[00:00:00] Stories, Labels, Misconceptions NHS remains a blessing. Created in 1948 We want it to remain great A podcast where we share our stories Explore solutions in all their glories. They say it's broken, but it's not done. With your host Val Barrett, Dr. Jeremy Anderson

Val: Today, we're exploring the crisis in the UK's care sector, a sector already overwhelmed. underpaid and reliant on overseas workers.

Val: The government has announced changes to immigration rules, including stopping new care workers from abroad, bringing family just when the sector needs the most. [00:01:00] This episode asks who will do the caring and what does it say about how we value care work and the people who do it.

Val: Welcome to another episode of Stories, Labels and Misconceptions.

Val: As always with me, Val Barrett. 

Dr Jeremy: I'm Dr. Jeremy Anderson. 

Val: Hello 

Dr Jeremy: and how 

Val: You today? 

Dr Jeremy: I'm doing great, and I was thinking I just need to start this off by saying, by just reminding people that I am an immigrant to this country. And work in healthcare service.

Dr Jeremy: So I think the issues we're talking about today are really directly relevant to, what brought me to the UK. And so I don't think you're going to hear me speak out against immigration it would be hypocritical of me to suggest that we should have fewer immigrants legally migrating to the UK to work in the healthcare service.

Val (3): That's 

Dr Jeremy: I do have personal experience. So I think I can comment on some of the things that the government was talking about [00:02:00] in their white paper because I've just reviewed that. I didn't review the whole 82-page white paper but I did get the highlights, and some things were a bit confusing.

Val: I was shocked at the language. 

Dr Jeremy: I didn't watch 

Val: land of strangers, I'm born here. 

Dr Jeremy: Yeah. 

Val: My parents came here from Jamaica in early sixties, about 1960. And my father worked on the M6. 

Dr Jeremy: Yes. 

Val: He came here first. Got a job because what normally happens is the man can sleep anywhere.

Val (3): You 

Val: can sleep on someone's floor, but he's not going to let his wife and kids. So he came first. 

Dr Jeremy: Yes. 

Val: Got a job, saved money. Thought, okay, I've got my wife and two children back in Jamaica. [00:03:00] Who do I send for next? The ideal thing is to send for the other person that can get a job.

Val: So we found a job for my mother. Before she came here. So he got her here. 

Dr Jeremy: Yes. 

Val: So she worked. They both worked hard found a home and saved up enough money he didn't want to send for one child and leave one out there. 

Dr Jeremy: So the kids weren't with mom. Mom came over. 

Val: My mom came over. My sister stayed with grandparents. 

Dr Jeremy: Okay. So what 

Val: happens is 

Dr Jeremy: Parents are separated from their kids. 

Val: The man comes first. So when people say where are the women? Where are the women? The man comes first, if you haven't got a home for your wife and kids, you're not going to ask your wife to sleep on someone's floor.

Val: As my dad could sleep on someone's floor, on their sofa. Save up money, [00:04:00] send for the wife. She can get a job. Save up money. Find a home then bring the children. 

Dr Jeremy: Yeah. 

Val: That's why when people moan and say, where are the women?

Val: Would you put your wife on someone's floor or you don't know exactly what you're coming to 

Dr Jeremy: is 

Val: easier for a man. 

Dr Jeremy: Yeah. 

Val: So in terms of integrating. I was raised in a small town in the Midlands. And as far as I know, there wasn't any problems as far as I know, not like in a city, we knew every single. neighbour, on our street, and when a new family moved in, 

Dr Jeremy: Yeah, 

Val: all the kids would go, knock on the door and introduce ourselves. Do you have any children? And we'd play. There wasn't this old. Your family are immigrants or you're not from here. There was none of [00:05:00] that so we weren't strangers we became friends. 

Dr Jeremy: So when you say there's no problems You mean your family was accepted into the existing community? It wasn't just a community of all immigrants but your family was an immigrant family.

