International care workers in
England: Practices and identities
Dr Shereen Hussein
Prof Jill Manthorpe
Dr Martin Stevens
Introduction
• Migrant workers in social
care in the UK
• The study
• Theoretical frameworks
• Findings
• Conclusions
Taken from Guardian
website – 26-03-2008
Evidence on international recruitment
• Migrant or migrant care worker make up 16% of the UK care
workforce
• Increased demand for care workers
– population ageing,
– high levels of female employment
– greater survival of people with long-term health conditions and
disabilities
• Rapid rises in labour migration, often related to shortages of
labour in health and social care sectors (Misra, 2003, Elrick
and Lewandowska, 2008, Doyle and Timonen, 2009)
• Migration and increasingly important political and social issue
– changing migration regulations
11th November
200911th November
The study
Funded by the Social Care Workforce Research Initiative of
the English Department of Health
1. Review of literature, interviews with recruitment agencies
& key stakeholders (35 interviews)
2. Analysis of national statistical data (international social
workers - 7K; and recent migrants working in the care
sector NMDS-SC - 5K)
3. In-depth 6 study sites interviewing migrant care workers,
their colleagues/managers and service users/carers (196)
4. Interviews with a national sample of asylum seekers,
refugees and people working with them (23)
4
Migrant care workers participating in
the study
Country of birth
Reason for coming to the UK
•
•
•
•
•
•
•
•
•
•
• Recruited from my country for a
specific job (32)
• Offered a work permit to work
in a specific job (6)
• Accompanying a family member
(24)
• An overseas student (14)
• An asylum seeker/refugee (2)
• Holiday/short visit (12)
• Looking for work (moving from
EU) (6)
Commonwealth (32)
EU14 (excluding UK) (8)
EU A8 (13)
EU A2 (1)
Other EEA (1)
Zimbabwe (5)
Philippines (21)
US (1)
Nigeria (4)
Other countries (10)
Models of migration motivations
• Standard economic
maximization models
• Economic motives
within household
decision making
• Search theoretic models
• Social mobility/social
status migration
motives
Motivations of migrant care workers
• Gendered nature of care work – therefore female perspective
important - under theorised
• Women’s motivations incorporate more than individual
factors – eg family norms and gender roles (De Yong, 2000)
• Macro and micro economic factors important and interact eg
Filipino migrant care workers (often nurses)sending money
home (Menjivar et al. 1998
• Personal and professional factors are also important (eg for
nurses: Ryan and Coughlan 2009)
• Importance of inter country dynamics
– Similarity of social work/ social care work context (Valios 2008)
– Differences in terms of workloads (Sale 2002)
• Care work as means of coping and stepping stone to other
work (MacGregor, 2007)
Theoretical framework – individual perspective
Intermediate
factors
Motive
Experience in
the sector
Future
plans
Motivations to come to the UK
• Positive views of the UK
– it’s my dream to come here to England’ (Nurse, Commonwealth - 412)
• Build on previous skills
– I decided [to come to England] because before in my country, I’m
working in the hospital and I’ve experience in home for the aged as
well (Nurse, Commonwealth - 412).
• Financial motives
– It [main motive] was more about money, I would think, in the
beginning. I thought I wouldn’t stay here longer in care (Senior care
worker, A8 - 518).
• Following spouse/family
• Other motives
–
–
–
–
Broaden horizons
Return to former profession
Passion for English language
Bringing spouse/family
Motivations by country of origin
Commonwealth
Philippines
EEA
Other countries
Positive views of UK
Financial
Passion for English
language
Build on previous
work
Builds on previous
work
Builds on previous
work
Following spouse
Following spouse
Broaden horizon
Positive views of UK
Financial
Positive views of UK
Stepping stone
Bringing family
Financial
Stepping stone
Gain qualifications
Gain qualifications
Following spouse
Broaden horizon
Positive views of UK
Bringing family
Following spouse
Broaden horizon
Bringing family
Keen to work in
social care
Build on previous
work
Gain qualifications
Gain qualifications
Passion for English
language
Broaden horizon
Stepping stone
Main motivations to work in social care
• Altruism (wanting to help others in difficult situations);
– It’s that, whenever I see vulnerable people or old aged people, it’s that
it really touches my heart. (Senior care worker, Commonwealth - 508)
• Better than previous UK jobs (mainly factory jobs);
– I took one other job in an agency and I didn’t enjoy it, so one of my
friends told me you can try caring, so I thought it would be good and I
gave it a try and it really work so I choose that one. (Care assistant,
other countries- 430)
• Social care sector is easy to get into;
– I started to work as a care worker. It was the first job I could get. The
first available one. (Nurse, A8- 244)
• Social care is a good career.
