0:12

The Sustainable Care team is exploring how care arrangements currently in crisis in parts of the UK

0:18

can be made sustainable and deliver wellbeing outcomes

0:26

in this sustainable care and COVID 19 podcast series.

0:30

Our researchers and special guests discuss how the pandemic has impacted

0:35

the different parts of the care sector we are studying.

0:53

Welcome everyone to one of our Sustainable Care and COVID podcasts.

0:58

Today, I am very pleased to welcome you to talk

1:02

about a very important topic and timely topic

1:05

of home care migrant workers

1:08

in the context of Brexit in the UK and COVID across the globe.

1:14

I am delighted to have with me

1:17

great guests who have done excellent work in this area.

1:21

First, Professor Sara Charlesworth, who is a Professor of gender work

1:27

and Regulation at their RMIT University in Australia.

1:31

Her recent research is focussed on aged care workers in cross-national perspectives,

1:37

also focusing on migrant workers and decent work.

1:40

Welcome, Sara. I'm very pleased to be here.

1:44

Thank you very much, Sara. And we also have Dr.

1:47

Ricardo Rodrigues, who is the head of health

1:50

and care unit at the European Centre in Vienna.

1:53

He has carried out comparative research on a number of areas pertaining to long

1:58

term care, including working conditions of migrant and native care workers.

2:03

Welcome. Thank you for coming, Ricardo.

2:05

Thank you very much for having me. And we have from our very own team, Dr.

2:10

Agnes Time Penny, who is a researcher, and she's currently

2:14

at the Institute of Public Care at Oxford Brookes University.

2:18

Welcome, Agnes. Hi, everyone.

2:21

And I am Professor Shireen Hussain, professor of health and social care

2:26

policy at the London School of Hygiene and Tropical Medicine.

2:29

And I led the stream of work looking at migrants care

2:32

workers in home care in the UK in the context of Brexit.

2:38

So welcome to this timely story.

2:40

And we all know that countries across the globe

2:44

have escalating demand for long term care.

2:48

With particular needs for home care, where people prefer

2:52

to receive care, where they continue living.

2:56

But we know also that most countries have faced,

2:59

you know, facing huge challenges in recruiting enough workers.

3:04

And we know that migrant skilled workers form a significant contribution

3:08

to this work. However, the issue does not does not happen with its own challenges.

3:15

So I'm just going to take this opportunity to ask our great guest

3:18

to give us a little bit of context about their own countries

3:22

and about the contribution of migrant workers

3:25

and the type of contributions, perhaps the challenges,

3:28

but also the advantages that they bring.

3:31

So I might start with the neighbouring Austria

3:34

and ask Ricardo to give us a little bit of a background and context.

3:41

Thank you. Thank you very much. So.

3:44

Austria has relied very heavily on migrant carers

3:49

as part of its model for long term care provision,

3:53

dating back really to the late nineties

3:57

when Castro care benefits were implemented and men and families

4:01

developed this solution in which they directly hired

4:06

migrant carers from neighbouring countries

4:08

to act as live in carers

4:11

with their relatives that were in need of care.

4:15

This has in the meantime been legalised at the

4:18

at the end of the past decade

4:21

and still we have now currently an estimated

4:25

60,000 migrant carers

4:28

that work as these so-called 24 hour carers.

4:31

So they usually work around sort of fortnight ships shifts,

4:36

staying in people's own homes and usually

4:39

working as self-employed

4:42

or with contracts with sort of brokering agencies.

4:47

In parallel we have also a

4:51

large number of migrant carers working in the sort of more informal care sector.

4:56

We don't have very good data on on on these migrant care workers,

5:01

but we've run a recent survey and we found that around

5:06

25% of all workers working in both residential care and home care

5:12

in Austria were migrant making care workers.

5:16

And we also then carried out some research in terms of differences

5:19

in working conditions between these

5:22

these workers and native workers.

5:25

So overall, migrant carers form

5:28

a very important, I would say,

5:31

part of the Austrian sort of approach to long term care.

5:35

And this is also very much driven by the wage differentials

5:40

that exist between Austria and the neighbouring countries, but also

5:44

it's very much driven by the geographical location of Austria, which is very much in the heart of Europe

5:49

and therefore can more easily sort of attract.

5:52

And these these rotating migrant carers

5:56

to to address its care needs.

6:01

Thank you. Very encouraged. It's a clearly there is a form of reliance.

6:04

It's a question of the workforce is coming from

6:09

migrant workers the contribution of migrants and is that really important to the sustainability of the whole system?

6:16

And it was really interesting as well that you said about the circular nature of migrants and

6:22

and the importance of the live in care work

6:24

which is something maybe not exactly the same here in the UK,

6:28

but it's really interesting to see how is that facilitated by Cash for Care

6:32

and the kind of bigger policies of ageing in place and marketisation.

6:38

So I wonder how the situation is in Australia.

6:41

Eric. Thank you for sharing.

6:44

Well, it's a very different context. Australia, unlike offshore, is an island and that in itself

6:50

that kind of we call this the tyranny of distance

6:53

and that's has created, I suppose,

6:56

opportunities and also currently barriers to market workers.

7:01

We start to a country that's relied on permanent

7:03

migration and particularly post-war migration.

7:07

And it used to be the case that certainly in homecare a large proportion

7:12

of healthcare workers particularly came from England, Ireland, New Zealand.

7:17

That has changed dramatically over time.