Val: I think they were 

Dr Jeremy: accepted 

Val: Yeah, I think it was because it's a small town. Yes, you're going to have a few, but overwhelmingly 

Dr Jeremy: Welcoming. 

Val: Good. Yes. 

Dr Jeremy: Yeah. 

Val: They saw my parents worked hard. They purchased their own home. They didn't come here to steal council homes, it's just ridiculous, wherever you go everybody wants the best for their families. At that time, Jamaica was under British rule. My dad had a British passport, and I can't remember what year Jamaica went independent, but when the British rule they were, a lot of them were asked to come [00:06:00] here. Remember the wind rush?

Dr Jeremy: Yes. 

Val: So you want people to come here and do the jobs the indigenous population won't fill, so it's alright to welcome them then, and now you don't want them here. Which is it? Yes, everyone says, I don't know the exact figures, there's a lot of immigrants here, or illegal. But, when they just had the council elections, the issues were illegal. Immigration, the boats. 

Dr Jeremy: That's what people are concerned about. That's what people are shouting loud about. 

Val: The boats. So why did Sir Keir Starmer get up that day to do that awful speech. Land of strangers. It just stuck out. And the fact that he didn't even mention the boats. Because you know why? [00:07:00] Because this is easier for him to deal with. And the more he ignores the boats, or comes out with a decent plan, you might as well hand the keys to number 10 to reform he needs to deal with it head on. But he took the coward's way out. He took the easy route the NHS is at breaking point. It makes no sense. 

Dr Jeremy: Do you think it makes sense to say, I'm going to make these changes to immigration? Even though this is a big change for him. Is this just a response to reform doing well at the local elections? 

Val: Yes. 

Dr Jeremy: It's the conservatives that are losing voters to reform. Is Labour losing voters to reform? 

Val: They're all losing.

Dr Jeremy: Losing to reform. Basically, 

Val: Don't forget Sir Keir Starmer's performance or whatever isn't doing as well, the worst thing that they're [00:08:00] doing, they keep beating reform with a stick. Stop beating them. 

Dr Jeremy: Yeah 

Val: Worry about what you can do. Tell us your plans. Tell us your policies. 

Dr Jeremy: Yes. 

Val: Stop, coming out with, Oh, they're racist. They're this, they're that. I think people are adults. People can figure that out for themselves. If he's pledging to do what the majority of the British people want done, people are going to vote for them.

Val: It is as simple as that. And quite frankly, people are fed up with the political establishment. 

Dr Jeremy: ~So ~Starmer looked at the writing on the wall and said, this is the issue. I need to change tack here and make changes to immigration otherwise. We're going to get obliterated. 

Val: It's all well and good saying they want to reduce the number by 50, 000 this year. But [00:09:00] this is a part of a new restriction to cut low-skilled foreign workers by 50, 000. So care workers can no longer be recruited from abroad. Did he consult the care homes?

Dr Jeremy: Yeah, 

Val: did he consult them who is going to look after your loved one? 

Dr Jeremy: Is there just an overabundance of care workers? No, right? 

Val: I Don't think there's a long queue British people waiting to step into these roles. It's just not there. One minute they say they're gonna fix social care. This ain't fixing it. 

Dr Jeremy: Yeah. 

Val: They need to value the care workers sector. More. Just like NHS nurses, if you do something wrong you can be struck off. There's no formal national [00:10:00] qualification to become a care worker. Yet, just like NHS nurses, they are dealing with the elderly and the vulnerable. Which doesn't make sense, which tells you The government doesn't value care workers 

Dr Jeremy: and 

Val: what they do

Dr Jeremy: yes. 

Val: When they say it's unskilled, I don't believe it is. 

Dr Jeremy: You have to have some skills, right? 

Val: Is a skill. 

Dr Jeremy: If they make formal qualifications Or registration like a profession, those people could command a higher salary. 

Val: That would make families feel better.

Dr Jeremy: Absolutely. 

