PF June 2018 Teaser by Redactive Media Group

PublicFinance P UBLICFINANCE .CO.UK

Issue 06 June 2018

ALL ROUNDER

TA ST E R E D I T I O N

IFAC president Rachel Grimes on ﬁnance and fair play COMMUNITY CHAMPIONS

Wigan’s winners share the secrets of their success MINDFUL MANAGEMENT

B R AC E D FOR B RE XIT? How public services can keep calm and carry on

.or LIN E g.u E

DI G M CO IT NF A AP cip ER L PI fa EN F an CE U N nu G al co N PRO TU A nf OW G RA R er en O M E ce N M

JUNE 2018 • ISSUE № 06

Tips to help you and your team take time out

news Public borrowing hits a low point

Use AI to raise diagnoses, says PM

Public sector net borrowing has fallen to its lowest level since 2007, according to the Office for National Statistics. From April 2017 to March 2018, it was £40.5bn – £5.7bn less than in the previous financial year, and £4.7bn less than Office for Budget Responsibility expectations.

The prime minister has urged the NHS to see artificial intelligence as a “new weapon” in the “fight against disease”. Theresa May outlined plans that will see at least 50,000 more people each year diagnosed with prostate, ovarian, lung or bowel cancer at an earlier stage than they would have been.

The East Coast Main Line railway will come back under public control temporarily, the transport secretary announced. Chris Grayling told the Commons on 16 May this was because the two companies operating the line – Virgin and Stagecoach – “got their bid wrong” and were no longer able to make their promised payments on the £3.3bn contract. The route was not “failing”, he told MPs. “It continues and will continue to generate substantial returns for the government, and the most recent figures show passenger satisfaction at 92%. The route has its challenges, but it is not a failing railway,” he said. But Grayling added: “Stagecoach and Virgin Trains got their bid wrong and they are now paying a price. They will have lost nearly £200m meeting their contracted commitments.” ● See opinion, page 17

UK tax haven secrecy tackled as law amended British overseas terroritories will have to publish registers of companies under clause added to anti tax dodging law By Simone Rensch The UK government has finally backed plans to crack down on “dirty money” and make tax havens more transparent. Britain’s overseas territories will now have to adopt public registers of company ownership by the end of the decade, following the acceptance of an amendment to the Sanctions and Anti-Money Laundering Bill, which received royal assent in May. Labour’s Margaret Hodge and Conservative MP Andrew Mitchell had been pushing for an amendment to stem the flow of cash obtained unlawfully or immorally. Previous attempts to amend the bill had been rejected. Mitchell said during the bill’s report stage: “It is now time for the house to assert its authority and nudge the government into the right place.” He declared himself “delighted” that the government accepted a new clause 6, which he said would help “in bearing down on money laundering, corruption, tax evasion, terrorist financing and fraud”.

�British Virgin

Islands: overseas territories will have to introduce public registers of companies by 2020

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6 PUBLICFINANCE JUNE 2018

Clause 6 is the requirement to introduce public registers of beneficial ownership for companies that are registered in British overseas territories. Hodge, who chairs the CIPFA-sponsored All-Party Parliamentary Groups on Responsible Tax, told PF: “Billions of pounds are laundered through the British overseas territories every year. “They encourage corruption, organised crime, tax evasion and avoidance and are a mechanism for funding terrorism. This is a huge problem. “Opening the overseas territories to scrutiny and accountability through public registers of beneficial ownership will make a massive difference. This really is a historic moment in fighting corruption and financial crime.” Foreign office minister Alan Duncan said ministers were reluctant to tell the overseas territories what to do but added: “We have listened to the strength of feeling in this house on this issue and accept that it is without a doubt the majority view of this house that overseas territories should have public registers.” The act requires all 14 overseas territories, including the financial centres of the British Virgin Islands and the Cayman Islands, to introduce public registers by the end of 2020 or face having them imposed by the UK government. CIPFA chief executive Rob Whiteman said: “CIPFA is a proud supporter of the kind of transparency this amendment represents, so we are delighted that the government is taking significant steps to clamp down on tax avoidance.” Meanwhile, MPs on the foreign affairs committee urged increased efforts to crack down on money laundering, warning that Russian corruption was putting national security at risk. The committee called on the government to use the powers outlined in the Sanctions and Anti-Money Laundering Act, once in force, and work with the EU, US and G7 to “tighten loopholes” that allow Russians to hide dirty money in the UK and elsewhere. Committee chair Tom Tugendhat said: “The scale of damage that this ‘dirty money’ can do to UK foreign policy interests dwarfs the benefit of Russian transaction in the City.”