7:19

We now see many more home care workers from Southern Asia

7:23

and at the same time our migration settings have changed.

7:26

So we've moved from a country of permanent migration

7:30

to much more of a European model, perhaps of the storico

7:34

model of guest worker temporary migration.

7:37

So increasingly, the migrants who are working as residential

7:41

care and in-home care are arriving on temporary visas.

7:46

And because the work is whatever qualifications they hold with,

7:50

the work that they're doing is classified as low skilled,

7:53

they are preventing them from attaining permanency.

7:56

So they're in a difficult situation.

7:59

Perhaps a distinguishing feature in Australia

8:01

is we've relied on some particular temporary visa programs.

8:05

International students, for example, make up a large proportion

8:09

of migrant workers in residential aged care and working holidaymakers

8:15

whereby people might arrive from a variety of different countries.

8:19

They're allowed to spend a year here travelling,

8:22

but if they work then they they're allowed to stay an extra year.

8:26

So we rely a lot on temporary labour.

8:30

So despite the very large proportion of migrants, so we're sitting at over

8:35

50% of migrants in residential aged care, 37% in home care.

8:41

Australians don't tend to think about

8:44

or haven't thought about migrants.

8:47

But when the borders slammed shut with COVID

8:50

and we have a huge issues because international students

8:53

weren't coming anymore, then increasingly the providers

8:58

or the employers are turning to the government

9:01

to adjust migration policy settings to increase migration.

9:06

Thank you. Thank you, Sarah and Ricardo.

9:09

It's really clear how the geography and history plays a big part here.

9:13

And it's interesting when we think about the UK position

9:16

because it's somehow the pathway to the inclusion of migrants

9:22

and allowing and opening the door to migrants have taking different forms

9:27

relation to the broader immigration policies

9:30

that from relying in the colonial histories

9:33

and having the work permits and relying on nurses coming

9:38

perhaps from the Philippines and from India to the open access

9:43

and the EU markets and maybe a little bit of the model

9:46

that Austria, you know, Ricardo was talking about.

9:49

But now we are heading to Brexit where things are quite going to be different

9:54

and they're looking interestingly to,

9:58

you know, ideas like the temporary visa.

10:01

And there are lots of lessons to be learnt here.

10:03

Agnes, you've been involved in this project for several years,

10:07

which is the Sustainable Care Project and part of that work, you know,

10:11

we've been collecting data and information and views about that.

10:15

Do you want to tell us a little bit about the project and then maybe reflect

10:20

in what Sarah and Ricardo have said to tell us

10:23

where the UK is sitting within this, within these dynamics.

10:27

So we started our sustainable project

10:30

in the UK and then a team that was able to use Brexit.

10:35

So it was clear that the UK was leaving the EU,

10:38

but at that time there was a lot of uncertainty,

10:41

especially around what would happen with free movement of labour.

10:46

So our research project

10:50

took place in this really kind of fluidly changing and very uncertain context.

10:56

Sometimes it was difficult to balance, but at the same time it also had benefits because we could

11:02

look at the sector at the time of change and kind of opinions and positions.

11:08

Very 43 states have growth methods to conduct their research.

11:13

One was a review of the existing literature

11:17

and data within the review

11:20

of the outcomes and the challenges

11:24

of migrant labour in homecare in the UK, which was published.

11:29

We understand that some of the data and skills for CARE publishes

11:34

data on the nationality of the workforce.

11:37

So maybe the question of trends and changes in that data.

11:43

The other part, as I referred to both of the survey

11:47

that the surveys, the survey of people,

11:50

they are stakeholders in the different parts of the sector.

11:54

So we invited experts, we identify very, very soon social care

12:00

experts or immigration policy experts

12:05

and also migrant rights organisations.

12:09

So we asked them about what they think the future

12:12

of migrant workers in social care could look like

12:18

in the first wave of this survey took part in 3019.

12:24

So before COVID and before we had a very clear idea

12:27

of what might happen with the immigration system based Brexit.

12:32

The second wave of the Delfi survey took place in 2021.

12:38

There was kind of like an emerging picture of what the immigration system

12:43

might look like and also very importantly with

12:47

the COVID pandemic was was really in

12:51

this wave of the pandemic, in the lockdowns, in some of the industry.

12:55

And then the third very important

12:58

part was speaking to different people who are affected

13:02

differently by immigration and social care.

13:06

So we spoke to provider organisations, STO managers,

13:11

owners of homecare and living care services.

13:15

How these kind of impending changes might have them, their operation

13:20

and what their expectations were and what sort of immigration system would work for them.

13:26

We also spoke to some families, the legal of social care

13:31

and the particular who who go on

13:34

social care, offering support provided by migrant workers,

13:39

voice their fears and thoughts of and birth.

13:43

And with this both migrants never faced them stay.

13:48

So then this was another very

13:51

important that was part of our big series.

13:55

Thanks. Thanks, Agnes. So it seems that the three countries that we're talking about

14:01

look at migrant workers as a core element in the provision of care.

14:04

So we know in the UK we rely actually on data that is collected

14:08

not from the whole sector, collected from parts of the formal sector,

14:13

and it indicates that over the last 20 years at least,

14:17

there has been a contribution of at least 20% of the workforce.

14:21

And what was interesting, the UK has been through huge changes in immigration policy.

14:26

So as I mentioned, there was the work permit schemes before 2003.

