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When Yvette Cooper announced she was cancelling visas for social care, in a round of tough-talking TV interviews earlier this month, she made clear that pay and conditions in this chronically understaffed sector must improve.
The home secretary is right. As any regular care home visitor will attest, these are highly skilled, overwhelmingly female workers, surrounding those they look after, not with an “island of strangers,” but with diligence and love. Wherever they come from, we should be treating them better.
In truth, the number of health and care visas being issued each month has already plummeted by more than 80%, since a Home Office crackdown on rogue employment agencies, and tougher rules about bringing in dependents.
And as Andrew Harrop, director of the consultancy Public First, pointed out last week, the vacancy rate in social care has declined, from 8.1% to 6.8%, over the period since the Tories tightened up the system. That offers some hope that choking off the supply of new visas won’t be the disaster some have predicted.
But improving terms and conditions across this neglected sector remains an urgent national challenge.
Labour came into government with a plan, to improve these low-paid and undervalued workers’ lives – though like so much of its agenda, the question of whether the Treasury is ready to foot the bill, is left hanging.
Wes Streeting has postponed confronting the political tradeoffs involved in long-term reform of social care funding, handing the fraught issue over to Louise Casey to have a good long think (the final report is not expected until 2028).
In the meantime, though, Streeting and the deputy prime minister, Angela Rayner, have pressed ahead with discussions over a “fair pay agreement” (FPA), for England’s 1.6 million social care staff.
Both cabinet ministers have popped up at recent closed-door meetings between unions, social care employers and government officials, about how to negotiate an agreement that would create a statutory floor for pay and conditions.
It is a painstaking process: given the fragmentation of social care, with 18,500 different employers, even the question of who will sit around the table is potentially contentious.
And while the unions involved are naturally experienced with negotiations, many care employers have never participated in collective bargaining – a recent meeting involved what one person called a “teach in” about how it usually works.
Labour’s employment rights bill, now in committee stage in the House of Lords, will give Rayner the power to set up the bargaining structure for an FPA. But even after the legislation has received royal assent, the government will have to consult publicly on the details.
It will then table regulations to establish the negotiating body with the outcomes – on pay and potentially other factors such as travel time and career progression – expected to be given legal force, right across the sector.
It’s worth pausing to underline how radical a change this would be in a fragmented and barely unionised sector. Staff have often been seen as less valued than their counterparts in the NHS, which has a long-established process of collective bargaining, known as Agenda for Change.
Optimists involved in the FPA discussions hope social care workers might expect to see the benefits in their pay packets as soon as April 2027; pessimists fear it could even be pushed beyond chancellor Rachel Reeves’s next spending review period, into 2029.
Transitional measures announced by Cooper to smooth over the cancellation of social care visas, by allowing employers to hire staff who arrived in the UK by another route, are due to expire in 2028.
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A timely new Fabian Society pamphlet, published on Monday, makes a first stab at envisaging what an FPA might need to do to tackle the recruitment crisis in the sector and give staff the dignity they deserve.
It recommends that care workers in England should be offered a higher minimum wage, of £13.17 an hour (Scotland and Wales have their own approaches), putting them on a par with healthcare assistants in the NHS. That would be a rise of about £2,000 a year and the analysis also recommends better pay progression for more experienced staff, which is currently dismal.
In addition, the Fabian Society calls for all social care staff to receive sick pay worth 50% of wages and employer pension contributions at 5%.
With the councils that commission much social care already on their knees, it makes clear that such a proposal is only workable if fully funded by central government.
As a package, the Fabian Society calculates these improvements would cost £2bn a year – a chunk of which would come back to the state in reduced benefits payments.
Presumably wary of proposing anything that resembles a “death tax,” a “dementia tax,” or any of the other doomed efforts at resolving social care funding, the Fabians suggest several small tax tweaks to pay for it instead, including raising VAT on private healthcare premiums.
Given the government’s determination to stick to its self-imposed fiscal constraints, this may be a reasonable way of bridging the gap between the pressing need to raise the floor for these workers, and whatever long-term fix Casey comes up with.
But it is no substitute for funding the creaking social care system in a fairer and more sustainable way, whether through an Andrew Dilnot-style cap on fees, an Andy Burnham-style “death tax” on estates, or any of the other well-studied options available.
And ducking that urgent question, for Labour’s entire first term, is every bit as politically “squalid” as the Tories’ decision to paper over the cracks with an influx of extremely hard-working staff from overseas.