Val: And leaving their loved ones, especially if they're living with dementia. Yeah. In a care home. Yeah. That they are taken care of by qualified staff. And if something does go wrong they could be struck off [00:11:00] and they can't work anywhere else. 

Dr Jeremy: So we're in a, we're in a country where we've got. A lot of care needs, especially as the population ages, 

Val: we've got a lot, land needs gonna get worse. 

Dr Jeremy: Yeah. We've got a lot of young people not working and people who want less immigration. If you don't want these people coming from abroad to care for people, you need to get people who are not working into these jobs. And the way to do that is to offer them training a higher salary perhaps, than what's being offered now. You've got to prepare people and value these jobs. 

Val: Last year alone, there was 152, 000 vacancies in adult social care. So imagine when this new policy, phases out in 2028. There's going to be a lot more vacancies. If you don't take care of one sector, they end up in another. If you're not looking after [00:12:00] primary care, social care, they're going to end up on the wards. That's exactly where they're going to end up.

Dr Jeremy: Yes. 

Val: They don't believe in spending all that money in this sector. Spend it in social care. A lot of them, don't need to be here. On a ward. 

Dr Jeremy: Yeah, 

Val: A lot of Elderly are there because they can't look after themselves at home and there's no one to take care of them A care home can only take as many I don't know what the ratio is obviously that is one.

Dr Jeremy: They need staff too, right? They'll be looking for stuff, too yeah, 

Val: For him to say this. It's just beggar's belief. It's just starving. 

Dr Jeremy: Yes. 

Val: It's starving for decent stuff. It's about what they value most.

Dr Jeremy: Yes. 

Val: Care is essential, yet treated as disposable. 

Dr Jeremy: One thing that was interesting to [00:13:00] me in the immigration white paper is the aim to end the long term trend of relying on international recruitment.

Val: Yeah. 

Dr Jeremy: And. It made me think about my experience I've been in the UK 10 years I'm Canadian. I have your citizenship. I do. So I came to this country in 2014. And the process for me was I had to first get re get my qualifications recognised 

Val: Well.

Dr Jeremy: So I in Canada, because that's where I'm from. And so my qualifications needed to get recognised. So before I've done anything, that was the first step. Once recognised, I had to apply for a job we were part of the EU back then, before Brexit.

Dr Jeremy: The employer had to actually, Show that they advertised the job sufficiently widely that first there was no local like UK applicant. Who could do [00:14:00] that job. And then, there had to be no EU applicant who could do that job. Because we were part of the EU.

Val: So all this about it's the best person for the job is nonsense, isn't it? 

Dr Jeremy: I understand they want to give their own citizens priority. But that doesn't 

Val: say it's the best

Dr Jeremy: Not necessarily, 

Val: yeah. 

Dr Jeremy: But I guess the reason I mentioned it is because, there's this idea that it's all these foreign workers, that are taking jobs from people who are here already, but that wasn't my experience.

Dr Jeremy: My experience was the people who were here got first crack. The people in the EU got the second swing. And then I was considered 

Val (3): in 

Dr Jeremy: Once you get a job, you apply for a visa. I got a tier two visa an extension and indefinite leave to remain.

Dr Jeremy: Last year my wife and I got our citizenship. 

Val: You came here as a clinical psychologist with a PhD, you won't be considered low-skilled. 

Dr Jeremy: I wasn't a low-skilled immigrant. I was [00:15:00] the high-skilled immigrant. 

Val: That is what they want. The one  high-skilled, but not low-skilled.

Dr Jeremy: Yes. 

Val: They're just stopping the low skilled care workers. Whether you came 10 years ago, or in 10 days time, you will be fine. 

Dr Jeremy: I suppose so. But the rules still apply there has to be a shortage of workers. Obviously the more specific or highly trained you are. There's fewer people to do that, but, or that, but,

Dr Jeremy: it's interesting when they talk about the skilled worker threshold. They're talking about creating a migration advisory committee. And a labour market evidence group. They want to draw on data to make decisions about the state of the labour market.