ISTOCK

East Coast rail back under state control – for now

Millions of homes called for

Tougher rules

England needs 340,000 new homes built annually until 2031 to meet housing demand, a report from the National Housing Federation and housing charity Crisis has said. It said new homes should be of the right type, in the right places and affordable.

The Hackitt review made recommendations to eliminate bad practice

Grenfell tower: the Hackitt report on fire safety found there had been a “race to the bottom” with costs taking priority over safety

➊ ➋

Consultation to go ahead on tower block cladding Government to consult on banning combustible materials in high-rise buildings as damning Hackitt report issued

GETTY

By Dominic Brady Ministers have bowed to public pressure and will consult on banning flammable cladding on high-rise buildings. Housing and communities secretary James Brokenshire made the announcement at the release of Dame Judith Hackitt’s independent review of building regulations and fire safety, which did not recommend this. “Having listened carefully to concerns, the government will consult on banning the use of combustible materials in cladding systems on high-rise residential buildings,” he told MPs. “I will ensure that there is no room for doubt over what materials can be used safely in cladding of high rise residential buildings.” The Hackitt review identified “ignorance” and “indifference” when it came to applying building regulations to

installing cladding on high-rises. Hackitt also said there had been a “race to the bottom”, where organisations were more concerned with costs than ensuring “that residents are safe and feel safe”. Her report called for a “culture change” and a new regulatory framework to encourage the “right behaviours”. “This is most definitely not just a question of the specification of cladding systems, but of an industry that has not reflected and learned for itself,” the review said. The review was commissioned following the Grenfell Tower fire in June last year, in which 71 people lost their lives. Brokenshire said: “The cladding believed to be on Grenfell Tower was unlawful under existing building regulations. It should not have been used.” Responding to the announcement on the consultation, Local Government Association chair Lord Porter said: “It’s great that the secretary of state has listened to our concerns.” He called for the government to act “without delay to introduce a temporary ban on the use of combustible materials on complex and high-rise buildings until

➌ ➍ ➎ ➏ ➐

Reforms for safe building Stronger regulation An outcomes-based approach to regulation overseen by a new regulator

No avoiding responsibility Clearer roles and responsibilities during design and construction, as well as occupation

Involve residents Residents to be consulted and involved in decisions affecting the safety of their homes

Tougher testing A more rigorous and transparent product testing regime and more responsible marketing

Oversee competence Construction industry to lead on strengthening competence of all those involved in building work and establish an oversight body

Rigorous enforcement Wider, more rigorous, flexible enforcement powers backed with serious penalties for those that abuse the system

Compulsory records Mandatory digital records holding a “golden thread” of information about each high-rise residential building

we have a regulatory and testing system which is ﬁt for the 21st century”. The public inquiry considering the Grenfell Tower ﬁre has started to take evidence, beginning with the testimony of survivors and families of www.publicfinance.co.uk/subscribe those who died in a series of commemoration hearings.

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► Watchdog Watch

WHAT’S GOING ON IN AUDIT AND REGULATION N AT ION AL AU D IT O F F I C E ⦁ A range of primary care services fell below acceptable standards because NHS England and Capita failed to understand the risks of outsourcing key back office services, the National Audit Office has found. The watchdog probed a seven-year, £330m contract between the NHS and Capita. Starting in 2015, this covers administrative support to GPs, dentists, opticians and pharmacists, such as processing payments, ordering supplies and moving medical records. NHS England hoped the contract would reduce its costs by 35%, while Capita planned to make a loss of £64m in its ﬁrst two years but recoup this later. Problems started to emerge in 2016 as Capita embarked on a programme of office closures, which meant its customer service centre struggled to meet demand. Some service failures put patients at risk of harm, the NAO found. For example, 87 women were told incorrectly they were no longer part of the cervical screening programme and processing issues led to an estimated 1,000 GPs, dentists and opticians being delayed from working with patients. Payments to some of these practitioners were delayed. To date, NHS England has deducted £5.3m from payments to Capita in penalties but it expects it may have to pay up to £3m in compensation to primary care providers, the NAO said. More than two years into the contract www.publicfinance.co.uk/subscribe and some basic principles have still not been agreed, which hampers NHS

