We carry a future: the potential of immigration for social care in Scotland.

On Tuesday past I met some of the UK Government ministers along with three Scottish Government ministers to explore the issues of immigration as they relate to the recruitment challenges facing the social care sector in Scotland. It was a useful sharing of perspectives though I fear it will not lead to the urgent outcomes desired by many of us in the social care sector in Scotland.

Whenever I mention the topic of immigration, I am acutely aware of the polarities and positions that folk seem to adopt with almost knee jerk automatic reaction. In this short blog I want to underline why I think we need to de-politicise the issue of immigration even if that be a hope beyond heeding.

Scotland has always been a country which needs and requires an international workforce, and this has often been the case in social care. There is a demographic truth that is undeniable which states on the one hand that we have an ageing workforce population and on the other that we have an ageing overall population. We know that that by 2039 there will be an 85% increase in those aged 75+.  Latest estimates show that:

‘by mid-2043, it is projected that 22.9% of the population will be of pensionable age, compared to 19.0% in mid-2018. As the proportion of Scotland’s pensionable age population grows, the proportions of both Scotland’s working age and child population are projected to fall.’

This is at the same time accompanied by a really positive reality which is that there are more of us living for longer and into what demographers call the ‘oldest old’ age categories. National Records Scotland projects that the number of people aged 90 and over in Scotland will double between 2019 and 2043 from 41,927 to 83,335.

As I said this is positive news especially if we can continue to work to address health inequalities so that more and more people are living healthier into older age. But at the same time all this good news has an impact on our working age population. It is this that makes a flexible and responsive immigration system even more urgent and necessary for Scotland as a whole but for social care in particular.

Put simply there are fewer people of working age in Scotland, and this is only going to increase especially with a relatively closed immigration system. Now whilst that has a direct impact on our fiscal ability as an economy and society it also has an impact on our ability to fill jobs from an indigenous population base. It gets even more challenging when we recognise that an ageing workforce is consistently less productive than a younger workforce. A recent report has stated that:

‘…although “long-term sick” as a reason for inactivity accounts for 6.6% of the inactive population of 16-24 year olds, this rises to 38.4% of inactive 50-64 year olds.’

Without rehearsing the arguments over Brexit and the reality that Scotland voted substantially to remain in the European Union, the impact of Brexit and in specific the introduction of new immigration procedures has had a profoundly damaging effect on social care in Scotland. There are several reasons for this.

One of the main reasons is that in the conversations I have had with employers and social care providers, especially in rural and remote areas, we know that many folks from Europe went back home when the pandemic hit to be with their families. This was wholly understandable as the virus swept across Europe. Many of those individuals are unable to return both because of the cost of and obstacles within the new immigration system. In some parts of the country up to half of those who had worked in the care home sector and who were from Europe have left.

Secondly the whole narrative around immigration not least around Brexit has been at times toxic and unwelcoming of the immigrant. Despite the efforts of some, not least the Stay in Scotland campaign, many folks have considered that they were not welcome and who would want to stay in a place where you are not valued?

Thirdly and perhaps most immediately we know that many of the amazing women and men who were at the frontline of our pandemic fight in social care have been exhausted by the effort and looking around at the relative lack of societal valuing of their work (and those of their colleagues in social care) have decided to move into other sectors such as hospitality and retail. Indeed, the inability of those two sectors to attract an international workforce has meant that there are many more opportunities in those areas of work for social care staff. As social care providers have always known the skills someone develops in social care – skills of integrity, empathy, communication, are very attractive indeed to other sectors who often pay more and reward better.

Lastly the introduction of the points-based system and visa requirements, together with the failure to recognise the distinctive needs of social care with a salary threshold which does not equate to the reality of reward in the sector, has meant that traditional routes for attracting international staff have largely been cut off to Scottish social care. This is in no small part because unlike in the rest of the United Kingdom most social care provision in Scotland is delivered by small and medium sized enterprises who do not have the scale, capacity or experience to manage the labyrinthine ways of the immigration process.

So, the above is the mechanics and the reality of a fractured immigration system which is resulting in real damage to our ability to care as a nation. Yes, we all recognise the importance of recruiting from within our own communities and we are seeking to do that and much more. Yes, we all recognise the criticality of improving pay and conditions, and we are on that journey but let us not forget that the vast majority of social care in Scotland (and in the UK) is paid for by the State so until the Treasury really opens the purse strings and recognises the social and economic contribution and criticality of social care we will always as nations be dancing on the edge of potential.

But against all this background it is not just numbers on a demographic spreadsheet that we have lost and are losing. We have lost people, real folks who have brought over the years, their skills and talents, their innovation and creativity, their humanity and adventure to our villages, streets and cities. They have been our neighbours and friends, they have sat alongside us, worked amongst us and have been one with us in all places and spaces.

A migrant and international workforce elevates our community to a new level. We are a better place and people because we have a door open to the world, a light of welcome to encourage strangers to find a place at our hearth.

People like me will doubtless keep working at opening that door to the world, because we know that for us to care for those who need it that we cannot do it alone with the demographic realities we are facing. I will keep arguing for the urgent necessity not of butchers and truck drivers getting visas, but for folks to get visas to come and work in nursing and social care, for folks to be prioritised and for social care to be added to the Shortage Occupation List. In all the focus on toys not being on the shelves at Christmas where has been the equal focus on people not being cared for? We need urgently a regionalised, flexible, responsive immigration system which meets the needs of all sectors and all parts of the country.

The sense of a broad, inclusive and confident community is at the heart of what I think permeates the rhythm of our way of being as a people in Scotland. Not emotional idealism wrapped around a flag but a hard reality rooted in open acceptance. The welcoming of divergence and difference are the marks of maturity – the comfortableness with otherness is the soul of community. The immigrant is not to be feared but to be nurtured.

This past week was the 100th anniversary of the birth of one of Scotland’s greatest poets, George Mackay Brown. I had the honour to meet GMB when I lived and worked in Orkney some 30 years ago and this last week I’ve been reflecting on and revisiting his poetry – hearing in the words and rhythm his distinctive voice of soul-filled space and Orcadian wisdom; a place which welcomed me as a stranger and has done for so many over the generations.

His insights on community infuse his poetry and describe well the hospitality and rootedness of a place not on the edge of civilisation but at the heart of nature. It was a place that taught me that what appears to be on an isolated edge can possess a creativity which centres itself in the heart of life. It taught me that community isn’t an idyllic calmness all the time, but a reality that has to be worked at alongside others prepared to roll their sleeves up to do the work. That’s why we are less without all those who want to come and work alongside us.

I leave you with one of my favourite GMB poems – a favourite because I lived overlooking Hoy for such a long time – Orkney with its iridescence and astonishing light draws you beyond a horizon of sight – it gives you a way of seeing the world unlike any other place I know. We need urgently in our addressing the workforce crisis in social care to have a way of seeing further than we have – to carry our future into our present.

Further than Hoy

Further than Hoy
the mermaids whisper
through ivory shells
a-babble with vowels

Further than history
the legends thicken
the buried broken
vases and columns

Further than fame
are fleas and visions,
the hermit’s cave
under the mountain

Further than song
the hushed awakening
of country children
the harp unstroked

Further than death
your feet will come
to the forest, black forest
where Love walks, alone.

Quoted at https://allpoetry.com/Song:–Further-than-Hoy

Donald Macaskill