Dr Jeremy: It rather than always relying on migration. They currently rely on the state of the labour market because they review [00:16:00] sectors of the labour market where there are shortages.

Dr Jeremy: They've always done that. They're portraying this as a change, something they're going to do differently. And it's not really clear to me that it's any different because that's really what I went through where. Yeah. Like they always had a case where it was easier to get. A visa automatically if you were applying for a job where there was an existing shortage. So the government monitored that. 

Val: Yeah.

Dr Jeremy: Some of these announcements are changes and I think some of this is just rehashing the same reactionary. 

Val: Politics. When Yvette Cooper was asked to give an immigration target, she refused. I don't believe her. You give a target, you set yourself up to fail.

Val: The Tories set targets in 2010. 2015 and 2017. They didn't achieve it. You can always set one, but will you achieve it? It's like they set that [00:17:00] housing one for Angela Rayner. They set her up to fail. It's weird how that gives some departments targets. But don't target the when it comes to immigration, because they know, it doesn't work.

Dr Jeremy: No, for as long as I've been here, politicians have been talking about, we're going to stop the boats and reduce immigration, and it never works, but I think this feeds into the popularity of reform.

Val: Nigel Farage comes across differently and people like him.

Val: I honestly don't know what Kier Starmer stands for. If someone. Stands for X. Whether I agree or not, you know what they stand for. Yes, absolutely. No, we're Keir Starmer I don't know if it's just me. I haven't got a clue. [00:18:00] I don't know. He flip flops and he's a reactionary politician.

Val: And to me, that's the worst type of politics. Because people don't know you. One minute, you're for 

Dr Jeremy: Yeah. 

Val: Immigration, people coming in, being offered jobs. You can't take someone's job. If you want the job and it's advertised, apply it's as simple as that. Apply. I just don't know who he is. And to me, that's odd. Now that he's PM, it says a lot about him. 

Dr Jeremy: It seems odd, but it's not the first time we've seen this. Starmar is pivoting on immigration, right? In response to reform. Didn't we see this with Cameron and Brexit pivoting because of UKIP?

Val: Mainly because of his own party, wanted to vote on it they've been on about that for years. 

Dr Jeremy: He couldn't know. Wasn't it the case that the conservatives were haemorrhaging votes? To UKIP [00:19:00] and they wanted to stop the bleeding. And so David Cameron was saying, okay, we'll do this referendum. And yes he wasn't for it. He didn't think it would pass and it did. I think Starmer is looking at reform and saying, it's not happening yet. 

Val: The reform that they are now, completely different to what they were then. Back then it was just Nigel Farage on his bandwagon. Give him credit. He banged the drum about the same thing over and over again. He never deviated. You knew what he stood for. Now it's different. They've got MPs. 

Dr Jeremy: Yeah, 

Val: they're getting council seats. It's a different ball game. People are voting for them in their droves. Yeah. Shouldn't have he had a plan about the boats? I thought he did, but to announce this, it would have been better if he'd announced something about the boats. He never mentioned it. 

Dr Jeremy: [00:20:00] No. To your point about what Farage stands for, there's a cautionary tale here. 

Val: Yeah. 