14:32

Then there was the expansion of the EU.

14:34

Then now we are facing Brexit. And what does it tell us that there is a core element and gap

14:39

in our supply of workforce that has always been

14:44

filled by migrant workers, regardless where they are coming from

14:47

or the pathway and journey to come to the UK.

14:52

So, so we kind of starting from a similar point

14:55

and obviously in the UK, unlike Australia, I've got a lot of information

14:58

on love and care. We don't have much information about that.

15:01

It's all anecdotes, but we can see that this is a growing area

15:05

and a growing area for the recruitment of migrant workers as well.

15:09

So clearly there has been a lot of interest

15:11

and a lot of utility of migrants in the long term care sector.

15:16

What was rather shocking through the whole systems is the pandemic

15:21

that has come and closed and shut borders and suddenly give this wake up call

15:26

to actually you can't continue relying or if you want to continue to rely

15:31

and you have to think about the means to do that.

15:35

So so maybe we can start first with the impacts of Corbett.

15:39

So what happened? What changes that countries have taken to respond to, to cope with the realities

15:46

of Corbett, bearing in mind the implications of migrant workers?

15:50

So I'm just going to invite Ricardo to start.

15:54

Thank you. Sherry. So when COVID 19 hit, Austria was

16:02

also very early on implemented quite stringent lockdown measures.

16:06

And this, of course, included also the closure of

16:10

of borders very early on in the pandemic.

16:13

At the same time, because of the relevance of this migrant care model,

16:19

there were concentrated efforts

16:22

to try to establish channels through which migrant carers

16:26

could still continue to come to Austria or remain in Austria,

16:31

and thus sort of fulfil the care needs of other people.

16:35

So fundamental. This took a number of time in a number of initiatives.

16:40

On the one hand, some of the migrant care workers that were already in Austria

16:44

when the borders were closed, they were allowed to extend their rotas.

16:48

So usually they stay, as I said, one fortnight with each family.

16:52

They were allowed to extend this and they received financial compensation

16:57

up to €500 for this extension

17:01

of their unforeseen extension of their rota in in Austria.

17:06

At the same time, a number of

17:10

trains and charter flights

17:12

were organised to the sending countries, so mostly Romania

17:17

and Slovak Republic, for example,

17:20

with the intention to bring in the migrant carers

17:24

that were sort of stranded, so to speak, in their countries of origin.

17:30

And these migrant carers then were placed on quarantine on arrival

17:34

so that they could then continue to work

17:38

in the houses of the families for the

17:41

for the uses they were working with.

17:44

At the same time, as I said, a lot of these migrant care workers,

17:47

the ones that live or that provide care in people's own homes

17:51

and they're self-employed

17:54

and they were able to benefit from a federal scheme

17:58

that was implemented in Austria in which people who were self-employed

18:01

and had seen a reduction in their income during the pandemic could apply for up

18:06

to €2,500 per month of federal support.

18:11

So this was kind of in a way on the positive side

18:15

of the reaction to the pandemic or to at least to the closure.

18:19

Fundamentally of the end of the of the borders.

18:23

But at the same time, these measures also clearly, I think,

18:30

shown the limits a bit also of this migrant care model in Austria, in the sense that, for example,

18:37

very few of the migrant carers

18:40

could actually benefit from this support

18:43

for self-employed people because their income

18:47

was just not sufficient for them to qualify, for example, to pay taxes,

18:52

which meant that they were then unable, they didn't have a tax number,

18:56

so they were unable to benefit from this, from this, from this support.

19:01

At the same time, and because they are self-employed, the majority

19:06

of the migrant carers, for example, do not are not covered by the sickness benefit.

19:10

So they would have to it's only after the 43rd

19:14

day of sickness that they would receive any sort of

19:18

health benefit unless they pay additional social insurance, which many

19:22

of them don't. And this

19:24

obviously was quite an issue in the context of a

19:28

of a pandemic

19:31

to finalise. Also, for example, the quarantine period

19:34

in which migrant came as place when arriving in Austria through these

19:38

formalised channels of chartered trains and charter flights.

19:42

This was also unpaid.

19:44

So at the surface A there was a coordinated response

19:50

by the authorities in Austria to keep the migrant care worker model running.

19:55

But at the same time, this response, I would say

19:58

built very much on the inequalities, still very much on the quite

20:03

a lot of the issues that were coming already from behind

20:07

in terms of this migrant care worker model.

20:10

Thank you, Ricardo. This is really interesting.

20:12

And you brought in the new ones

20:14

and also great to the surface that we talking about a sector

20:18

that does not follow the normal kind of work and employment

20:22

conditions that when policy Putin assumes

20:26

and hence maybe the policy response doesn't have the positive effect

20:30

because it's basically not addressing the structure and the

20:34

inequalities within the structure that you have describe,

20:37

because maybe a lot of people don't know the level of fragmentation of work and types of contract

20:42

and the pay that doesn't give you certain allowances, etc..

20:47

So I wonder what's happening with Australia.

20:49

We know that that that that may be the response to COVID was quite strict,

20:55

that Australia was one of the first to close border and to

20:59

to do all these lockdowns. This or I would be really keen to get your feedback and reflections on this.

21:05

So let me thank Shereen will we shut our borders,

21:10

closed them shut in February last year.

21:12

They're still not formally opened, apart from some exceptions.

