What happens to social care when free movement in Europe ends?

By Linda Burnip

In October 2020 the government promised the House of Lords that an independent report into the ending of free movement and the social care workforce would be completed within six months, that is, by the end of May 2021. Disabled People Against Cuts (DPAC ) are very concerned that as yet no plans have even been put in place for this to happen. Meanwhile, the end of applications to the EU Settlement Scheme, which has been fraught with problems due to the Covid pandemic, is due to end on June 30th 2021.

The social care sector includes a variety of employment options. The vast majority of social care workers work in care and nursing homes, or in domiciliary care where the workers go into disabled and older people’s own homes, for short periods of time to provide social care support.

Another important group of social care workers are employed directly by individual disabled people, either through PAYE or on a self-employed basis. They receive a direct payment to fund their care from a Local Authority or through Continuing Health Care funding. Most disabled people who require this type of social care have high support needs and require 24 hour input. It is a unique employment relationship affecting a small minority of disabled people, probably fewer than 100,000.

To employ Personal Assistants, disabled people have to become employers with HMRC. But they remain individual employers only, so are unable to sponsor staff to work in the UK through any of the current pathways – skilled worker, shortage occupation, Health and Care Worker or Temporary Worker routes, which as individual employers they are unable to utilise. Alternatively, they can employ Care Workers introduced through an agency which provides live-in care support where staff often work on a self-employed basis. Again, disabled people who use these options to employ staff are currently left without any means to employ new, replacement staff outside of the resident workforce.

The provision of quality care is important to the mental and physical wellbeing of a vast swathe of the UK’s disabled and older people – who are often denied rights and opportunities that many non-disabled people take for granted. 

Having good quality social care for independent living is literally a life and death situation for disabled people and they must not become collateral damage in pursuit of the removal of freedom of movement. The inherent dangers this would create for disabled people must be acknowledged and mitigated by urgent action from the government. It needs to put in place changes to provide a specific non-sponsored visa route for disabled employers of PAs and live-in social care workers and agencies that provide live-in social care workers.

In theory any EU and EEA staff already working in the UK by December 2020 have the option to apply, before June 30th 2021 for settled, pre-settled status or Frontier Worker status. However, there is at present no option for these schemes to be extended to new staff who were not working in the UK by December 31st 2020.  Due to the impact of Coronavirus, many EU nationals, possibly as many as 1.3 million, who should qualify for one of those schemes, will fail to, as they were unable to work in the UK in 2020 because of the pandemic.

The Joint Council for the Welfare of Immigrants states that EU and EEA social care workers are among those at risk of slipping through the cracks in the scheme. One in three of those they spoke to had never heard of the EU Settlement Scheme (EUSS), and a large proportion of those who had did not understand what they needed to do in order to secure their status and rights. Half of those interviewed in person did not know when the EUSS deadline was. (See here, p.34).

As the turnover of staff in social care remains high, the loss of such future workers will exacerbate the overwhelming pressures that our crumbling social care system already faces. We are asking for a sector-specific scheme for PAs and live-in care workers, introduced by specialist agencies, similar to the Frontier Worker scheme to be implemented. This will allow disabled people who employ PAs directly or live-in care workers through an agency to be able to continue to recruit new replacement staff from outside of the UK in the future.

Kevin Foster, minister for future borders and Immigration, and Helen Whately, minister for social care, have stated that unemployed UK workers can become social care workers. However, this type of work is not suitable for everyone and there is a major misconception that bedevils the sector and directly leads to disability inequality and the wasted human potential that flows from inadequate support for disabled people.

There is a huge degree of responsibility involved in providing live-in social care support for independent living. The lack of any peer supervision and the importance of a personal relationship make this a role unsuitable for just anyone. Tasks can include, for example, being hoisted in and out of bed, assisted with personal care needs, sometimes involving manual bowel evacuation and assistance with bladder functioning, managing diabetes,  having medication, drinks and food provided, supporting the use of Bipap and Cpap machines for breathing, as well as being supported to work and take part in society.

It is well documented that the social care sector suffers from a massive shortage of skilled staff and that demand far outstrips supply. Even if some UK unemployed workers entered the sector we do not think that alone would help solve this shortage, particularly in the short term. The GMB union has estimated that for the social care sector as a whole the number of vacant posts will be 460,000 post-Brexit, three times as high as now.

Ironically the government claims to be committed to having more than one million disabled people in work by 2027 and is currently boosting the number of Disability Employment Advisors to “help disabled people to secure and stay in work” through the ‘Plan for Jobs scheme’.  This however will be doomed to failure if at the same time it removes access to a suitably qualified workforce to support disabled people to live independently in the community and by doing so denies them any possibility of working.

While the government has made exceptions for corporations to employ agricultural workers from abroad, absolutely nothing is in place to help direct payment recipients to continue to be able to employ the most suitable live-in staff in the future. Supporting Disabled People to live independently in the community is comparatively much more cost effective for the tax payer. The cost of an Adult Treatment Unit placement can be around £12,000 per week. A care home placement for those with a Learning Disability at, for example, Winterboure View costs on average £4,500 a week and a hospital bed £2,500 a week, according to NHS figures.

DPAC are asking for a specific visa route for individual disabled employers to be able to use after June 30th to recruit new and replacement staff which would give social care workers a right to come and work here for periods of time while living primarily in their home countries, as now.

Linda Burnip is co-founder of Disabled People Against Cuts.

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