Dr Jeremy: I was listening to another podcast where someone from Reform was talking about the Canadian model. They're actually looking at this in terms of what happened in Canada. Probably 15 years ago, or 20 years ago, a similar dynamic existed in Canada when I was growing up, where there were a lot of people who were alienated. And so the conservatives were fractured between a reform party and a Tory party, which they called themselves progressive conservatives. It's an oxymoron, but they were socially progressive and fiscally conservative, they got wiped out in an election after Brian Mulroney stepped down in scandal and Kim Campbell Canada's only female prime minister. They got wiped out in an election and they were split with [00:21:00] the reform party came out of Western Canada. Then they changed the name to the Alliance Party at some point, and then the Tories, who didn't have any seats, they decided, okay, we need to unite the right and create what was the conservative reform movement. Alliance Party, which name didn't last very long because they realized the acronym was CRAP so they did the Canadian Reform Alliance Party. So they changed, they then changed the name of the party. So it was the Conservative Party of Canada. But what it did was it merged social conservatives. And fiscal conservatives. So it made the Tory party much less like the Tory party before the Tory party, like in the UK, more like the Republican party in the U S and when they got in, they were promising one thing, but a lot of things came along with that, that didn't, [00:22:00] that weren't really talked about before the election. So they got rid of the national census. Does the UK have a census? Every five or 10 years? 

Val: Yeah.

Dr Jeremy: A full census. The conservatives axed the long form census. They didn't want to collect data that would mean they would have to respond to inequalities. They didn't they made cuts to a lot of education related initiatives. They talked about cutting waste. But basically efforts of the previous government to reduce inequalities were axed that's why my wife and I left Canada was because the organization that she was working for got axed. And so just as a cautionary tale, parties campaign on one thing and you think you know what they stand for. But when they get in, they start doing things. That you didn't expect. And I see a similar thing going on in Canada right now. So there's a separatist movement in [00:23:00] Alberta. In one of the western provinces. The current leader doesn't, is not a secessionist, does not want to leave, but she's being pressured to put it to a referendum vote. And I can see that happening very much like David Cameron, where the leader of an area is saying, okay, we're going to have a referendum it'll work, but the people campaigning for this, we know they don't tell the truth, right? Where's the 300 million pounds a week for the NHS, that we were promised, and so we know people doing this lie and things happen you didn't expect. But the motivation is the same. If your support is, if you're losing support to a secessionist group and you think, okay, I just need to pacify people with a vote. That never works. I'm very worried but the same thing could happen with reform. In the UK. 

Val: At the end of the day, we know that the government need to reduce [00:24:00] immigration. Whether it's legal immigration or illegal, they want to reduce net migration to prioritize British workers. Now I'm British, but as told you before, I've walked down the street. Woman was flagging me down, so I thought, oh my God she's lost. She was quite old-ish. . So I waited for her to cross the road to ask me, 

Dr Jeremy: where are you from? 

Val: Where am I from? . 

Dr Jeremy: Yeah. 

Val: Now the two of us are sitting here. I can see you can see me. We know you are Canadian by your accent. And the fact you've said 

Dr Jeremy: I'm not from here, 

Val: you are not from here. But if you and I were walking down the street. People would assume I was the immigrant 

Dr Jeremy: people never flagged me down From far away saying hold on. Where are you from? No [00:25:00] one's done that. 

Val: So when they say british workers 

Dr Jeremy: Yeah, 

Val: do some people in their heads think white workers? 

Dr Jeremy: Sure some do 

Val: What does it mean? Because if I was working in a care home I'm born and bred here, but my parents weren't, but I was, this has to do with me where I was born.

Val: Cause we can always trace and think, Oh, whatever wasn't born here. They're great. That grand granddad wasn't born here, whatever. But when it comes to me, I'm British, I was born here. But when people scream that out. Do they mean British as in white? Is it a color thing?

Dr Jeremy: That's a good question, 

Val: sometimes I feel it people, when they look at you, they automatically, like I said before I speak, [00:26:00] they other me. I'm not from here. I'm a stranger. Do you see what I mean?

Dr Jeremy: Yeah, I do 

Val: so when he said what he says He could have made the place more dangerous for people like me and my son 

Dr Jeremy: Yeah, if people use skin color as a proxy 

Val: He could have said it differently, 

Dr Jeremy: yeah 

Val: I shouldn't have to always explain that I'm born here. I shouldn't have to carry a flag saying, yes, I'm born here and may not look like you, but I'm born here. I shouldn't have to, I shouldn't have to prove that you don't have to prove that you're not born here. He has to be careful of the language that he uses, he really does, he doesn't realise the impact it has on communities.[00:27:00] 

Dr Jeremy: Yeah, I, so there's, skin colour is this proxy. For immigrant, right? Yeah. It's just simple. Everyone can see it, but what do you think about the importance of culture and people having a compatible culture, if somebody really wants something different.

