A ‘key worker’ is defined by NHS Business as ‘a care professional who takes a key role in coordinating the care of the patient and promoting continuity, ensuring the patient knows who to access for information and advice’. National Health Service (NHS) workers under the Key Worker Living Programme used to be given priorities by the government on some low-cost home ownership schemes with loans of up to £100,000 or some intermediate rent schemes with social landlords.
The ‘key worker’ concept has again been a topical subject with the COVID-19 outbreak. Yet it has been exactly a month since the new Australian-style points-based immigration system, one of the government’s post-Brexit strategies was unveiled. This confirmed that the UK government would end free movement and not implement any exemptions for lower-skilled workers.
On the 19th March, the government listed health and social care sector together with seven other sectors: education and childcare; key public services; local and national government; food and other necessary goods; public safety and national security; transport, and utilities; communication and financial services. People in these sectors were pronounced as critical workers. It was in this context that Boris Johnson said that only vulnerable children with at least one parents who is a key worker could continue to go to schools.
Before locating the ‘key worker’ term into the categorisation of health and social carers, it is essential to note that the criteria used to classify these workers are both controversial and fluid. For example, salary, prestige, personal qualifications, and skills may vary historically. Also, the categorisations of lower-skilled, skilled and highly-skilled should not be taken for granted without critical considerations.
The concept of a ‘key worker’, in the context of health and social care, seems to be consolidating all occupational categories into one big de facto category. This was because not only the workers categorised as skilled or highly-skilled in the government’s eyes, such as doctors, nurses, midwives or paramedics, but also social workers, care workers, other health and social care staff (including volunteers and the support and specialist staff) were mobilised to fight against the coronavirus crisis as frontline staff. The UK government could have used this mobilisation as an opportunity to identify and support the work of affiliated health and social care professionals who are not necessarily involved in medical treatment but who constitute essential elements of health and social care with what they do. Moreover, it could have understood better in this way that, despite migration management as a national issue, human health matters globally and closing the door of the country to the overseas-trained healthcare workers would be closing the doors to the opportunity to survive.
Nevertheless, it appears in the current situation that the UK government officials have not learned any lessons from this crisis. Furthermore, the ‘key worker’ concept is nothing but the means of a major discrepancy. A striking example can easily bring us to this conclusion: Home Secretary Priti Patel announced a one-year, free of charge extension for the visas of overseas doctors, nurses, and paramedics in NHS and their family members on the 31st March. There is no doubt that, albeit for a while, this extension will ‘give the peace of mind’ to these workers with the Secretary’s words. However, the deprivation from such right to stay will also be a severe trauma for thousands of workers from many nationalities in other job roles – i.e. for over 15,000 EU or 10,000 Asian clinical support staff and over 2,500 African infrastructure support staff in NHS as well as for many others in social care and private sectors. How can these employees be expected to save lives wholeheartedly by risking the lives of their own and their family members with this feeling of exclusion?
The concept of ‘key worker’ in its current form has only brought a virtual status to non-clinical workers. It gave these people a title to be proud of for a very short time and created an illusion of a world where every health worker has equal value in terms of the tasks that she/he fulfils; it did not value these workers and their jobs though. It did not promise them to eliminate the threat of remaining illegal and losing their immigrant statuses and jobs anytime. It did not guarantee them better pay and better social status. Even worse is the recent claims about that some private care homes refuse to give Statutory Sick Pay (SSP) to its care workers who are advised to stay at home and self-isolate themselves in case of coronavirus. However, according to the announcement before, those who do not feel well should not have been forced to work by their employers and 80% of salaries of these workers would already be covered by the government.
Unfortunately, the idea of serving a country where you can simply get deported when your visa expires cannot be a strong motivation if you are an immigrant worker. In my view, the single and most important suggestion for the government might be to give up the discriminatory policies around visas and start to implement inclusive strategies for all immigrant healthcare professionals in this state of emergency and afterwards.
The UK government might think that everything will go back to normal. However, what they are missing here is that we can define ‘normality’ only with the information of what we have already had. No one knows anything about the social, cultural, political, and economic effects of this pandemic; we can only guess. Additionally, the health system in this country was suffering from the staff crisis before the pandemic that was getting worse. What is as clear as crystal is that health workers are needed at all levels and will continue to be required. That is why the UK must know the value of this workforce and be generous towards them.
About the author: Buse Ozum Dagdelen, is a PhD student in the Sociology Department, at Lancaster University. Her PhD is about immigrant health and social care professional women in North West England.