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MAC report brings light at the end of the tunnel

I hope by now you’ve heard the very good news! After a campaign by SIA, the Migration Advisory Committee (MAC) which advises the Home Office has recommended to the government that they introduce fast-track work visas for care workers from overseas wishing to work in the UK.

We welcome MAC’s interim recommendation as an important step to mitigate the care crisis. The Home Office must now implement it with the urgency that the crisis demands.

Many people with spinal cord injury rely on expert carers to deliver the care they need to live. Our helpline has been deluged by members left desperate by the care worker shortage.

We are pleased that MAC has also recognised that this recommendation is not relevant to the specific crisis faced by disabled people who receive NHS and social care funding as Direct Payments to employ care workers directly. We welcome their confirmation that they are working to find a bespoke solution for their final report in April 2022.

Our members who employ health and social care workers directly are some of the most seriously disabled people in society, amongst the most vulnerable, and with the most complex needs. The constant fear of being left without life- sustaining care has left many desperate and fearful. A solution cannot come fast enough.  At the end of this blog you can read more about how some of our members are experiencing the current crisis.

Brexit put a stop on the flow of labour from Europe into U.K. social care workforce. This has been exacerbated by the Covid pandemic. The combination of the two has resulted in PAs/carers being rarer than hen’s teeth, so this news could not come soon enough. For the past six months we at SIA have been providing compelling evidence to the MAC that this is something which needs to happen – and needs to happen sooner rather than later.

Much has been written about the social care crisis, but we spinal cord injured people know better than anyone the urgency of the situation. For many of us, it’s not a case of relying on carers to help us flourish, it’s a case of relying on carers to make sure we stay out of over-stretched NHS hospitals where we risk catching life-threatening Covid infection and depending on them to stay alive.

Our helpline has been flooded with members left desperate by the lack of care workers. Our members who employ health and social care workers directly are some of the most seriously disabled with the most complex needs. The absolute terror of being left without support is something which many of us feel – but we shouldn’t have to.

So for me, a tetraplegic person who has relied on the skill of PAs and carers, 24/7, for over 30 years, yet has found it increasingly difficult to recruit new people, I welcome this news. I would go as far as saying I’m cautiously optimistic.

What next? The government must listen to MAC’s recommendations and act NOW to bring about much-needed change in the care and immigration system. The Home Secretary must bring in fast-track work visas for those overseas nationals wishing to become carers in the UK and we must all continue to speak truth to power to ensure this vital issue does not get pushed to the back of the queue.

Dr Rupert Earl

Chair of SIA trustees

Our members share their stories


“I think what the hell am I going to do if I can’t find a PA?  It can be extremely dangerous for a tetraplegic person to be left on their own, especially because of the risk of autonomic dysreflexia”




“My partner of over nine years, is currently my full-time carer and has not had a break over the last few years due to the UK’s shortage of adequate carers”

Lynda’s story


“Speaking as someone who relies on a live-in carer, the fear of being left alone without any care is absolutely terrifying and all-consuming”

peter’s story