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Senior Care Workers

Volume 465: debated on Tuesday 23 October 2007

The quality of the life of a nation is judged by how it treats people who are most dependent upon the care of others. In this country, the care of our elderly should be not only one of our most important concerns, but one that we constantly monitor and assume to be fundamental to the quality of their lives.

Some months ago, I was approached in my constituency by a series of Filipino care workers who, to be frank, I did not know existed in my constituency. They gave me the names of and information about three care homes, owned by Southern Cross Healthcare, which I did not realise existed. They told me that they, who had been working for periods of between four and six years in this country, almost all of them with children in local schools, mortgages and stable homes, had suddenly been confronted with a case that they had never expected.

The new Border and Immigration Agency had decided, without, as far as I can see, any consultation with Parliament, that the rules for care workers needed to be changed. The work permit applications for senior care workers were altered in such a way that people who had been working sensibly and quietly at difficult jobs were told that their work permits would not be renewed. I am glad that my hon. Friend the Minister is replying to the debate; but frankly, in the past three months, I have been appalled by the way in which his Department—the Department for the Home Office, or whatever it happens to be called presently—has batted me about from one area to another with the highly spurious argument that not one Department is responsible for that set-up.

The Home Office Border and Immigration Agency, however, directly changed the rules of the game. In other words, when those workers entered the United Kingdom, not only were they accepted as capable of acting as senior care workers, but no one ever questioned their status.

The situation that my hon. Friend describes is very much like that in North-West Leicestershire and elsewhere in care homes in Coalville and in Castle Donington, where Filipino carers have worked for several years. Its worst aspects are tardiness and uncertainty, because the Border and Immigration Agency and the Home Office are not replying to letters. I wrote to the Minister, whom I greatly respect, on 4 July—not a single reply yet. I raised the matter in the Chamber on 9 July with the Home Secretary. I hope that that speeds things up and that we receive replies, so that we can remove the uncertainty hanging over many hundreds of people who perform a vital role for the very elderly in our society.

I hope to set out exactly that set of circumstances, because the whole episode has been a stain on the responsibility and reputation of the United Kingdom.

Many of the Filipino care workers were told that they must apply through their existing management, who initially said that it was the Government’s responsibility and that the workers were not allowed to apply for an extension. Then, when we obtained information from the Government, the management said that a certain rate of pay—£7 an hour for people of their status—had been imposed and that it had been made very clear that, unless the workers were paid that rate, they could not be employed.

Is the Home Office now in charge of wage negotiations for people employed in private care homes? If it is, I understand why the Department of Health sent me a letter that said:

“Matters relating to pay and conditions of employment of staff employed by independent care home operators are for negotiation for employers and employees and/or their representatives, taking account of relevant employment legislation…the Department of Health extends only as far as the regulations and national minimum standards governing the quality and safety of care”.

If that is true, how have we found ourselves in that situation? In reality, large numbers of private health care workers, working in many instances for American chains, have been told that they cannot apply for an extension of care. Owing to the fact that those women—they are largely women—are Filipino and Indian, very law-abiding and extremely worried about whether they will be able to remain if they do not have legal status, they have in some instances been driven out of the country at very short notice, and they are in others terrified that, in some way, they will contravene the rules.

I congratulate my hon. Friend on securing the debate. She mentions that the Filipino workers are law-abiding. Does she agree that, of all the immigrant groups, they are probably the most industrious, well-motivated, law-abiding and socially integrated in our society? Does she agree also that the Minister should show some compassion when dealing with that group and that they should be allowed to work out their current permits? Their precipitous removal would be at great personal cost to the individuals, their families and the hundreds of thousands of elderly people who need that top-quality care.

I strongly agree with every word that my hon. Friend says. Let us enumerate the qualities of those women: they are English-speaking; they are enormously warm in their approach; and they do difficult jobs in care homes dealing with the elderly—in some cases for the minimum rates of pay. They are doing jobs that Britons do not want to do—jobs that will not be filled successfully by people who are non-English-speaking. However, that appears to be the burden of the argument: get rid of people who are without the European institutions and countries, and replace them with people from eastern Europe. If that is true, it has been done in the most astonishingly incompetent, insensitive and appallingly thought-out manner.