Val: Yeah, 

Dr Jeremy: If the things that are important to the people here are not important to the people that are coming in. And if you have a large, I think this is really what the fear is, right? There are large numbers of people who want different things in life than what the people here want. And they say they don't like that, right? 

Val: Wherever you go all of us have our own culture our own way of doing things Probably our own religion Things we practice, food we eat, we know food brings people together, the music, whatever it is.

Val: My parents came [00:28:00] here, they still brought their rice and peas and chicken every Sunday, what I like about that, culture, that way of life was that we'd sit down on a Sunday, knowing that wherever Jamaican is around the world, we're eating the same dish. 

Dr Jeremy: Yeah 

Val: know what I mean?

Dr Jeremy: Okay. Food brings people together and you'll get no argument from me 

Val: we call it salt fish. You call it salted cod. We get that from you, 

Dr Jeremy: Canadians. Yes. Absolutely. We're family. Having a good meal is, one of the perks of being human, food is a good example, so what if people come in who don't eat something you would eat, right? You said rice, beans and chicken, right?

Val: No! Rice and peas and chicken.

Dr Jeremy: Rice and peas and chicken, sorry. Hypothetical example, right? What if we have mass immigration of vegans, they'll eat rice and peas, but not the chicken, right?

Val: That's up to them. 

Dr Jeremy: What [00:29:00] if they won't eat with you? If you are eating chicken? Yeah, but now you're, but the point is you're not eating ~now. That's not ~

Val: some people don't eat meat, some people don't eat fish. That's not a culture thing. That's a choice. Not all Jamaicans eat meat. 

Dr Jeremy: I was making a hypothetical example if large numbers of people, make that choice to not eat together, we're not eating together, right? If you have large numbers of people who are not, are choosing not to do this, now we don't eat together. We're losing that benefit, right? 

Val: What does integration mean to you? 

Dr Jeremy: Integration? It means the people moving have to make changes.

Val: Make changes.

Dr Jeremy: I think that's the easy part that everyone, at least the people here would say, yes, those people need to change. They need to simulate. And what I would argue from the Canadian [00:30:00] perspective is that the indigenous people the people who are born and bred here as new people come in, they have to change too. Integration means both sides making changes. So the people who are coming from someplace else and are moving and being accepted into a new place. Have to make some accommodation. 

Val: Oh yeah, it's easier when the languages are easy. My dad, Jamaican is still his patwa is so that's easier. But when they talk about integration, People may want to integrate with you, but you may not want to integrate with us. You may not want to be friends with a person of color. It works both ways. When this community here go to live in Spain, do they not live with the English?

Dr Jeremy: Yes, I think [00:31:00] if you retire in Spain for the last 20 years of your life, you should know some Spanish. You should be willing to eat Spanish food, drink Spanish beer, integration means you take on some characteristics of the place where you're living.

Val: I wouldn't live in a country If I couldn't speak the language and get by, it's hard enough understanding their ways culture and laws. People have to respect the laws of the land you're in.

Dr Jeremy: That's a key part of integration. 

Val: If I can't speak it, I would find that extremely hard. Exactly. If you can't speak it, you can't integrate. Had a neighbor. All the years she was here, it was really bad. Really, bad. 

Dr Jeremy: Yeah, 

Val: I was walking down the road and this lady frosted her phone in my face because she couldn't communicate with the people at the [00:32:00] council. I thought, how am I going to communicate with you to communicate with them? We may be both ethnic minorities. I don't speak your language. 

Dr Jeremy: Yeah. 