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10 PUBLICFINANCE JUNE 2018

�Looking bad:

failures in the Capita contract put some patients at risk of serious harm

1,000

GPs, dentists and opticians being delayed from working with patients because of Capita service failures

“Neither NHS England nor Capita fully understood the complexity and variation of the services being outsourced” ON BOTC H ED BAC K O F F I C E : AM YAS M O R S E , NAO

England’s ability to hold Capita to account. The auditors said taking elements of the contract back in house should be considered. NAO head Amyas Morse said: “Neither NHS England nor Capita fully understood the complexity and variation of the services being outsourced. As a result, both parties misjudged the scale and nature of the risk in outsourcing these services.” He added that value for money was about more than just cost reduction. In a separate report, the NAO has said that HM Courts & Tribunals Service has set itself a “daunting” modernisation challenge and has not made the progress it should have done. In 2016, HMCTS set out ambitious and wide-ranging plans to introduce new technology and working practices. This would allow it to cut staffing, make courts more efficient and accessible and save £265m annually by 2023. Morse said: “The tight timetable could force HMCTS to make changes before fully understanding the consequences for the justice system.”

CO MMI TTE E O N STAND ARDS IN PUBLIC LIFE ⦁ Little signiﬁcant progress has been made on reinforcing ethical standards in outsourced services, the Committee on Standards in Public Life has concluded.

ALAMY

—

voice of the nations

In brief… T EC H N O LO GY

Cyber research centre for Wales A National Digital Exploitation Centre for Wales, which will provide digital and cyber education and research could be built in Ebbw Vale. The project is led by global technology company Thales, which is seeking support from the Welsh Government, Blaenau Gwent Council and the University of South Wales. Economy secretary Ken Skates said the Welsh Government was assessing the proposal but said it could help Wales exploit the “global opportunities of digital transformation”, and boost skills and jobs.

H E A LT H

Neurology inquiry chair appointed Brett Lockhart QC is to chair the inquiry panel into the recall of neurology patients by Belfast Health and Social Care Trust. More than 2,500 patients treated by consultant Dr Michael Watt were recalled following concerns they had been misdiagnosed. Watt has been suspended but remains an employee. Lockhart and his fellow panellists will review how the trust handled concerns and whether it should have intervened earlier. EC O N O M Y

New bank to invest in Scottish economy A new, publicly owned bank is to invest £2bn over the next decade to make Scotland’s economy fairer and more prosperous, the Scottish Government has said. Economy secretary Keith Brown said the

Scottish National Investment Bank would be a cornerstone of the economy, operating on a commercial basis with a strong ethical focus. Although ministers will set strategic missions for the bank, it will be independent of the government. S O C I A L S E RV I C E S

Consultation on looked after children Northern Ireland’s health and education departments are seeking views on their draft strategy for looked-after children. This aims to improve outcomes for those in care, on the edge of care and who have left care but need support. Chief social work officer Sean Holland encouraged young people to respond. “They know better than anybody what steps we need to take to make life better for a child or young person in care,” he said.

N O RT H E R N I R E LAND

in a budget earlier this year that saw a real-terms increase to council funding, as well as a £400m boost for the NHS. “This ﬁnancial year I had a real-terms reduction to the Scottish budget from Westminster but, using the powers as we have, I turned [that] into real-terms growth ⦁ The Northern Ireland government is to for Scotland’s public sector,” he said. fund efforts to roll out mixed teams of “I recognise local authorities are still health professionals in GP practices this facing challenges around population [and] ﬁnancial year. demand for services, which is why as It has said that £15m of the £100m well as being properly resourced health and social care transformation there must be ongoing fund will be focused on transformation.” enhancements to The public sector should primary care. be looking at how to share Of this, £5m will be used services and management, to extend provision of improve procurement and multidisciplinary teams at work together more smartly, GP practices, which will he said. Health and social include physiotherapists, care integration was an mental health example, he said, but specialists and social more transformation workers. Investment into economy from new, was needed. It is hoped this will publicly owned bank planned for Scotland

More service types at GP surgeries

UNP

£ bn

help ease pressure on hospitals. Other investments from the £100m fund include up to £30m for reforms to community and hospital services, including mental health and pharmacy. This funding tranche will also put in place new strategies for service areas including cancer care, stroke services, paediatric services and diabetes care and prevention. A further £5m will focus on communitybased prevention initiatives, in particular in children’s social care. It was previously announced that £30m of the £100m transformation fund will be spent on reducing hospital waiting times, funding an additional 24,000 outpatient assessments and 7,400 treatments.