I wrote to the Prime Minister saying that I was being bounced from one Department to another without any clear statement about the circumstances. I shall quote a letter from a marvellous man called David Edgar, who has been doing his best to protect those workers, simply because he was so concerned about what was happening in the care homes about which he knew. He said:

“There is…abundant evidence that…many small care home companies who are desperate to employ experienced and qualified Senior Care Workers who…speak excellent English…are quite happy to pay the imposed hourly rate however their nightmare is the constant moving goalposts of the Home Office, the rules are now so complicated and conflicting that care home managers do not know how to apply for Work Permits, Visas and…at a cost of £190 for each Work Permit…are very reluctant”

even to try.

Those are the responsible companies. The irresponsible ones have simply told people that they will not apply for extensions, and they are leaving large gaps. In subsequent evidence, Mr. Edgar says that he believes that many of those women are “now being blackmailed” into doing much harder work to fill the gaps and that, in some instances, they are being told that, if they create any difficulties about their terms and conditions, the Home Office will be told that they are not to remain because the company will not apply for any extended permits.

I apologise, but only yesterday did it occur to me that I could not be the only Member who was dealing with the situation. As we can see from the number of my colleagues who are gathered in the Chamber for a half-hour debate, that is true. Some 24 Members e-mailed me with specific details. Some of them had as many cases as me—I have more than 20 in my constituency—and some Members have up to 50. Some of the cases involve the most appalling stories. In one case, six care workers had their work permits refused, even though they had been here for four years.

My hon. Friend the Member for North-West Leicestershire (David Taylor) and many others have given me detailed case histories that not only chime with what I have discovered but make it clear that the problem continues. My hon. Friend the Member for Eccles (Ian Stewart) has approached Ministers and been given the same sort of reply as me and has also been told by a care home:

“The handling of this matter by the Home Office has been shambolic…No one at the Home Office gives a damn about the effect these guidelines have had on staff welfare. This is nothing more than an effort to increase the deportation figures”.

I do not have to agree with every word of that to say that Members of Parliament are extraordinarily concerned about what has been happening to those people.

If the Minister gets to his feet and says, “Of course, this is not a matter for me; it is for the Borders and Immigration Agency”, I can say to him only that there is a lamentable failure in management care in the Government, considering that two major Departments seem totally incapable of deciding what they want to do. If there was wide consultation on the change in the rules, with whom did it take place? When was it brought before Parliament and why were we not aware of it before it happened?

Once Members of Parliament started to raise the matter, the Home Office mildly backed off by saying that there should be a degree of flexibility in how cases are handled. However, as far as I can see, there has been no plain statement of the status of the women in question, even though it is known not only that they are desperately needed in the care homes where they worked, but that their absence is putting enormous strain on the existing health care staff and the quality of life of the people living in those homes.

Since a Department of Health Minister is responding to the debate today, I want to know what the Department intends to do. Why is it not possible for the Home Office to grant those women an amnesty for a minimum of three months after the expiry of their work, if it can clearly be proved that they have been working here, in some cases for up to six years, so that they can apply for other jobs? Let them apply for other jobs in the health service or the care homes sector. There is absolutely no reason why that should not be so.

Filipino nursing qualifications are extraordinarily good. It is all very well for the Department of Health to say, “Well, of course they can get themselves accredited and apply.” Those women have no support system, do not know what they have to do to get themselves accredited in a foreign land and face the considerable pressure of wondering whether they will be thrown out of the country in a short time. It is clear, since none of us seem to have accurate figures of the number people involved, that more and more people’s work permits will soon expire and their cases come to light. Their Members of Parliament will ask for clear protection for people from whom we have clearly benefited, yet seem prepared to abandon without a thought to their situations.

