Scotland’s Health Secretary has requested an urgent meeting with the UK government over the impact the new immigration system will have on social care in Scotland.

‘Acute pressure’ is being placed on frontline carers in Scotland by the pandemic, Jeane Freeman says in a letter to Immigration Minister Kevin Foster, and the steps taken to mitigate the impact of the end of freedom of movement between the UK and the EU are simply not enough.

Scottish Care CEO Dr Donald Macaskill said the UK government had so far been deaf to calls for action from the sector, which was already finding it harder to recruit new staff.

Earlier this month the Home Office announced changes to immigration rules affecting some health and social care workers.

Several roles were added to the Shortage Occupation List – including pharmacists, senior care workers and nursing assistants – meaning it would be easier for them to obtain a skilled worker visa.

Scottish Care and the Royal College of Nursing however have previously called for all social care roles to be recognised as skilled work, warning that the exclusion of non-senior social care staff from the Shortage Occupation List would exacerbate vacancy rates in the sector.

In today’s letter, Ms Jeane Freeman says the UK Government’s “limited action” so far to mitigate the impact of Brexit and covid on social care “are not sufficient to mitigate against impending staff shortages”.

The letter calls for Boris Johnson’s administration to extend the EU Settlement Scheme (EUSS) amid fears many workers may be unable to apply by the deadline of the 30^th June, re-evaluate the “significant costs” of migration and add all social care roles to the Shortage Occupation List.

The costs of recruiting from overseas represent a “significant barrier”, the letters states, particularly when so many of Scotland care homes and care at home providers are smaller providers, often family-run businesses.

All social care workers are required to pay a visa fee of up to £1,220 and those who do not qualify for the health and social care visa remain liable for the immigration health surcharge of £624 per year.

Providers are required to pay for a sponsorship license of up to£1476 as well as the immigration skills charge – another fee of up to £1000 – and a certificate of sponsorship for each worker that costs £199.

“We would consider it necessary for these costs be re-evaluated if this sector is to meet its workforce needs now that free movement has ended”, Ms Freeman says.

Late last year the Scottish government warned the country would lose up to one in ten social care workers if the UK government continued to regard them as unskilled. The UK health and care visa programme was described by Scottish Care CEO Dr Donald Macaskill as a “slap in the face” for care workers who would struggle to qualify under the UK’s new points-based immigration scheme.

Ms Freeman added: “I am informed by sector stakeholders that these factors are having a substantial impact on the delivery of crucial health and social care services in Scotland. The Minister for Europe and International Development, Ms Gilruth, and I have received increasingly concerning reports from Scottish social care stakeholders regarding staff shortages in our social care sector.

“…We have particular concerns around staff shortages in rural areas where there are high concentrations of EU citizens in social care roles, and a limited pool of domestic workers to replace them, as well as shortages of nurses working in social care.”

“It is both galling and shameful that after the efforts of the last year during the pandemic we are faced with increased difficulties to recruit to essential posts across the country.”

Scottish Care – the representative body for independent care providers – has thrown its weight behind the letter.

CEO Dr Donald Macaskill says he continues to be “disappointed and dismayed” by a lack of appreciation shown by the UK government of the challenges being faced by social care providers in Scotland:

“It is both galling and shameful that after the efforts of the last year during the pandemic we are faced with increased difficulties to recruit to essential posts across the country.

“Scotland has been enriched by the skills and contribution of an international workforce. As a nation and society we are better because we have a door open to the world. The effect of the new UK immigration process is to shut that door.

Dr Macaskill says the care sector is facing “real and immediate” challenges to fill vacancies that cannot be filled by the existing population.

“At the very least we are calling for all social care roles to be added to the Shortage Occupation List to reflect the reality of social care rather than what the Home Office may assume to be the real world of social care provision.

“We support the call to extend the EU Settlement Scheme (EUSS) as we are aware that frontline workers already in Scotland have been focussed on saving lives and dealing with the pandemic and many have not made application to the Scheme. They need time to recover and renew themselves.

“We hope the Minister will heed the call and meet the Cabinet Secretary. Sadly the UK government has been deaf to our calls for action on these critical issues.”

Asked whether the Home Office intended to push back the EU Settlement Scheme deadline or add all social care roles to the Shortage Occupation List, UK Minister for Future Borders and Immigration Kevin Foster told healthandcare.scot: “Our new Health and Care Visa, plus the expansion of the occupations which qualify for it, has given employers access to skills and talent at a global level, with fast track processing and an exemption from the Immigration Health Surcharge.

“At a time when the economic impacts of covid-19 mean more people across Scotland face an uncertain future about their employment it is right employers and the Scottish government focus on domestic job seekers first, providing the training needed to take up roles in social care and the rewarding packages these workers deserve, rather than turning to UK Immigration Policy for an alternative to this.”

Read more: Migration experts call for social care wage hike; RCN says immigration must recognise care workers; Ministers demand care worker visa U-turn

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