If ever there’s an issue – or a sub-section of a broader issue – that sums up the sense that the UK is broken, even eight months after a new government was supposed to set a new direction, it’s social care.
The crisis in social care has been recognised for decades, but successive governments have failed to tackle it, and it’s getting rapidly worse. This is bad enough on its own, but it has two serious knock-on effects: it reduces the effectiveness of the NHS as it cannot release from hospitals some patients who are fit to leave but have nowhere to go; and it further drags down the reputation of local government, which doesn’t have the resources to deal with social care and sinks ever lower in the public’s estimation. Add the effects of Brexit, Covid, the cost-of-living crisis and a toxic debate on immigration, and you see why the situation with social care is worse now than it has ever been.
So what do we do? Well, a lot of money would help – most solutions to the social care problem require money, but, let’s face it, the kind of public spending that just isn’t feasible at the moment. So we have to look in other directions.
There have been four major shocks to the social care system in recent years: Covid, the cost-of-living crisis, Brexit, and Britain’s attitude towards immigration. The first two are factors largely outside our control. We can’t undo the loss of so many NHS and care staff due to the impact of Covid, and the cost of living crisis, coupled with repeated rises to the Real Living Wage and NI rates for employers, has sent the cost of staff rocketing, with many care companies struggling to compete for permanent staff and often forced to pay high wages to agency personnel.
But Brexit and immigration are political. One of the less well known consequences of Brexit is that professional qualifications gained in the UK are no longer automatically recognised in the EU. This means young nurses or physiosbased in the EU, who might in the past have felt that spending some years working in the NHS would be a good career move, can no longer use qualifications gained here in their home counties. This immediately shut down a key source of keen young staff in both the NHS and care sectors in the UK. The change didn’t even benefit the EU – those workers often returned to home countries such as Romania or Portugal with new skills learned in our large teaching hospitals, a mutually beneficial exchange of skills and knowledge. Revisiting the Brexit agreement to eliminate this short-sighted lack of cooperation would make a small but significant improvement to social care.
In parallel, public antipathy towards immigrants and pressure to reduce levels of immigration mean recruiting staff from overseas is harder, as the UK is seen as a less attractive destination. While many in politics rush to emulate the anti-immigration language of the far-right, who is thanking the migrant workers who are keeping our fragile NHS and care system alive? We need to make a stand or it will become even more difficult to recruit care workers. The recent papersubmitted to the party’s policy review What would Paddy do?will no doubt attract much flak for saying the party should outwardly champion immigration, but we just shoot ourselves in the foot if we don’t make migrants feel appreciated.
This is not just principled liberalism – it is enlightened self-interest for today’s adults! Many of us will one day rely on social care. And with an aging population, if many of us want to retire at a similar time to our parents, we need to recognise the huge benefit to the country of the stream of talented young people who would love to come and work here, if only we were willing to offer them the opportunity.
We need to find the language to convince the UK public that the fact that many people want to live and work here bringsmassive potential benefits, not just for social care and the NHS, but for the economy generally. We can all benefit from the creativity and talents of the many people who want to come to these shores. Changing the narrative on Brexit and immigration is key to fixing the care crisis – and so many other problems for our country too.
* Lucy Nethsingha is Lib Dem Leader of Cambridgeshire County Council. She was MEP for the East of England from 2019-20. Her pre-politics career was in teaching, where she took a particular interest in early identification of Special Needs.
Follow @libdemvoice.org on Bluesky
Like us on Facebook
Subscribe to our feed
Sign-up for our daily email digest
The Joy of Six 1339
Kemi Badenoch vs the Conservative Party: how the polling compares - The Week in Polls
F10 is passed overwhelmingly. Now the work begins...
Blackness Road - 1967 #dundeewestend
Torchwood is now a Cardiff Bay institution
Zachary Adam Barker
tom arms
Neil Hickman
Joe Bourke
14 Comments
Two issues. Should we keep bringing skilled staff from very poor countries that desperately needs to retain personnel.
Secondly – we have record inward immigration and not seen the so called economic benefits that’s meant to arise from this .. Stagnating growth, flat lining wages for many , soaring rents , ballooning housing & NHS waiting lists, huge rises in council tax and utility bills ..The so called benefits of such significant inward migration had just not materialised on the
scale we’ve been led to believe.
I disagree that the solution is to attract workers from abroad when we have so many potential workers in the UK currently classified ans rconomically inactive. Sure it makes sense to prioritise these people – something that will benefit the individuals themselves while also saving money currently spent on Welfare that can be directed to the Social Care budget
I have never understood what is Progressive or Liberal about a rich country pillaging a poorer country for their health care workers.
Do the people living in the poorer country not deserve health care? We should be training our own rather than relying on poorer countries to train them for us.
The increased GDP from migration does not result in increased GDP per capita if the increase in population is larger than the increase in GDP. Which it has been , recently.