I shall not take the Minister through everything that has happened to senior care workers, but I shall say that David Edgar, who has been fighting this battle almost single-handed, dealt with another Southern Cross home, not in my constituency. He made a request to the Home Office in July, and the carers in question were ordered to leave the UK on 27 July. The Minister was served with a letter before action, and legal action is taking place. However, in August, Southern Cross—the very people who were saying to their workers, “Well, I’m awfully sorry, but as far as we are concerned, once your work permit ends, you are on your own”—signed up to a skills pledge. Like me, David Edgar then went to every relevant Department. There was a change on 13 August, when new work permit criteria were introduced.

A parliamentary Committee condemned the poor treatment, abuse and neglect that elderly residents receive in many care homes, at the same time that even more difficulty was being caused. David Edgar then made formal complaints on behalf of various care workers about the way in which they had been cheated out of money. He was received not only with little evidence that the police intended to investigate but with scant courtesy. Since the beginning of the episode, there has been an appalling set of circumstances that does nobody any credit.

I wish to ask the Minister a number of things. Has his opposite number in the Home Office said that he is prepared to assist those women if they can genuinely show that they have been here for a certain length of time and have the skills to find jobs in the health care sector? If not, is the Home Office prepared to make specific undertakings on how those workers can be assisted in the interim period to deal with the circumstances in which they find themselves?

The Minister will forgive me—I am allowed an elderly moment. I did not realise that he was indeed in the Home Office. I am surrounded by Ministries whose names I cannot pronounce and whose acronyms seem to produce such sounds as “Brrrrrr.” He will forgive me for not realising that he has moved on.

Although I am allowed senior moments, I, too, will need care at a certain time in my life. I shall want it to come from people who are nice, warm and caring and have proper training. The group of women affected exemplify those standards and the best in care work. Many of them are now terrified—I use that word advisedly. I have had people wandering into my surgery, as I am sure other Members have, saying cheerfully to me, “Oh yes, I was refused the right to remain here”—10 years ago, in one instance. Yet these women come to me weeks before their work permits expire and say, “We are so frightened. What are we going to do? We will have to leave our homes and take our children out of school. We will have to deal with it.”

If a mistake has been made, which I believe it has—24 Members of Parliament are not making up the problems that they have told me about—the Home Office should simply say so. It should bring in interim arrangements and make them clear and public. It should stop running away from what it obviously perceives as a suggestion that it is giving special care to those who come from outside the European Community, and it should ensure that it does not impose such things as hourly rates and then tell me that the matters for negotiation are for those in the health care service. It is a case of one or the other: the Government might decide on home care rates—fine, I do not have a problem with their setting minimum rates—but they should make up their mind. When they do, they must remember that the people affected are not toys or counters; we are playing with people’s lives. So far, we have not done a very good job.

I endorse everything that my hon. Friend has said. There have been such cases in my constituency, and we cannot get people to fill the jobs created. The ladies at Stocks Hall nursing home do a fantastic job. They are caring, diligent and everything that one would want. The residents want them and so do the directors, but they cannot afford to pay them £7.02 an hour. I ask the Minister whether it can really be fair to allow those individuals to come to England, take up employment, settle in the community and then face deportation after two years. They are efficient staff members and really needed.

The Minister knows the case. Let us hear his explanation or, better still, his excuses and decisions about what he is going to do to assist such people urgently. This is an urgent problem.

Let me start by congratulating my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) on securing the debate. As she has said, I used to be the Minister with responsibility for social care, and in my time at the Department of Health, the issue of the work force in social care detained me more than most.

This afternoon, I shall sketch out the chronology of events that has brought us to this stage and the transitional arrangements that I put into place, which are benefiting nearly 80 per cent. of people in this category. Before I expand on those points, I apologise to my hon. Friends—we are all hon. Friends this afternoon—if there have been delays to the replies that they have received. Such tardiness has sometimes been due to my concern to ensure that the policy was right before we got back in touch with people, because it has been changed substantially. I take personal responsibility for the policy, because I have spent a considerable amount of time on it in the past few months, not only with officials, but with hon. Friends and other hon. Members.

That brings me to my second introductory point: if colleagues have particular cases that they want to bring to my attention, I am always happy to meet them to discuss in detail how I can help. My hon. Friend the Member for Weaver Vale (Mr. Hall) is not present, but he has been particularly vocal in arguing this case to me, so I wanted to put his name on the record.

