Britain’s national health service is, by any definition, facing a turning point. It needs help, not hindrance. Of the many stress points, the inability to move mostly older patients between hospitals and care homes is perhaps the most extreme. The principal reason has been the shortage of 165,000 workers in the care sector, or about 11% of its labour force. Crucial to this service has been the temporary visa scheme for care workers and home carers introduced last year, after EU recruitment was crippled by Brexit. About 58,000 new workers have come in under the scheme. The care sector depends on these workers, which means so do the hospitals dependent on moving patients into care.
Enter the proposal by a small group of rightwing Tory MPs complaining that the overall level of immigration into the UK has eroded public trust in the government. They want to cut the number of care home visas, thereby reducing immigration, so they say, by 82,000 people. It is like preparing for the Battle of the Somme by slashing infantry numbers. The MPs also want to cut the number of overseas students and their dependents, raise the income threshold for visas to other British jobs, and limit incoming refugees. Overall, they say, this should more than halve immigration, which in turn should make people feel better in “red wall” seats. They do not ask how people would feel in hospitals and care homes.
One of the more plausible rocks on which Tory ideology has rested, at least since Robert Peel, is that prosperity results from opening your economy to free markets. That includes the market in labour. Throughout its history, Britain has benefited from incoming Huguenots, Jews, West Indians, Africans and migrants from the subcontinent and east Asia. During the UK’s EU membership, Margaret Thatcher boasted of the competitive opportunities of being part of Europe’s single market. Supporters of Brexit, including these “new” Conservatives, disagreed. They argued that Britain would do better by exchanging Thatcher’s single market for a much larger one – the entire world. This would somehow also mean fewer immigrants.
Brexit cut Britain off from the EU’s labour market. It has been a disaster for sectors such as farming, hospitality and welfare services, which depend on an often seasonal supply of new workers. In the case of health and social care, a cut-off in supply was replaced, of necessity, by longer-term immigration from the rest of the world. Between a quarter and a third of UK doctors are now from abroad, while demand for staff has meant net inward migration rose to 606,000 last year, which is nearly double pre-Covid levels. You can no more close your economy to new labour without harm than you can close it to energy or food.
There may be separate arguments for reducing the role of Britain’s universities as finishing schools for the world’s middle classes. There are certainly arguments for reaching a hard and fast deal with the French to stop them cynically decanting their immigrants on to British shores. There are no arguments for crippling Britain’s care homes.
The “new” Conservatives are not Conservatives, but reactionaries. They are pandering to prejudice in the hope of garnering a few xenophobic votes. We might point out to them that users of welfare services vote, too. The reality is that these politicians promised immigration would be lower under Brexit. They now complain that the care sector is leading them to break that promise. Like so much of Brexit, that promise was a lie. Better by far would be to apologise for the lie, and do what it takes to find enough staff for the care homes.
Simon Jenkins is a Guardian columnist
