Somebody call a doctor
All latest updatesThe NHS may escape the worst, but less sensitive public services might struggle
MANY of the 52% of Britons who voted to leave the European Union did so because they wanted to reduce immigration. Since the June referendum, however, the implications of such a policy have started to dawn. As well as keeping British businesses ticking over, European migrants fill jobs in the country’s public services: one in ten doctors and one in 25 nurses is EU-born, for instance. Thousands more work in low-skilled public-sector jobs, as bus drivers, street sweepers and school caterers. “We are reliant on foreign labour to deliver public services more cheaply,” says Jonathan Clifton of IPPR, a think-tank. What will happen if that stream of labour dries up?
There are 3m EU-born migrants in Britain. Theresa May, the new prime minister, has indicated that they will be allowed to stay, as long as Britons abroad get the same treatment. The bigger question is how the country will treat new arrivals. Last year net immigration from around the world topped 330,000, of whom more than half came from outside the EU. Non-Europeans’ entry is determined by a points system based on criteria such as education and salary, whereas Europeans are free to enter Britain at will. If Britain opts out of the EU’s free-movement rules, EU citizens might be subjected to the points system, or something like it.
At present the minimum requirement for non-EU work visas is an annual salary of £20,800 ($26,900)—due to rise to £30,000 next year—and a graduate-level job. Last year, only 19% of EU migrants employed in Britain were in graduate-level jobs earning more than £20,000. Indeed, only one-quarter of all jobs in Britain meet the conditions for the most common non-EU work visa. In some migrant-heavy industries, almost no workers would qualify: in “agriculture, forestry and fishing” only 4% would meet the conditions; in “distribution, hotels and restaurants” 6% would. Few of those toiling in unskilled public-sector jobs—waste disposal or cleaning services, say—would meet the criteria. “That would have a significant impact on public services across the board,” says Bob Price, leader of Oxford City Council.
How, then, would public services respond? Many are worried that the National Health Service (NHS), whose junior doctors are in revolt over a new contract that they consider miserly, might find it even harder to attract staff. Britain is already 24th out of 27 in the EU for the number of doctors per person. Many of its home-grown medics are leaving in search of better deals in Australia and Canada. Carlos Vargas-Silva of the Migration Observatory at Oxford University thinks that, if necessary, the government may impose less restrictive criteria for visas in the NHS. Most doctors would anyway satisfy the current non-EU visa conditions, and nurses are on a “shortage occupation list” which means they do not have to meet the usual requirements. “It is hard to see any scenarios where there would be limitations on medical professionals,” says Mr Vargas-Silva.
But other, less politically sensitive services might struggle. One in 20 people employed in adult social care—which includes old folks’ homes and social work, for instance—is EU-born, a total of about 75,000 people. The sector is already acutely understaffed: last year there were 70,000 unfilled vacancies. Even before the Brexit vote, a report by Independent Age and the International Longevity Centre, two NGOs, estimated that, by 2020, this figure could rise to 200,000, or 14% of the workforce required.
Polls suggest that support for Brexit was strongest among pensioners, around 60% of whom voted to leave the EU. Those who did so in order to limit migration may find, too late, that they were the ones who needed it most.
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