– Working in one sector will make you ready to work in another sector.
You don’t need other training to work in one place. With your
experience you can work in other places. (Social worker, Nigeria - 615)
• In most cases, multiple interacting motivation
Intermediary factors
• Level of skills/qualifications
– Language skills
– Skills and prior experience
• Historical and current links between home country and
England
– Variations in organisation of care services - So that’s the
difference, [here] we are more dependent. Here you cannot take
your decision, you can, but in terms of how much is less decided.
(Social worker, Commonwealth - 310)
• Personal factors
– Non work stress (over half) (eg sending money home or
separation from family)
– Time in the UK
Common experiences of working in UK
social care
• Valuing the Caring Role
– That particular woman said to me, she said, she said, you are the only one I
remember who stood there and spoke to me and she smiled at me. I
thought, you couldn’t have seen me. She said she could....She said you were
the only one who treated me like a human. That means such a lot. I’ve
never forgotten it. I’ve never forgotten it. (Care worker, Commonwealth 248)
• Demands and stress
– Workload - We don’t have octopus hands (Care assistant, Philppines 228).
– Emotional demands - My main calls are really because they are alone and
that hurts me. It does, terribly (Care assistant Commonwealth - 248)
– Working with challenging service users - It can be, because your residents
can be challenging and upset and other days, it can be all calm and serene
and nice. From one day to another, you don’t know what you are going to
get. (UK care assistant – 111 )
• Administrative work
• Low pay and status
Working relationships
• Supportive employers
– Well, actually the management here are very equal. Everybody
gets support from them. They give all the trainees all the hours
if you want, you know. There’s no limitation. Of course there’s
always limitations, but what I mean is they are always giving us
equal opportunities. I’m happy that I am working with them in
this place. (Senior care worker, Philippines - 316)
• Less supportive employers
– I should think she was more of authoritative in a way, whatever
she says because this is how she feels and that’s it. (Social
worker, Commonwealth ‐ 310)
• Colleagues
– When I first came over to the UK and certainly like in any post as
a foreign worker I think it takes you longer to kind of get good
working friendships. (OT, Commonwealth ‐ 516)
Working with people from different cultures
• Complex web of culture interchange within social care services.
• Breaking cultural rules
– Even though if a White girl goes out to assess a British older woman,
she doesn’t see anything wrong with the woman staying by herself, but
for me I tend to feel concerned, there should be somebody around. So
it’s going to be a kind of a training or a kind of lecture about
that.(Social worker, Nigeria - 615)
• Language and skin colour may be used as markers to classify, and
negatively evaluate, others’ cultures (Johnstone and Kanitsaki
2008).
• Mutual respect (positive and negative)
• Interpersonal relationships overcome cultural differences?
• Time overcomes cultural differences
• Local context
Experiences of racism
• Over two thirds of the migrant workers in the research
sites (68/96)gave accounts of racist behaviour of:
– employers,
– colleagues
– service users
• Differential experiences of different ethnic groups
– Visible social markers
– Being ‘foreign’
• Accounts of mistreatment on the grounds of language
were fairly evenly spread
• Time reduces racism
Conclusion
• Multiple motives reflect different models
– economic and mobility – general and for status
– macro and micro economic
• Interactions between motives to migrate and to
work in social work and social care
• Interactions between motives, experiences and
‘intermediary factors?’
• Identity, ethnicity, gender and country/region of
origin all important
• Time in host country