related to migration and adult social care impact on the ability of the workforce to deliver care to an ageing population?
  7. 7. Social care crisis and migration policy  Underfunding plus rising demand for care limiting ability of sector to deliver for those in need.  Introduction of National Living Wage – supports pay but big challenge for some providers.  Non-EU migrants judged on points-based system, with Tiers 1 and 2 subject to an annual cap of 21,700 people. Tier 3, for low skilled migrant labour has never been opened.  From April 2016, high-skilled non-EU migrants who have spent 5+ years working in the UK, will be required to earn £35,000 per year. Recent exemption for nurses.  Govt trying to renegotiate EU-UK rules around migration – EU migrants who haven’t secured work in 6-months of arrival would have to leave.  Govt likely to hold referendum on UK’s membership of the EU and to try and impose restrictions on in-work benefits for EU migrants.
  8. 8. Migrants in the care workforce today  1 in 5 care workers born outside of the UK.  Non-EU migrants account for 191,000 people.  Changes to migration policy has resulted in falling share of migrant care workers coming from non-EU countries and a rising share from EU countries.  Migrants play particularly prominent role in providing direct care to those in need, as well as professional support.  Private care providers utilise care workers to greater extent than local authority run care providers.  London and the South East are particularly reliant on migrant workers with nearly 3 out of every 5 care workers in London being born abroad.
  9. 9. Migrants concentrated in direct care and professional jobs
  10. 10. ….London and SE highly reliant on migrant workers Source: Author’s calculations from NMDS-SC worker’s file and NMDS-SC 2015 report
  11. 11.  Care sector’s vacancy rate is significantly higher than for economy as a whole.  Social care work is perceived to be low in pay, low in status, and with poor opportunities for progression.  Employers face shortage of workers relative to demand for care, exacerbated by the relatively older age of the current social care workforce.  Some employers have said migrants more reliable, flexible, and better qualified than and they are able to pay them lower wages than comparable UK born workers.  Migrants attracted for economic reasons. Even though it is poorly paid within a UK context, it pays a better wage than a job in many migrants’ home countries.  Also choose the care sector out of genuine desire to help, as a method of improving English skills, and as a way to move to the UK. Why are migrants so prominent in this sector?
  12. 12. “We don’t have a skill shortage coming up to 2030, we have it now. Why do we think it’s hard to get people into this job? Well I think, for one, it is hard work for most people… and people don’t want to do that if they’re being paid less than the minimum wage.” Manager of care agency Selected quotes
  13. 13. “We don’t have a skill shortage coming up to 2030, we have it now. Why do we think it’s hard to get people into this job? Well I think, for one, it is hard work for most people… and people don’t want to do that if they’re being paid less than the minimum wage.” Manager of care agency “The minimum wage for that job is not enough. And there are a lot of agencies that pay minimum wage to the employees. Maybe that’s why one day there won’t be enough staff for this job because no one wants to do that job for that amount of money. It’s a very difficult job.” Female, 27, from Bulgaria, who works for a homecare agency Selected quotes
  14. 14. “We don’t have a skill shortage coming up to 2030, we have it now. Why do we think it’s hard to get people into this job? Well I think, for one, it is hard work for most people… and people don’t want to do that if they’re being paid less than the minimum wage.” Manager of care agency “The minimum wage for that job is not enough. And there are a lot of agencies that pay minimum wage to the employees. Maybe that’s why one day there won’t be enough staff for this job because no one wants to do that job for that amount of money. It’s a very difficult job.” Female, 27, from Bulgaria, who works for a homecare agency “It is a hard sector to work in and sometimes, because of our background, we are used to things like that, so we don’t think it’s anything, so we do it. We are thorough. We are committed. We do it well even when it is hard.” Female, 51, from Nigeria, works in residential care Selected quotes
  15. 15. Start with the simple notion that in order to adequately meet future demand for care we must keep the ratio of care workers to those aged over 65 constant over time. Then we make certain assumptions regarding future workforce participation in the care sector (gradual increase/gradual decline) Apply different ONS population projections based on high, central and low migration variants. Calculate the care gap (the extent to which supply fails to meet demand) under the different migration and workforce participation scenarios. How do we get there? The long-term workforce challenge
  16. 16. Critical assumptions for scenarios Sector unattractive, low migration  ONS low migration population projection for England.  Proportion of the current working age population who work in the care sector falls by 0.04% per annum for the next twenty years. Sector unattractive, high migration  ONS high migration population projection for England.  Proportion of the current working age population who work in the care sector falls by 0.04% per annum for the next twenty years. Sector attractive, low migration  ONS low migration population projection for England.  Proportion of current working age population who work in the adult social care sector gradually rises by +0.04% per annum up to 2037. Sector attractive, high migration  ONS high migration population projection for England.  Proportion of current working age population who work in the adult social care sector gradually rises by +0.04% per annum up to 2037.
  17. 17. Gaps by 2037 Sector unattractive, low migration 1.05 million Sector unattractive, high migration 1.00 million Sector attractive, low migration 0.43 million Sector attractive, high migration 0.35 million How the workforce gaps evolve over the scenarios
  18. 18. Some key takeaways from the scenarios  Current status quo - which seeks to curb migration + continue to underfund care - could lead to substantive care workforce gaps.  Alternative approaches seeking to plug gap either through migration, or, separately by increasing the attractiveness of the sector unlikely to succeed.  Need to raise both the attractiveness of working in care for UK born workers and encourage more foreign born workers. But still 353,000 gap.  Only substantive policy change including dramatic shift in the perceptions of UK born workers about working in the care sector can ensure we close the gap altogether. Otherwise greater reliance on informal care giving.