WALES

Warning over ‘one off’ care funding ⦁ Welsh councils and social care leaders have warned that current funding arrangements will not meet increases in cost and demand facing social care. A report produced by the Welsh Local Government Association and the Association of Directors of Social Services, and submitted to the Welsh Assembly’s ﬁnance committee, said councils would be facing additional pressures of £344m by 2021-22. This was caused by rising workforce costs coupled with more older people needing social care support. The number of people in Wales aged over 65 is predicted to increase by 33% by 2035, while those aged 85 and over is set to rise by 107%. Huw David, WLGA’s spokesperson for social care, said one-off funding boosts would not be enough. “As our ageing population increases, so too does the demand on social care services,” he said. “Now is the time to have a real debate about fundamental changes to social care funding, and to do away with www.publicfinance.co.uk/subscribe the short-term sticking plaster approach that is no longer ﬁt for purpose.”

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cover feature the BREXIT debate

ins or Brexit? Customs union or council tax? The answer, of course, is both. Two years on from the EU referendum, Brexit remains a potent political issue on the doorstep, at local as well as national levels. That much is clear from England’s recent council elections. According to the psephologists, leaver and remainer divisions played at least as significant a role in the outcome as refuse collection, potholes or the social care precept. Which is hardly surprising, given the relentlessly Brexit-dominated news cycle. Yet, away from the tortuous Brussels negotiations – and their increasingly torrid Westminster fallout – Brexit seems to figure little in the day-to-day thinking of those in charge of our public services. Ten months before Brexit day dawns on 29 March 2019 – and 30 months before transition arrangements end on 31 December 2020 – the public sector looks less than combat ready for what may be coming down the tracks. Senior council finance officers say they are worried about the budgetary implications of Brexit. Recent surveys indicate two thirds feel “pessimistic” about its impact on local financial sustainability, notably in some heavily Brexit-supporting areas such as the North East. However that is probably all of a piece with general austerity fatigue. Behind closed doors, public finance professionals confess that, in the here and now, planning for a hard, soft or somewhere in between Brexit is way down their list of priorities. Most are far more concerned about business rates retention, local government reorganisation, the state of their reserves and the grim prospect of making yet more cuts to core services. In short, many of www.publicfinance.co.uk/subscribe the issues that arguably fed into the referendum result itself. If anything, Brexit is widely seen as an irritant and a diversion, By Judy Hirst

22 PUBLICFINANCE JUNE 2018

DAVE EASTBURY

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www.publicfinance.co.uk/subscribe Politicians are on manoeuvres over various Brexit scenarios. But how prepared are public services for what’s coming over the hills?

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►

SSHAKING GROUND TTHE THE GROUN UND HE GROUND DD TOeACCESS THEmagma FULL Th Brexit flowing under VERSION OF PUBLIC FINANCE MAGAZINEis , causing tremors in all Whitehall SUBSCRIBE HERE

areas. Could eruptions be on the way?

SHUTTERSTOCK

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28 PUBLICFINANCE JUNE 2018

feature the BREXIT debate

hen lava began spitting from the earth at various points around Hawaii’s Kilauea volcano, a volcanologist was asked: “Why is this happening so far from the volcano?” Her reply was startling: “You don’t understand – the whole island is a volcano, well, five volcanos actually.” It’s starting to look like Brexit may be having similar effects to the magma flowing under the main island of Hawaii. Tremors and eruptions are occurring all over the Whitehall village. It is shaking up relationships between government departments and reconfiguring the departmental landscape, sometimes at breakneck speed. Flowing under parliament, it is shaking up how it tries to hold the executive to account. And it is even changing the relationship By Colin Talbot and between parliament and its accounting and value Carole Talbot for money watchdog, the National Audit Office. The first and most obvious consequence of Brexit for the machinery of government was the rapid creation of two departments in Whitehall – the Department for Exiting the European Union and the Department for International Trade, headed by two new secretaries of state, David Davis and Liam Fox respectively. Thousands of civil servants have been rapidly recruited or moved to staff these new departments, one of which – Dexeu – will have a very short lifespan. Rapid changes are not unheard of in Whitehall. Some were already under way before the Brexit referendum triggered even bigger moves. The old Department for the Energy and Climate Change and a large chunk of the Department for Business Innovation and Skills have been reformed into the new Department for Business, Energy & Industrial Strategy. The rest of BIS (about 1,000 staff ), together with UK Trade International (another 1,300) and an extra 800 “Brexit” staff formed the new DIT. Confused yet? You should be. These new structures have had zero time to settle and clarify who does what. The result has been a great deal of confusion – and tension – within Whitehall. For example, it has been unclear who is really supposed to be coordinating Brexit. Initially, it appeared this was what Dexeu had been set up to do, but it soon became apparent that both No 10