21:17

And certainly people who are working in the care sector,

21:20

bugs in residential aged care and home care who are on temporary visas

21:25

were very badly done by the government.

21:28

The federal government provided quite a bit of income support

21:31

to workers who lost hours of work, workers who lost jobs and

21:36

with the shuttering of residential aged care,

21:39

the diminishing in terms of services provided to home care clients.

21:45

A lot of workers lost hours of work, a lot of workers lost their jobs.

21:49

And so a decision was made simply to provide no support whatsoever

21:53

to people on temporary visas so that that was one tangible effect.

21:58

The complaints that certainly unions brought to the fore

22:02

and unions haven't been particularly good around migrant workers.

22:06

They don't focus on them

22:08

despite the fact that they are a very large proportion of the workforce.

22:12

But the big issue for all home care

22:14

workers was access to PPE.

22:17

And just recently in the last few months since jumping ahead,

22:22

that COVID vaccination has been mandated in residential aged care.

22:27

It's been left to the states.

22:29

And being a federal system, the federal government

22:31

is in charge of aged care, but the states are in charge of health.

22:36

So in Victoria, where I live, the Victorian Government

22:39

has now just mandated home care workers

22:42

need to be fully vaccinated in order to continue to provide services.

22:47

And the Federal Government is now requiring providers

22:50

to provide details of the vaccination status of their workers.

22:55

However, we don't know any other characteristics

22:58

of those workers, so it would be impossible to tell.

23:01

For example, if there has been a special reach out

23:05

to migrant aged care workers

23:08

that has in terms of migrant communities.

23:11

But our main problem in Australia is because

23:14

we appear to contain COVID in its first wave.

23:19

We took a long time to get to vaccination and when we realised

23:23

vaccination was important, it was a huge issue of supply.

23:27

So while residential aged care

23:30

residents were designated as a priority group and so were workers,

23:35

in fact, when the rollout occurred, workers were left out of that.

23:40

And in home care it's been even slower back

23:44

to research like myself, it's incredibly difficult to get any data about

23:48

the characteristics of workers who've lost hours, workers who have been vaccinated.

23:54

In terms of what's happening now,

23:57

we are moving to open our borders, even though we're in the middle of a delta

24:02

wave and the program that was put in place to bring in Pacific

24:06

Islanders to work in aged care in response to employer complaints

24:10

that there weren't enough workers has just been reactivated.

24:14

So 50 workers from the Kiribati islands

24:18

have just been flown to regional Queensland.

24:21

It's very unclear what conditions await those workers

24:26

when they arrive in these regional communities and I think

24:30

that is of a concern and just following some of the debates

24:33

in the UK, the same debates that have been happening here,

24:37

if we need more workers, the argument goes

24:39

we should provide better wages and conditions.

24:43

You know, following the debates in the UK, the Prime Minister's been putting

24:46

forward a similar argument to not really adjusting migration settings.

24:52

The particular pressure in Australia is that we've recently

24:55

had a royal commission into aged aged care, quality and safety

24:59

and it's now recommended mandated carers choose the resident,

25:03

which means that we would need to quadruple our current workforce.

25:08

But in my view, and this is particularly the case, in-home care

25:12

model of work organisation

25:15

which provides employers with numerical flexibility,

25:18

it keeps workers on short hours of work, is less

25:22

underemployment, particularly for home care workers.

25:26

And employers seemed reluctant to offer more hours of work.

25:29

And we know from survey data that migrants in particular, not surprisingly, want to work

25:35

longer hours than do locally born workers

25:38

because they need to set up

25:41

homes, they need to support their families, etc.

25:44

And yet that's a real issue, particularly in home care.

25:47

You can have incredibly fragmented time schedules.

25:51

You can work for as little as an hour at a time

25:55

without any guarantee of any further hours.

25:58

So the the ongoing issues that face the sector,

26:02

but they're particularly acute for migrant workers.

26:06

And I suppose what covered one of the

26:09

lessons of COVID was that you were second class citizen

26:12

if you weren't locally born, went on a permanent visa.

26:16

Thank you, Sara. And it's really clear

26:20

that, you know, the difficulties that faced by migrants

26:24

within these kind of fragmented systems and unprotected systems,

26:29

I guess in the UK, response to COVID

26:33

is specific to long term care have been has been very little.

26:37

In fact, it has been criticised

26:40

not to take into consideration the effects on the sector.

26:44

So there has been some delays even in guidance to care homes,

26:50

home care has remained in the blind spots.

26:54

There hasn't been really guidance about how to meet shortages.

26:58

But what was interesting that happened in the UK that we were

27:02

we were discussing Brexit in relation to closing borders

27:07

and obviously there have been some efforts to maintain

27:10

the stock of EU, particularly EU migrants

27:13

that already in the country through the EU settlement scheme,

27:17

many of whom were working in the care sector.

27:21

But one of the main policy

27:23

and strategies that we've done as a reaction to COVID was the furlough scheme

27:28

that the government introduced, which is paying 80% of the salary

27:33

or income of workers who have to stop working due to lockdown.

27:37

So we had really big lockdowns and certain sectors

27:40

has been impacted dramatically, particularly the retail sector.

27:44

The hospitality. And what's happened is that there was this interesting

27:49

opposite direction flows with Brexit and prior to the call

27:54

that there was a lot of people leaving the country

27:56

because they weren't certain about what's going to happen.

27:59

Kelvin happened and then a lot of the local workers

28:03

were available in in the markets because of the lockdown and closure.