Might Spain’s approach to migration be worth discussing?
https://www.theguardian.com/world/2025/feb/18/how-spains-radically-different-approach-to-migration-helped-its-economy-soar
@Steve: Spain is in a very different situation to the UK. Up until 2015, Spain was net losing population due to migration (See https://www.statista.com/statistics/445930/migration-flow-in-spain/), so unlike the UK they had a very good reason to encourage more immigration. And even with that encouragement, net migration to Spain per head of population today isn’t that different to the UK. Besides, the very article you cited makes it clear that there are other reasons besides migration behind Spain’s economic growth.
Might this article, entitled “Europe To Be Short 44 Million Workers by 2050 Without Increased Immigration, New Study Finds” be relevant?
https://www.cgdev.org/article/europe-be-short-44-million-workers-2050-without-increased-immigration-new-study-finds#:~:text=Press%20Release-,Europe%20To%20Be%20Short%2044%20Million%20Workers%20by,Increased%20Immigration%2C%20New%20Study%20Finds&text=WASHINGTON%20%E2%80%94%20The%20European%20Union%20and,the%20Center%20for%20Global%20Development.
@Slamdac
Claiming that foreigners who come here of their own free will for a better life are victims of human trafficking denies their agency and implies that human beings are nothing more than a nations resource. I doubt you would argue that British expats living in Norway victims of Oslo’s pillaging.
Furthermore, poorer countries tend to have higher birth rates and fewer pensioners, and stand to gain immensely from remittances.
What is more poorer countries have high
Furthermore,
@Slam
“Do the people living in the poorer country not deserve health care? We should be training our own rather than relying on poorer countries to train them for us.”
And don’t professionals from poorer countries deserve to be able to better themselves for their futures and their families’ futures?
A nurse in Ghana for instance, earns 2500 GHS a month, in case your wondering, thats about £130 a month. After years of dedication to get their degree, they are now expected to live on pittance, mind you, I guess you could say that 2,500 Cedis a month is better than what the minimum wage is in Ghana which it typically around 600 cedis a month arounf £30 a month.
In Ghana they dont have the privilege of paying rent monthly, they are expected to pay 1-2 years up front of around £400 a year, for a slum you would not want to put your dog in.
Why wouldnt these people want to escape that to a country of better opportunities for themselves and their families.
Would you live under those conditions willingly if you were born in such a country, or would you look for a better future?
None of this changes the fact that in the UK we have a birth rate of 1.6 whereas we need a stable population with a birth rate of 2.4 to support an aging population, and therefore, we need immigration to sustain ourselves, unless you want to ask people to work till they are 90
Slamdac was questioning – and rightly so , is it morally right that a Ghanian nurse trained for by the state should end up in a very rich country that doesn’t seem prepared to train pay and retain it’s own staff – given the number of people that are currently inactive? Doesn’t Ghana deserve a functioning health service with qualified staff employed by it.
We’ve all heard the mantra about immigration being a good thing and the economic benefits it brings – people will be forgiven for wondering just what they are, given the current state of affairs. That claim is getting a bit tiresome.
It’s sad that a discussion which started about social care was easily diverted into an ill-informed discussion about immigration.
It is even more sad that addressing the biggest issues around social care were written off as “ let’s face it, the kind of public spending that just isn’t feasible at the moment”. That argument, along with HM Treasury reluctance to allow any open-ended financial commitment, has resulted in misery, pain, indignity and death along with appalling demands on family carers.
@Gordon: We’re discussing an article about – to part-quote the title ‘attitudes towards migrants’. Seems quite reasonable to me that people might want to discuss immigration in response to an article that’s partly about immigration! And in what way do you think the discussion is ill-informed?
Back to the article: I feel one mistake the article makes is to confuse wanting lower immigration with hostility to migrants. The two are not the same thing! Personally I totally get the migrants are often making a huge and very brave decision to uproot themselves move to another country in search of a better life, and many migrants contribute hugely in the process. But I also recognise that our rapid population increase driven by our very high levels of immigration of the past 20 years has placed huge strain on our housing supply, infrastructure and communities (and remember, shortage of housing leading to high housing costs is one of the main drivers of poverty) and that is not sustainable. I’m very sure my views are not unique, and most of the desire of many voters to reduce immigration arises from concern about infrastructure etc., NOT from hostility to migrants. I feel it’s very hard to have a sensible discussion when people keep mischaracterising the debate in this way.
The migration debate is actually two separate debates – one debate is about how many migrants we should give permission to move to the UK per year, and the characteristics, skills etc they should have. A second debate is over how to remove those who come to, or remain in the UK without legal permission. Most voters I speak to are happy to have a planned number of immigrants per year for reasons that benefit the country but oppose those who come or stay illegally being rewarded for their actions by being allowed to stay
It is mainly difficult to recruit for care work in the UK because of low status and low pay.