Migrant Care Workers in Ageing Societies UK
Background
The UK has historically had a heavy reliance on overseas doctors and nurses staffing the National Health Service, and significant research has been carried out on the contribution of migrant workers to the development of the health care workforce. In contrast, ongoing debate on the challenges faced by the social care sector has focused to a greater extent on the financial sustainability of the sector and on restructuring the delivery of care than on who will deliver the high-quality services that are needed. In particular, little attention has been paid to the role played by migrant workers who have become increasingly important actors in the delivery of paid care services to the older population. Given the reliance of the UK residential and domiciliary care systems on migrant workers, these gaps in knowledge leave policy makers without an adequate evidence base for policy development.
This research aims to bridge these gaps by exploring: i) the factors determining the current and future demand for migrant workers in the care of older people; ii) the implications of employing migrant care workers for the quality of care; and iii) the experiences of migrants employed in the care sector, including their relationships with care users.
Methodology
A major strength of the project is its multi-disciplinary empirical approach, drawing on expertise on migration, ageing and social care, and combining quantitative and qualitative data. New data collected for the project has included:
• a mail survey of 559 organisations providing residential or domiciliary care for older people, followed up by in-depth interviews with 30 selected respondents;
• 56 in-depth interviews with migrant care workers who are working in home care, residential homes and private households;
• 5 focus group discussions with older people (current and prospective users of care services);
• interviews with key informants and stakeholders in the fields of policy and practice.
Original data has been supplemented by analyses of existing evidence, including: i) estimates of the social care workforce based on the Labour Force Survey and other national datasets; and ii) projections of future workforce needs in care for older people.
Emerging Themes
• The employment of migrant workers in care occupations has increased significantly in recent years. Almost one in five care workers and one in three nurses employed by organisations providing older adult care in the UK are foreign-born, with higher proportions in the South of the country, and among those recruited in the past two years.
• Care workers, who do not necessarily migrate with the expectation of working in the care sector, originate mainly from Zimbabwe, Nigeria, the Philippines, India and Poland. The latter has become the main country of origin for those recruited since enlargement of the EU in 2004, but arrivals of Poles have been decreasing since 2007 and return migration has become more frequent.
• Employers report that their main reason for employing migrant workers is difficulties experienced in recruiting UK-born care workers. Poor wages and unattractive working conditions are perceived as the main factors behind the reluctance of the UK-born workforce to take up care jobs.
• Employers nevertheless report advantages of employing migrants: a good ‘work ethic’, respect towards older clients and willingness to learn new skills. Many argue that migrant workers have improved the quality of care provided by their organisation.
• Migrant ‘willingness’ to accept working conditions unattractive to UK-born workers may be the result of constraints rather than choice. Interviews with migrant workers show that restrictions attached to immigration status shape their decisions to enter the care sector, to stay in a job and to accept particular working conditions.
• Language and communication issues, including accents and lack of knowledge of the customs and preferences of older people, are reported to be a challenge by employers, migrant workers and older people alike. Other conditions such as staff shortages in care homes and the inadequacy of time allocated to home care visits affect the opportunity for all care workers to develop relationships with older people, leading to discontinuity in the care relationship.
• Discrimination against migrant workers in relation to working conditions and incidence of verbal abuse emerges as a key issue to be addressed.
Research Outputs
1. Conferences
Alessio Cangiano and Isabel Shutes gave a paper on "Migrant Workers in Older Adult Social Care: Unpacking the Nature of Labour Demnd and Supply" at the Workhop "New Perspectives on Care, Gender and Migration in Europe" at the Open University, Milton Keynes, on the 11 November 2009.
Alessio Cangiano and Isabel Shutes gave the presentation "Migrant Care Workers in the provision of social care services: roles, challenges and policy implications" at the Social Policy Association Conference. To view the presentation click here.
Alessio Cangiano gave the presentation "Ageing, welfare transformation and the role of migrant workers in the provision of care for older people in the UK" at the conference of the British Society of Population Studies. To view the presentation click here.
2. The report was launched on 25th June, 2009.
To open the Executive Summary, please click here.
To open the full report written by Alessio Cangiano, Isabel Shutes, Sarah Spencer and George Leeson please click here.
Speeches in responses to the report (held at the launch seminar on 25 June 2009)
Ticekty boo by Baroness Jane Campbell, DBE, Equality and Human Rights Commission
by Gail Adams, Head of Nursing, UNISON
by Mandy Thorn, National Care Association
by Kate Roberts, Kalayaan
by Ronald Cortez, Migrant Care Worker
3. Press responses
Dream Teams in Guardian Society
Migrant care workers facing discrimination and hostility in Community Care
UK will need 3,000 overseas care workers per year, says report in Nursing Times
UK more reliant on care workers from India: study in The Hindu Times
3,000 UK visa holders needed by care industry annually on Global Visas
Report finds overseas staff take unpopular jobs but lack respect and recognition in Community Care
4. Articles before the publication of the report
Some of the issues which emerged from the preliminary analysis of our data were summarised in the articles:
• Alessio Cangiano, Migrant workers’ care role is set to increase, January 2009
• Isabel Shutes, Who is going to care for an ageing population?
Further outputs will include academic papers and policy briefings.
The Team
Researchers: Dr. Alessio Cangiano, Dr. Isabel Shutes and Sarah Spencer in cooperation with George Leeson (Oxford Institute of Ageing)
Administrative support: Vanessa Hughes (formerly Carolyn Slauson)
Funders
Nuffield Foundation, Atlantic Philanthropies