To give a brief chronology, the changes in this area began in October 2006, when new age discrimination legislation was introduced. Against that backdrop, care home operators continued to advertise senior care worker jobs in local job centres, as they are required to do to pass the resident labour market test. In those adverts, they specified that the post of senior care worker required a national vocational qualification level 3 and three years’ experience in a job at that level. That is important, because the work permit system has operated on two important principles since 2000—this is not a recent innovation; it has been around for seven years. The first principle is that people coming in under the work permit scheme have to be skilled. Only two parts of the immigration system operate low-skilled schemes: the seasonal agricultural workers scheme, which will soon be given over to residents of Bulgaria and Romania, and the food processing scheme. Between them, those schemes have about 20,000 places.

The second principle, with which I am sure all Labour Members will agree, is that people must be paid the going rate to do the job. My hon. Friend is right that the Home Office does not conjure its guidance out of the air. It simply reflects what Skills for Care and other sector skills councils tell us is the going rate for a particular post. Another problem then arose: Jobcentre Plus pointed out to us that employers could not justify advertising those posts as requiring an NVQ level 3 and three years’ experience because the role being performed did not require such skills. Age discrimination legislation says that a job requirement cannot stipulate skills that cannot be justified and cannot be potentially discriminatory. Research was then undertaken within the sector to see whether the senior care worker post did, in fact, meet the skills criteria. Let us not forget that the reason why the post existed was that the care industry said that the job required that level of skill. However, evidence then emerged that there was no such requirement, and our research confirmed that, which placed us in a difficult position.

Obviously, the Home Office cannot operate a policy under which we give work permits against our own guidance—the relevant guidance being that people need to have a certain level of skill to do the job. The result was that 100 per cent. of the people who applied for extensions were being refused. I was not prepared to countenance that, so I asked my Department to work with the Department of Health to see how we could introduce new guidance that would allow the post of senior care worker to be retained and waive the skill requirement that we insisted on before, on the condition that employers stepped up to pay the going rate for that job. My hon. Friend is right that it is not for me or a Health Minister to determine that pay rate; we have been advised by Skills for Care that it is the going rate for that job. Some hon. Members have said to me that that is a national raise. Of course, social care is a different business, and there are different rates of pay in different parts of the country.

The Minister has four minutes left in which to tell us what he is going to do now. I accept that his Department got itself into a mess. The legal advice that it received was unhelpful, and it is my experience that one can get different legal advice if one wishes. The reality is that the women whom we are discussing, who have enormous abilities, are being thrown out of the country and are not being replaced, and that the ones who are left are being overworked. What is he going to do about it?

Let me come to that point directly. The Home Office has to translate Government policy into the immigration rules, and that is sometimes difficult, but I do it to the best of my ability. I have put transitional guidance in place, and the figures show that 79 per cent. of the people who apply for extensions to their leave are being given further leave to remain. That is partly driven by employers accepting their responsibility to pay individuals the going rate for the job. My hon. Friend is right that those workers are hard-working, well integrated and doing something with a level of tenderness, expertise and care that is, in my experience, second to none. It is not unreasonable for businesses in the social care sector—I name Southern Cross in particular—to pay £7.02 an hour for that job.

I hear what the Minister has said. We should tackle the employers that treat their employees shoddily, not the employees themselves.

My hon. Friend is absolutely right. That will take some fundamental changes to the way in which the immigration system is run. One of the founding principles of the points system that will be introduced at the beginning of next year is that employers will need a licence to sponsor people into the country, so that we will have a means of quality control.

My hon. Friend asks, from a sedentary position, about people—her constituents, I think—who are here now. I have made it my policy not to discuss individual cases in the Chamber.

There are 20 of them. What is the Minister going to do about the 20 that I have and the 50 that my hon. Friend the Member for North-West Leicestershire (David Taylor) has? We need an undertaking now.

I ask my hon. Friend whether we can meet privately to discuss her constituents’ cases and see whether there is something specific that we can do. As a general principle, the transitional guidance means that 80 per cent. of people in that category are getting their leave extended. For those who are not, I challenge the employers to pay the going rate for the job.