28:08

So the social care sector had a period of great recruitment

28:12

at the beginning of the COVID, and that kind of delayed the thinking for a bit.

28:17

So we did research in this area at the time

28:20

and people will say we're recruiting for a post

28:23

and we've got like 80 fantastic CVS and we can pick the best.

28:28

But that was very short lived.

28:30

It was very temporary. But what it did, it's kind of delayed it thinking about, okay,

28:35

what's going to happen when people go back to the UK didn't put in place

28:40

strong financial compensation for any of the social care sector,

28:44

unlike, for example, hazard pay that we've seen in Canada.

28:48

There has been some extra money coming, particularly from Scotland,

28:53

Wales, Northern Ireland, but not much in in the English side,

28:57

the single site restrictions and ensuring infection control.

29:01

Again, that was not mandatory.

29:03

Like other countries, it was just recommendations.

29:07

So and in that narrative, migrant workers were completely absent,

29:11

that there was not a discussion that is specific to migrants care workers.

29:16

So the UK is actually now facing a perfect storm because,

29:21

you know, people going back to work who were kind of

29:24

in the in the local market and there has been now suddenly,

29:28

you know, organisation care organisations seeing a.

29:31

Huge. Level of recruitment challenges, huge shortages.

29:36

And it's unclear how how that could be resolved.

29:40

And the discussion, Sarah, you know, you put it eloquently about better jobs,

29:46

which is fantastic, but we can't see how the better job is going to happen

29:50

and how we're going to happen fast enough to attract the workers

29:54

and the reality of population ageing where you don't have that surplus anyway.

29:58

So there is a limit to this attraction.

30:00

Even if you have a very good job, you can attract a certain number.

30:04

But we're running at a very low unemployment rates anyway,

30:08

so it's around, it's less than 5%. So you have a little bit of room, but not a huge and we are thinking about that.

30:15

You need 20 to 25% of the workforce, which is estimated

30:18

at 1.6 million jobs in the UK.

30:21

Then we're talking about huge numbers.

30:24

So I think this this hasn't been really thought through.

30:28

And I guess within all these discussions at the higher policy level,

30:32

nobody or very, very few people talk about the implications on the individual.

30:37

So people who were able to come from, say, South Africa to do a bit of work here

30:43

in the UK for three or four weeks and then go back or three months

30:47

and go back, that was not possible and that had a lot of implications

30:51

on the wellbeing of migrants. So maybe we take them, you know, we take our discussion

30:56

towards thinking about the humans doing the work.

30:59

So these people that we rely on, they are either

31:03

presented in the policy without a clear understanding

31:07

of their conditions or completely absent from the policy picture.

31:13

And we talk about the evidence that we have as researchers

31:17

around their particular working conditions

31:20

and will be situating this within a really difficult sector.

31:24

So it's not like it's rosy for everybody else, but realising

31:27

that migrant workers have an extra layer of implications

31:32

that have, you know, affect them adversely.

31:35

So Ricardo, you have been really your centre have been really active

31:40

in doing surveys and talking to migrant workers

31:43

and it would be really insightful for us to see you give us some findings

31:47

from your recent work, particularly in that period of COVID.

31:51

Yeah, thank you very much. I mean, that's I think that's a very good point that that that you raise,

31:55

because as I was talking about, some of the measures

31:59

that were implemented, such as this extension of the rotas,

32:02

for example, in in Austria following the closure of the borders,

32:07

of course, what this sort of

32:11

what this didn't consider was the fact that

32:14

a lot of these migrant care workers have families away from Austria,

32:19

have also found the responsibilities away from Austria, not only

32:23

in terms of the parents of these care workers that they probably will be looking after

32:29

during this fortnight periods where they are in their home countries,

32:33

but also children. And because this is very typically the sandwich

32:37

generation that has really

32:40

caring responsibilities and this is of course

32:42

these are mostly also women and this is something that I think

32:46

has been very much overlooked in the discussion

32:51

of this of this of this

32:54

model that relies a lot on migrant carers.

32:58

And besides that,

33:00

we've we've carried out the survey on the working conditions of

33:05

migrant carers in England in the formal sector,

33:08

so in residential care homes, in the home care sector and we compare this

33:12

with native native workers.

33:15

And what we found is curiously at the first layer of comparison,

33:19

we didn't find much in terms of differences in working conditions between migrants and natives.

33:25

So that was a sort of positively surprised result.

33:29

We got, of course, a lot of this was

33:31

driven by the fact that, as Sarah mentioned

33:35

before, a lot of the migrant care workers, they really want to work longer hours.

33:40

They want to sort of save

33:42

and earn as much money as possible so that they can send this back home.

33:46

They also tend to be younger. And as this sort of young migrant effect

33:50

that we see very much also

33:52

in our in our survey sample.

33:56

And the other aspect that then we were able to uncover

33:59

when we looked a little bit more careful into these differences

34:02

in working conditions, is that although we didn't find

34:05

significant differences between

34:08

EU migrants and native workers, we found quite significant differences

34:13

between non-EU migrants and both

34:17

native and EU migrant workers.

34:20

And we did this also together with some colleagues in Sweden

34:24

with a similar survey. And curiously, even though the countries

34:28

of origin outside the EU were very dissimilar between

34:32

Austria and and Sweden, we had similar findings there as well.