Val: I can't chat if it's personal business, you don't know me, so that hinders you as well. 

Dr Jeremy: It does. 

Val: See what I mean? It really does. But I couldn't do it, let's have a breather. 

Dr Jeremy: Yeah. 

Val: Because we've digressed a bit as we used to do and we'll get back on topic.

Val: We're back.

Val: We did start off talking about the care sector. Who are very starved of stuff. And we know this and Sir Keir Starmar our leader has announced he wants to reduce the healthcare worker visa by 50,000 this [00:33:00] year. That's a lot considering there's over a hundred thousand vacancies. The NHS and the care sector as a whole, it has been heavily reliant. On immigrants has yes, no matter what country you're from you, you are As an immigrant, I mean in two thousand and twenty four about eleven thousand people from overseas Took up post in england But that was down from twenty six thousand the previous year this includes staff on health and care visas and other immigration routes The home office issued 106, 000 visas to social care workers. That is a lot 

Dr Jeremy: They want to reduce that. 

Val: They want to reduce that. If [00:34:00] there's that many visas. Being handed out. There's obviously a need. 

Dr Jeremy: And you said there's 150, 000 vacancies, right? 

Val: Yeah. So we know care homes are going to suffer, but most importantly, the residents of those care homes are going to suffer. And then the families will suffer. It impacts everybody. And then the NHS. Suffer. 

Dr Jeremy: Yeah. 

Val: Cause and effect. When these knee jerk reactions and policies are made with slogans, cause we got to have a slogan, a land of strangers.

Val: Do they ever think, okay, if we take away X, there's still going to be a gap. We've already got a gap we can't fill anyway. [00:35:00] How are we going to fill an even bigger gap?

Dr Jeremy: They have to train the local population and make it a design. 

Val: Local population don't want, 

Dr Jeremy: yeah, 

Val: I've got a breakdown of why British workers are hesitant to enter the care sector due to a combination of factors, low pay, challenging working conditions limited career progression opportunities. And the stigma of the job 

Dr Jeremy: stigma. 

Val: Yeah. And a lack of public recognition contribute to the unattractiveness. Of care work, what do you want the public to do? 

Dr Jeremy: Okay, low paid, low status job, nowhere to go. 

Val: It's considered low skilled, and it's not it often involves long hours. Shift work [00:36:00] and physically demanding tasks leading to burnout and a sense of being undervalued.

Dr Jeremy: If it's low paid and low status, you are undervalued. 

Val: Yeah. And it has, made it unattractive to the British people. It really has, a mental and physical strain takes a toll on them. So the government have a lot more work to do. 

Dr Jeremy: I guess 

Val: with a slogan and a policy because of reform.

Dr Jeremy: Yeah. 

Val: So perhaps like the nurse in a Midwifery council, the N M C. Perhaps care workers should have their own national registration 

Dr Jeremy: registered 

Val: professional qualification 

Dr Jeremy: make it attractive, better paid, higher status. 

Val: Everybody knows, including the government, that everyone working there has been trained to a [00:37:00] standard. When things are against the wall care workers need them fast. They're given basic training to get by. Which you wouldn't do as an NHS nurse. I'm not saying that these care workers are doing, pulling in catheters and lungs, but they might be. I know there's different levels of care homes, 

Dr Jeremy: I suspect the kinds of workers they're talking about without training would not be qualified to put in a catheter. But the problem remains We've got a lot of people not working. A lot of positions, these low skilled, low status jobs that we want filled. And they want to reduce immigration, which is the way those jobs have been filled in the past. So it seems the only solution is to. upskill and upstatus. These jobs make them [00:38:00] desirable posts for the local population.

Val: Did you know in Wales and Scotland There is a care workers register. 

Dr Jeremy: Okay. 

Val: Yeah. 

Dr Jeremy: There's, a step towards, professionalization they need a bit more carrot, less stick. 

