• Recommendations to government likely to address NHS concerns
  • Recommends reduced threshold for “medium-skilled workers”, covering most NHS groups
  • However, committee warns of impact on social care

Post-Brexit immigration laws proposed by the government will “increase pressure on social care”, while resulting in only “slightly improved public finances [and] slightly reduced pressures on the NHS, schools and on social housing”, its independent advisory body has said.

The Migration Advisory Committee’s points-based system and salary thresholds report, which was published today, has recommended a reduced salary threshold of £25,600 for skilled migrants, resulting in an extension of the tier-2 visa route into the UK to include medium-skilled occupations. This is likely to mean most potential NHS staff can come to the UK.

However, the MAC warned the tier-2 route “is not the appropriate one to use to solve the problems [social care] faces for low-skilled workers”.

The MAC said: “We remain of the view that the very real problems in this sector are caused by a failure to offer competitive terms and conditions, something that is itself caused by a failure to have a sustainable funding model.

“A government very concerned about the impact of the new immigration system on low-wage sectors might want to use a salary threshold lower than the general threshold.”

MAC chair Alan Manning said: “No perfect system exists and there are unavoidable, difficult trade-offs. The largest impacts will be in low-wage sectors and the government needs to be clear about its plans for lower-skilled work migration.

“The government should ensure that the mistakes of previous UK points-based systems are not repeated.”

Short occupation list

The MAC said it was “unclear” whether there was a benefit to continuing the “shortage occupation list” for medium and high-skilled jobs in any future immigration system, because of the changes to the salary thresholds. At present, this allows exceptions to the salary threshold for some roles, and most NHS professions are covered.

“The MAC does not support lower salary thresholds for occupations on the SOL: there should be upward pressure on wages in jobs in shortage, so lower salary thresholds for roles in shortage would be perverse,” it said.

The MAC was asked to consider whether salary thresholds should vary by region, but it found there should be a “single national salary threshold”, as it did not want to “institutionalise some parts of the UK as ‘lower wage’”.

“We also recommend government may want to pilot, and evaluate, some variation in salary thresholds within remote areas, as these places may face more complex challenges in recruitment and retention of workers,” the MAC said.

The MAC also recommends there should be an “immediate pause” in proposed increases to the settlement salary threshold — the amount someone has to earn to remain in the UK once their visa has finished — as it is “quite high and unrealistic for workers in a number of professions”.

Support for social care

Danny Mortimer, co-convenor of the Cavendish Coalition and chief executive of NHS Employers, welcomed the MAC’s recommendation to lower the salary threshold, but said “it does not go far enough to address the workforce crisis in social care despite recognition of the problem”.

“If social care is unable to recruit from overseas, the sector will simply not be able to meet the growth in demand, leading to significant implications for the health and wealth of the nation,” Mr Mortimer warned.

Mark Dayan, policy analyst and head of public affairs at The Nuffield Trust, said if the MAC’s recommendations were to be taken on board there would be “much less change for NHS than expected”.

“This is about switching EU migrants onto something that looks pretty similar to the current non-EU system,” Mr Dayan said. “There are some aspects of that which might be off-putting. But it’s not a move in the direction of restriction.”

However, he also warned it is “very difficult to see how the majority of social care workers could get through any of these systems”.