34:37

So this I think is an aspect also that we should bear very much in mind

34:42

sort of this how how the migrant care worker

34:46

model intersects with these different sort of migration regimes as well.

34:51

And I was I was thinking very much of this as listening to the both the Australian

34:55

and the UK sort of context.

35:00

And this is something that is perhaps going to become even more relevant

35:04

also in the context of Austria, because we've seen already that

35:08

there has been a change in the profile of the migrant care workers we have.

35:13

So up until a couple of years ago, the majority of the migrant

35:17

carers were really coming from Slovakia, from Hungary.

35:20

So there's a really neighbouring countries where it's relatively easy to commute.

35:25

So to give you an idea between Bratislava and Vienna, there's only about 45 minutes

35:30

a distance with the car and now about three years ago

35:35

it was the first time that carers from Romania became

35:38

the single most

35:41

relevant group among these migrant care workers.

35:45

We've also witnessed with little data that we

35:48

have an increase in care workers

35:51

that are coming from further places in Eastern Europe,

35:55

many of them not covered by the that are not members of the EU.

36:00

And this, of course raises even more issues, not only in terms of what is

36:05

what is the effect of these longer

36:08

spells outside of home, but also in terms of social protection.

36:12

There are a number of

36:15

mechanisms that guarantee social that the guarantee

36:18

also the transfer of pension rights, for example, within the EU.

36:23

And these are not always the same

36:26

when we talk about countries that are outside of the of the EU.

36:29

One final aspect I would like to highlight in terms of the wellbeing

36:33

of migrant carers and I think particularly in the context of the pandemic, is

36:37

and so a lot of these migrant carers, as I said, they provide care in people's

36:42

own homes, which means that they were also as socially isolated

36:47

as the older people that they were caring for themselves.

36:52

And this was again something that there was a lot of emphasis

36:55

placed in Austrian, rightly so, on, on the increase in loneliness

36:59

and social isolation of older people. But I don't think there was a

37:04

similar concern, a similar sort of spotlight

37:08

placed on the migrant carers that were sharing

37:11

the houses with these same older people

37:15

and that were not only at a heightened risk of infection as well,

37:19

but were displaced from their families, from their social networks.

37:23

So for for whom the question of psychological well-being

37:27

arising from isolation, I think was

37:30

is very, very, very much relevant.

37:33

Thanks, Ricardo. You know, all what it said resonates with a lot of things in the UK.

37:38

But it was really interesting as well when you said about the differentials in relation to being EU or non EU migrants

37:44

and the similarities that you found with Sweden,

37:48

although the country of the country of origin are different

37:52

and just thinking about the future, how we see this moving forward

37:57

in terms of moving post-COVID, hopefully things will return to normal one day.

38:02

It's not going to be normal. It's going to be the new normal.

38:06

But that may be called it have made us all pose

38:10

and think because just kind of nothing impacts.

38:14

And hopefully maybe that would would shape the future policy.

38:17

So as research, a strong research is in this field.

38:21

What would be your advice to the kind of future

38:24

looking policies in relation to aged care and the role of migrants within that?

38:29

I'll I'll start by Sarah,

38:32

because I know you're very involved in this policy and and I know

38:35

that you have been working in this area for, well, for many decades

38:39

around the bigger picture of employment conditions and better jobs

38:44

where we go from here, ideally What's your advice for policymakers?

38:49

Well, it's interesting, Shireen.

38:51

I mean, if there can be a silver lining of COVID, it really shone a light,

38:56

particularly on residential aged care, unfortunately, much less on hunting.

39:00

But how vital it was,

39:03

how terrifying it was

39:05

to have certainly in Victoria in our second wave,

39:08

we had a very high death were relatively high compared to the UK,

39:12

but relatively high death rates in residential aged care.

39:16

That's where most of our deaths were.

39:19

So there has been a grasp by the community at large, but certainly

39:25

perhaps reluctantly by the Federal Government that something has to happen around wages and conditions.

39:30

So for example, I'm involved as an expert witness in two different work

39:35

value cases under our industrial relations system, which are seeking

39:38

to increase the wages of frontline

39:43

residential aged care workers and home care workers by $5 an hour.

39:47

Now, whether or not this is going to be successful is a moot point.

39:52

But the royal commission is probably the first of 20 inquiries

39:57

we've had into the aged care sector over the last 20 years.

40:01

To actually say this has to be addressed.

40:04

Yes, we may well need migration, but until we can prove

40:08

providing decent wages and conditions a career structure,

40:13

we are not going to be able to provide the care because that's also

40:17

the other thing that came out of the royal Commission was the poor quality of care.

40:22

And given that rhetoric, quite rightly,

40:25

we adhere to this idea of relationship based care.

40:29

And this is why the Royal Commission has mandated up to 3 hours

40:33

per resident per day of individual care that comes in in 2022

40:40

simply going to need more workers to provide that

40:43

and if we're actually going to be providing this in a meaningful way,

40:47

then we've got to invest a lot more in training and resourcing workers.

40:52

The other interesting thing to come out both through time

40:56

within the royal commission is the lack of accountability of providers

41:01

for the funding that they receive.

41:04

So we have limited aged care funding, nothing like the austerity.

41:08

We haven't suffered the austerity cuts you have in the UK,

41:12

but we all used to think, well, we just need more money.