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►

If you go overseas and learn a lot, come back and make sure you put back into the community

The role has been a “door opener”. She has travelled the world more than she ever imagined, racking up frequent flyer points and catching up on films. She’s met the Pope, heads of states and even her all-time favourite cricketer Desmond Haynes. She has visited countless countries, from Mexico to Ethiopia, Brazil and Austria. She could, she says, “bore you to death with stories” from her trips. She has also achieved what she stepped up into the presidency to do. “One of the main pieces for me always was to have technology as a key platform. And I think I’ve been well placed, given my day job, to make that happen,” Grimes tells PF. At IFAC, she set up a technology advisory group and chaired it for the first year. The group talks about the ABCD of technology – artificial intelligence, blockchain, cybersecurity and data. “All of those things are the areas we are focusing on in order to prepare accountants for the future,” Grimes explains. The role of technology is key in the profession right now, but accountants shouldn’t be afraid of the change. In 10-15 years from now, some parts of the profession will be very different, Grimes says with excitement. “I think [technology] will allow accountants to go back to being the trusted adviser because it will eliminate

�Australian cricket team

at the test match with South Africa; Grimes says both sport and accountancy should be underpinned by ethics

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34 PUBLICFINANCE JUNE 2018

some of the compliance work that is probably giving the perception that some of the work can be boring.” Given the pace of change, there’s “never been a more exciting time to be an accountant,” she adds. Looking back at her 20 years at Westpac, one of Australia’s big four banks, change and evolution have been continuing. “We had laptops the size of your grandmother’s sewing machine,” she laughs.

ccountants have no reason to fear robots will take over, she predicts – quite the opposite in fact. “I think we should be excited that robots will take the boring parts of our jobs,” she says. The new technology – and accountants

– also play a big role in fighting corruption, she thinks. “The Nordic Federation believe they won’t have any money in circulation within five years – and I think that is about right,” she says. “I was in Norway recently and I didn’t take out any cash. It was tap-tap-tap with your credit card everywhere. “With less money in circulation, you are able to track where money is and so there will be fewer cases of brown paper bags. Both the government and the private sector will be able to track that money really well.” It seems appropriate that PF is reaching across the world to speak to Grimes, as she sees the profession as a global one. “It gives you a passport to the world,” she says, and this is something more and more women in particular are realising. It is like no other profession, she says, as your qualification will allow you to work anywhere in the world. “I think it’s fantastic that women are embracing the profession. It is one that you can come in and out of and that global passport is well worth it.” But she adds: “If you go overseas and learn a lot, come back and make sure you put back into the community.” Grimes is the second woman to hold the presidency of IFAC. She served as ► deputy under the first female

Top tips… Do ➊ Start the day by giving yourself time to think

➋ Focus on one task at a time

➌ Allow people to work away from their desks

Don’t ➊ Let yourself or other ➋

➐

discussion, start with a mindful pause. Ban mobile phones, laptops and tablets from meetings for one month and see what happens. You might be surprised how much more stimulating and efficient a meeting is when you have everyone’s full attention. Freedom from electronic distractions enables you to engage more fully and listen well and attend to others. Fully listening builds trust and enhances relationships while allowing you to make better, more informed decisions.

what we may think. When multitasking, the project at hand takes 40% longer and you make twice as many errors. Think of the benefits to your bottom line if you save that much time and are that much more effective in what you accomplish. Repeat after me: “One thing at a time, one thing at a time ...”