Val: We are the United Kingdom on certain things and on certain things where England, Northern Ireland, Scotland and Wales. So if Scotland, Wales, and I think Northern Ireland does it as well. They've got the Northern Ireland Social Care Council. Scotland has got Scottish Social Services Council. And Wales has got social care Wales. So their care workers must be registered.

Dr Jeremy: Does that requirement to be registered, allow them to command a higher salary?

Val: I don't know. Let me tell you what the. Salary is when it comes to wages, [00:39:00] it is low. So that's driving the recruitment crisis really bad. 

Dr Jeremy: Yeah. 

Val: The average wage for a care worker is 11. 58 an hour. Just 14 pence above the national minimum wage. It's less than a typical McDonald's worker, a burger is more important. 

Dr Jeremy: Yeah.

Val: Yeah. 

Dr Jeremy: Yeah, if you get paid more to flip burgers

Val: they value McDonald's more 

Dr Jeremy: I worked for McDonald's for almost six years as a kid. 

Val: Of the wage. 

Dr Jeremy: Yeah. 

Val: Do you see what I mean? And this is why they get such a high turnover in the care sector.

Dr Jeremy: Yeah. 

Val: And it's a place where you want consistency. 

Dr Jeremy: Absolutely, 

Val: If you're working in a home where you know the elderly got dementia [00:40:00] Alzheimer's whatever It's good for staff to be consistent. 

Dr Jeremy: Yeah to know the person well 

Val: their families 

Dr Jeremy: hmmm 

Val: We've got to value That that's the key thing for me.

Dr Jeremy: Okay. 

Val: We've got our story. That is the story. Yeah. 

Dr Jeremy: Yeah, 

Val: The government want to Reduce net migration. Take away the health care worker visa reduce it by 50, 000 That's just this year and we're nearly halfway through Imagine that.

Val: That's the story. 

Dr Jeremy: Yeah. 

Val: What's your label? You might have the same. 

Dr Jeremy: Yeah, it's a good question. We didn't talk much about how labels contribute to misunderstanding. I think the idea of, an economic migrant. In some discussions, people get vilified for being economic migrants rather than [00:41:00] asylum seekers. I was an economic migrant.

Val: I know you'll say that, but you're looked at differently. I am. 

Dr Jeremy: Yeah, I am looked at differently, but the misconception is that you could just set a quota to reduce immigration and think everything will be fine. You have to do more, right? We're working in a system, so if you make a change in one area, you have to anticipate changes in other areas too. 

Val: Wow. I think the label is it's all is. Cheap labor. 

Dr Jeremy: Yeah. 

Val: But nobody wants to do a job here. Let's go abroad. Let's drag them in cheap labor 

Dr Jeremy: Yeah, 

Val: My misconception is that care work isn't skilled. I don't do it myself, but as a carer myself, it does have a certain amount of skill. I don't think you could [00:42:00] drag Joe Bloggs off the street and just, go and do this. 

Dr Jeremy: Not everybody can do it. 

Val: Help people with their toileting or whatever. I can't remember what it is. Yeah. There is something. Yeah, but they believe it to be the lowly of the low. Because when you think about it, no government, whether Labour, Tory, really care that, I don't know if it's care, really value, they don't value what unpaid carers do, and they don't value what care workers do.

Val: They don't. Never have, but those two areas are to me the most important in primary care, because if you haven't got your unpaid carer taking care, they might end up in A& E. You don't have a bed, you don't have your care, what your care workers.

Val: They'll end up clogging up A& E and clogging up a bed. We have to protect these [00:43:00] two areas and value them. 

Dr Jeremy: Absolutely.

Val: We always have this top down approach where the value comes with, okay, you've got your PhD, your degrees, but the ones really doing the hard work that are really holding up the NHS sector, really holding it up, because if unpaid carers and care workers weren't in place, the system would collapse. And I think they're that. 

Dr Jeremy: Okay. 

Val: That's my last word. It would collapse. Value us.

Dr Jeremy: Okay.

You