41:15

In the aged care sector. Increasingly, focus is now on governance,

41:20

on private providers, whether they be not for profits,

41:23

for profits, actually having some accountability for their funds

41:28

so that there is a large and vocal

41:32

consumer voice now around aged care, older people in their families.

41:38

We want decent aged care.

41:40

Given the ageing population, the increasingly complex social,

41:46

but also clinical needs, we need a really good skill mix.

41:50

So these messages I think have been received loudly and clearly

41:54

and the what was exposed during COVID was appalling.

42:00

Care was unpreparedness of providers who took the survey and said yes,

42:04

they were prepared for the second wave of COVID with that quality agency.

42:09

And clearly they weren't. They didn't even have basic infection control measures in place.

42:15

They were putting residents with COVID in with residents who didn't have COVID.

42:19

I mean, extraordinary, extraordinary stuff.

42:22

But it's really, I think, made

42:25

the Australian community more broadly.

42:28

See, this is really important, and I think that's

42:32

we will see hopefully an improvement

42:35

in conditions and recognition of the aged care workforce.

42:39

But I think we will always we are going to be reliant on

42:43

migrant workers and we need to be looking at ways

42:47

in which we can then provide pathways to permanency

42:50

and this model of having being tied to an employer

42:55

that was tried in New Zealand, that was a model for bringing in

42:59

low skilled aged care workers once again, mainly from Pacific Islands,

43:03

and that was seen as creating incredible vulnerability for workers.

43:08

So I think we need to make sure that we have,

43:11

you know, a supply of workers who are attracted

43:15

by conditions in the sector, but also, if they wish.

43:18

Not everyone wishes a pathway to permanency.

43:21

I think that's going to be certainly in the Australian context, really important.

43:27

Thank you very much, Sara. I think that it's very wise words that we want to propagate

43:32

and I'm sure that we can resonate with a lot of your accommodations records.

43:37

What's the what's what do you think of the future,

43:40

especially with the specific context that you've got with the live in care,

43:44

which something not present in Australia, for example, and, and,

43:48

you know, maybe the difficulties in regulating that though,

43:52

that I know that it is quite relatively highly regulated industry.

43:55

For example when we compare it to Italy where there is a huge reliance

43:59

of living care, it's very much unregulated.

44:04

Yeah, that's, that's, that's a very interesting and challenging question actually, how this is going to evolve in the

44:10

wake of the COVID, because I could see, at least in the Austrian case,

44:15

sort of different contradictory sort of forces in place.

44:20

So on the one hand, I don't think the sort of the appetite

44:24

or the demand for this live in arrangement is going to diminish,

44:30

especially as we have also witnessed

44:33

in the industry, in the Austrian society,

44:35

a large increase in the labour

44:39

market, attachment of women

44:42

and and in Austria traditionally care

44:45

even more perhaps than in other countries has been sort of

44:50

placed firmly in the realm of the family.

44:52

And the 24 hour care solution was is also

44:55

also a way to outsource part of this from the family

45:00

and from working Austrian women to very often

45:06

working non Austrian women.

45:10

So I don't think it's this demand. I think it's going to continue there.

45:13

It's going to continue particularly also in a society that values

45:16

very much ageing in place.

45:19

That's very is very much the maintains of older people

45:23

within their sort of community environments

45:27

and for which for the time being

45:30

there is also a that's been at least a steady supply of people interested

45:36

to work as 24 hour carers, even if this, as I said, has,

45:40

even if the profile of these carers has moved further,

45:43

further east and further further away

45:46

some extent from the from the EU.

45:49

So that's one, one aspect.

45:51

On the other hand, perhaps also because this is

45:56

this is a phenomenon that pertains very much also to the neighbouring countries,

46:00

I could see that sooner or later there will be a call

46:02

for a greater coordination of policies

46:07

that that rely on migrant carers, although in this,

46:11

in this transnational movement of, of, of carers and,

46:15

and there are, there are also some indications, for example,

46:18

that this is not only a phenomenon of sort of eastern

46:22

born carers moving into Austria and we've seen also in the past

46:27

that also nurses from Germany for example, were very keen

46:31

on working in some of the care homes in Austria because for example,

46:33

they perceive that to have much less administrative burden

46:37

when they, when they work in Austria than they did in Germany.

46:41

And there's also quite a lot to be said about the recognition of competencies,

46:47

particularly in in, in in a context such as the Austrian one where,

46:50

as you said, it's still relatively regulated.

46:53

So there is, even for these migrants,

46:56

24 hour carers, there are some conditions in terms of recognition of

47:00

of experience and of competencies to work in this sector.

47:03

So I could see or a hope to see at least a greater

47:08

attempt at

47:11

the this this this this whole phenomenon of transnational care within the EU.

47:17

And I would say even for from outside the EU,

47:21

I could imagine that this would be also something that might

47:24

play a role in terms of the negotiation of accession to the EU for some countries,

47:29

for example, coming from the former from from Yugoslavia.

47:34

The danger, on the other hand, is that I think the pandemic

47:38

really put a spotlight on a long term care on the low cost

47:42

model of long term care that we've had in many countries in Europe.

47:47

But I think a lot of it that's going to be also determining sort of in the period after the pandemic

47:51

in terms of how much this newfound relevance, policy

47:57

relevance and also public in the public discourse

48:00

is going to carry forward.

48:03

And I'm thinking very, very much in terms of how much

48:05

I think this will be very much determined. Also to what extent we will have the return of austerity policies

48:11

or not to the European space, because this is going to,

48:15

I think, also shape very much

48:19

the ability that different countries will have to really invest the money

48:22

that is necessary to create proper

48:26

and resilient, long computer systems.