➌

➍ ➎

Be open and non-judgmental Do you or other leaders in your team tend to dominate discussions or support an open and lively debate? Encourage everyone to speak and listen with curiosity and openness. Allow differences of opinion. This openness includes listening to difficult truths without blaming anyone. Questions you can ask to get started could include: why are we doing what we are doing and how is that aligned with our purpose? What can we learn? Does anybody have a concern about our current project? What is the intention behind our actions, products or marketing campaign?

Step away from the desk Treat your team like adults and trust them to deliver the work even when they are not physically in the office. Give them permission to work outside the office, whether that’s from home or from a coffee shop, and to take breaks for a walk, a power nap or meditation when their brain is cooked. Creative insight happens when the brain is in a relaxed state and most people have their best ideas when they are not sitting at their desks.

Ban phones from meetings and during conversations Mental presence is more important than physical presence. For team meetings, instead of immediately jumping into the

➌

leaders dominate conversations Allow phones and tablets in meetings Schedule meetings back to back

➏ ➐ ➑

Meditate every day The most effective way to encourage your team to practise mindfulness is to act as a role model and get into a daily habit of practising meditation for about 10 minutes. Share your experiences with the team. Start by observing your breath or use meditation apps like Insight Timer or Headspace.

Have breaks between meetings Schedule 45-minute meetings with breaks rather than 60-minute meetings back to back, for example. This meeting management technique gives you time to attend to your physical and work-related needs between meetings and clear your head before tackling another subject. This will mean better, more productive meetings.

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Introduce mindfulness gradually

Instead of forcing mindfulness training on your employees, offer an introductory workshop with a well-qualified teacher who can explain the neuroscience behind stress and mindfulness and is able to link mindfulness to workplace challenges. Afterwww.publicfinance.co.uk/subscribe this session, offer a longer course for anyone interested – regular practice is key.

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numbers game Cash for grammar school places A £50m selective schools expansion fund to allow grammar schools to offer more places has been launched. Schools will have to commit to educating disadvantaged students to get a share of this. The funding will allow existing grammar schools to extend their premises to take on more pupils.

Counting on it

EU workforce In the public sector Souce: Brexit Advisory Commission That’s

5.6% of the total workforce

149,000 EU nationals work in education

62,000 NHS staff in England are from the EU

That’s

5.9%

95,000 of

That’s

of the total workforce

11,000 doctors 21,000 nurses 1,400 midwives 7,700 scientific and technical staff and therapists

of the total workforce

Differing consequences Being unable to recruit EU staff would have varying consequences in different public sector areas, according to CIPFA’s Brexit Advisory Commission for Public Services. It said that a loss of staff would be noticed immediately in areas with large numbers of low-skilled workers, such as social care, because they would exacerbate existing shortages. In the longer term, the UK would be less able to compete globally for high-level staff in academia and medicine, which would not only affect the quality of NHS services but also damage health industries. “There is a serious risk that more of our own leading professionals will go abroad to work with the best,” the commission added.

Growing younger

Changes in London population by age London saw a net increase of people in their 20s in 2016, but a net decease in every other age group

25,000

Number of people (net)

20,000 15,000 10,000 5,000 0

TO ACCESS THE FULL VERSION OF PUBLIC FINANCE -10,000 -15,000 MAGAZINE, -20,000 SUBSCRIBE HERE -5,000

www.publicfinance.co.uk/subscribe 0– 5– 10– 15– 20– 25– 30– 35– 40– 45– 50– 55– 60– 65– 70– 75– 80– 85– 90+ 4

Age 48 PUBLICFINANCE JUNE 2018

Approximately 62,000 of the 1.2 million NHS workers in England are from other EU countries. They include 11,000 doctors, 21,000 nurses and health visitors, 1,400 midwives and 7,700 scientific and technical staff and therapists, according to NHS data analysed by the House of Commons Library and cited in CIPFA’s Brexit Commission report.

79 84

Source: YouGov

London is becoming an increasingly young city, according to research by pollster YouGov. In 2016, there was a spike in the number of people in their 20s in the capital, particularly those in their early 20s. However, every other age group saw a net decrease, from babies through to those aged over 90. “In effect, London is attracting better educated young people, who in time are deposited back into commuter belt towns,” YouGov said. “The political effects of these significant patterns can be seen in elections since 2015.”

SHUTTERSTOCK

social care workers in England are from the EU

mil ion

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