  19. 19. Policy recommendations: short term  Skilled care worker roles, including senior care worker, be included in the current Migration Advisory Committee’s Tier 2 Shortage Occupation List.  Non-EU migrant care workers who have entered the care sector through Tier 2 should be exempt from £35,000 income threshold.  Tier 3, which is for low-skilled workers filling temporary labour shortages, be opened up for care workers in order to help the sector meet immediate staffing needs.
  20. 20. Policy recommendations: medium to longer term  Step up to adult social care: Intensive Postgraduate Diploma to equip future generation of adult social care workers with the right mix of knowledge and practical skills to drive the sector forward.  Care-prentices: Offering care-prentices – structured on the job training with formal mentoring and support for those over 50 – could be one way to entice older workers into the sector.  A national campaign to attract more male care workers: Government and industry could work together to deliver a joint campaign calling out for more male care workers.  Support for informal carers: With more emphasis on informal care likely there is clear case for providing better support for unpaid carers to alleviate the financial, mental and physical costs that they can face.
  21. 21. Policy recommendations: improving funding arrangements  Underfunding contributes to many of the workforce challenges highlighted in this report. It limits the resources available for providers to invest in their staff and recruitment.  Agree with the principle of a single ring-fenced budget for health and social care. However, integration must not result in both health and social care fighting over one increasingly limited pot.  Recommend creation of an independent committee to continually monitor current and projected health and social care needs at the national level and to recommend future funding levels.
  22. 22. Many thanks Ben Franklin and Cesira Urzì Brancati International Longevity Centre - UK benfranklin@ilcuk.org.uk CesiraUrziBrancati@ilcuk.org.uk 02073400440 Twitter: @ilcuk @bjafranklin
  23. 23. Dr Shereen Hussein Principal Research Fellow King’s College London Response to Research This event is kindly supported by Independent Age
  24. 24. Response: Migrants and social Care Dr Shereen Hussein Principal Research Fellow King’s College London
  25. 25. 19/11/15 shereen.hussein@kcl.ac.uk 26 Social care and migrant labour Past Present Future • Reliance on migrant workers is not a new phenomenon • But many changes has been happening • Including changes in the profile and characteristics of migrant workers • How did we get here links to how social care work has evolved
  26. 26. Narrative from the front line Of course, it’s a national problem. I mean, the health service is full of agency staff … with the free movement of labour in Europe, you are getting nurses that have trained in Romania, Poland, Bulgaria, they are not of the standard that I would accept. ….. The best group, that is the Filipino nurses. They are amazing. We’ve had quite a lot of students, brilliant. That has sort of died down now, really. I don’t know why that is. I don’t know whether again, immigration is a lot stricter. Manager, nursing home, LoCS T3 - 2015 19/11/15 shereen.hussein@kcl.ac.uk 27
  27. 27. 19/11/15 shereen.hussein@kcl.ac.uk 28 Reliance on migrants is partly due to the inability of the sector to attract enough quality staff •I think women migrant workers will be channelled into private nursing homes, private old peoples’ homes, because they could be paid minimum wage, not going to make a lot of demands, work hard and work shifts, being available. Residential care home manager, 2011
  28. 28. 19/11/15 shereen.hussein@kcl.ac.uk 29 Which has a lot to do with the level of investment we put in the sector … • The value we place on social care as a society • How adequately social care is funded • the state funds between 20 to 25% of adult social care only • How we treat care workers: poor wages; increasingly fragmented work; lack of employment protection .. General casualization of work • Commodification of care • With no or little consumer choice – a commodity that you are forced to buy ..
  29. 29. 19/11/15 shereen.hussein@kcl.ac.uk 30 How sustainable is social care provision? •Think short, medium and long term •Projections of demand are escalating •Migrants will continue to play an important role • Around 20% of the workforce, rising to nearly 50% in the capital •There is a global and European competition on migrant care workers •Enable the sector to maintain its ability to select and retain quality migrant workers • at least for the short to medium term
  30. 30. 19/11/15 shereen.hussein@kcl.ac.uk 31 In the long term .. the only option is to make social care work a desired and respected job that.. • Attracts a broad range of British people • The young, the old and the in-between • offers a secured line of work .. (not temporary or vocational) • Improved contracts with secured rights and employment benefits • requires a clear set of recognised skills • Enabling a fluid transfer of skills between health and social care • Creating opportunities for specialism and higher qualifications • rewarded both through decent wages but also other support mechanisms
  31. 31. 19/11/15 shereen.hussein@kcl.ac.uk 32 Key points •Current state of funding social care is not sustainable •Care workers, both British and migrants, should be rewarded adequately to improve severe turnover and vacancy rates • Not only pay needs to be improved by employment terms and conditions •Older people and their families need to have a say of how care is organized and delivered •Quality care is a ‘right’ not an option for British older people
  32. 32. Shereen.hussein@kcl.ac.uk 0207 8481669 19/11/15 shereen.hussein@kcl.ac.uk 33 THANK YOU FOR LISTENING
  33. 33. Madeleine Sumption Director The Migration Observatory Response to Research This event is kindly supported by Independent Age
  34. 34. Discussion and Q&A • Research Findings: reflections and challenges • Impact on Migration Policy: is it just marginal, or will it have a major effect on workforce supply? • Attractiveness of the care sector: what would help boost the attractiveness of the care sector to the degree the research highlights is required? • Next steps: what would make the greatest practical differences to closing the care workforce gap, and to what extent can we look to alternative models of caregiving to help plan for the future?
  35. 35. Migration and Social Care Report Launch Thursday 19th November 2015 This event is kindly supported by Independent Age

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