48:30

Thank you very much, Ricardo. It's really interesting that that relevant to the Brexit

48:34

discussion here, that even with the open border

48:37

and thinking about extension of the EU and the issues of competition

48:42

and migrant agency remain, this is something we didn't discuss it.

48:46

We need another podcast to talk about, but we we don't operate in a vacuum.

48:51

So countries have competitors

48:55

and migrants have their own agency

48:57

to go through the decision process, where to go and how long to stay.

49:02

And I think maybe I'll invite Agnes here just to tell us

49:05

about the kind of current discussion, because the

49:09

the visa scheme which is called this way, but it doesn't really cover.

49:13

So she clear there is of course the new levy in health and of course the health and social care,

49:18

which is 1.5% extra net insurance taxation that coming into effect in April.

49:23

But more and more we learn that it's more health rather than social care.

49:28

And as I mentioned earlier

49:31

with Brexit from the first venue response offensive

49:34

on free movement for free, you let us know.

49:38

Remember if in the UK and these people have survived through the settlement

49:43

was to stay at the same time

49:46

and there was some discussion, some debate around this venue.

49:50

These are the new immigration system.

49:54

It's very heavily on the old one, basically

49:58

cut off the birth rate, essentially Catholic social care,

50:03

most in social care

50:06

with not based on the education.

50:09

We have also the qualification and also this was within the prep school

50:14

and even in certain that both terms of senior

50:19

workers, the pay

50:22

levels in the sector are really not sufficient.

50:25

Theoretically, it's possible that with the expected growth

50:32

in direct social care, but in reality it is very difficult.

50:36

But in the new system, the government considers the health care visa,

50:41

which I think slightly misleading the name

50:44

because in reality it is very,

50:48

very fourth visa

50:50

and they say from the beginning of the year

50:53

are the intensive application is only about

50:57

300 came from EU countries

51:01

and the majority of these are most likely

51:03

are probably for the NHS.

51:06

Effectively. There's no direct

51:10

social care for people who like to move to the UK

51:14

and this is kind of starting to show we haven't seen before the impact

51:19

because it's going to unfold over a longer period of time.

51:22

But the most recent data

51:25

shows that the non-EU staffers,

51:28

the share of people from outside the non-EU business.

51:32

Now the case has from about 5% then to 18%.

51:37

So that's close to the whole.

51:40

There are a lot of I also mentioned the fact sectors

51:44

the temporary visa schemes, there are calls for social care

51:49

and the government to open this discussion.

51:53

So there is the migration advisory committee that they are this for this.

51:58

So it really remains to be seen.

52:02

It's very clear there are very different interests

52:06

and how this needs to be balanced.

52:10

This is a very, very interesting period.

52:14

Absolutely. It's a very, very difficult period.

52:17

And it's there is no kind of easy winning cards because even if we think about

52:22

a temporary visa or specific, these that we have to think about the implications

52:26

and whether we are taking a whole approach in terms of better jobs,

52:30

seeing really clear steps to improve jobs,

52:34

but realising that the contribution of migrants has to remain

52:39

part of that and then how to integrate their

52:43

contribution in a decent way and in a way that based on human rights,

52:47

really to recognise that we're not putting them

52:51

in an extra vulnerable position because they are already

52:53

in a vulnerable position and can accept certain working conditions.

52:57

I think this is a topic that is not going to go to sleep.

53:00

It's a topic that we are all kind of trying to deal with in different countries

53:04

and it has been really great to listen to the insight

53:08

from Austria and Australia and I've been really grateful

53:12

to have you as partners during the Sustainable Care

53:16

Programme of Work, which is coming to an end this year.

53:19

So I just want to end by thanking you greatly for your contribution

53:24

over the last few years for the programme and also for your contribution today,

53:29

and I just give you the space to say any final remarks that you might have.

53:34

So thank you very much for having you today.

53:39

Thank you. Sharing This was a pleasure. It was a pleasure to be here.

53:42

It was a pleasure also to listen to the experiences

53:46

of the UK and Australia as well, and

53:50

also, for my part, a big, big

53:55

commitment of the of the work that you're doing in a sustainable care.

53:59

And I look forward to, to complete the the project further.

54:03

Thank you, Ricardo. Sara, we're very grateful to have you.

54:07

You have to deal with time difference and timezone,

54:09

so we're very grateful to have you today.

54:13

It's a pleasure to be here. Shereen and very nice to be here with you and

54:18

Agnes in particular and the work that you're coming

54:21

that you've been doing in the Sustainable Care Project.

54:24

It's so important. And what I've been impressed by today and to be hearing from Riccardo

54:29

about the Austrian situation is more the commonalities

54:34

issues might be differently expressed, and there is obviously the historical

54:38

and the cultural backgrounds that this is a real, I think, a rich example of

54:44

we if we go back to Fiona Williams idea of intersecting regimes

54:48

so that they can produce very different outcomes.

54:51

But there is such a strong similarity, particularly in the space of time

54:57

care between of the countries that I feel I've met a lot from this in this podcast.

55:03

So thank you for letting me be part of it.

55:06

Thank you. And thank you everybody for listening to this podcast and we hope you enjoy it

55:11

and to look out for more of our outputs from the Sustainable Care program.