Macclesfield: Immigration, the NHS and Brexit trade-offs

The National Conversation on Immigration has just returned from Macclesfield, a comfortably-off Cheshire market town of 50,000 people. Here we found that migration was not a hugely salient issue. In our citizens’ panel discussion everyone saw positives as well as challenges:

“Migration is crucial to business. In pubs and hotels we rely on people from eastern Europe. The flip side is there are pressures on the NHS, but the majority of doctors are also not British.”

The citizens’ panel had one dominant concern about immigration – pressure on the NHS, particularly on A&E. As our interim report sets out, this issue has been voiced in different parts of the country, but predominantly in London and the South East where the rate of recent population increase has been highest. Macclesfield has not, however, seen a significant population increase, compared to the average for the UK, nor as much international migration.

But the NHS ‘winter crisis’ is in the news, with stories of cancelled operations, long waits in A&E and beds in corridors featuring in newspapers and broadcasts almost every day. Some of the Macclesfield citizens’ panel told us of their own recent experiences of using the NHS and linked this to recent population increase. They were, however, clear that they did not blame new migrants for this situation and felt that more of the taxes that migrants pay should be invested in public services.

We found another interesting local difference in the Macclesfield, in the discussion about the Brexit negotiations. Everywhere we go we ask each citizens’ panel if they would be willing to accept fewer restrictions on EU migration if it meant that British businesses – large and small – could get a better deal and better access to the single market. Most citizens’ panels reject such a trade-off. We are often told that British business will be able to trade with other parts of the world if faced with tariffs and barriers from the EU.  Even those who are willing to accept fewer restrictions on migration as a price for a better deal for business often qualify their opinion, saying that the economic benefits would have to be big. In a recent London citizens’ panel, for instance, one participant was willing to accept the trade-off “as long as we’d get a big economic benefit, like 10% of GDP”. UK GDP was calculated at US$2,619,000,000,000 in 2016, and most of us find it hard to get our heads round such a large figure.

In Macclesfield, the citizens’ panel took a different view. Unanimously, they felt that the UK government should be willing to make such a trade-off in the negotiations, with this opinion voiced by Leave and Remain voters alike. Participants believed this was essential for their big local employer – the pharmaceutical giant, AstraZeneca – as well as for the area’s growing bioscience sector.

Why did the Macclesfield panel have a different view? As we have said, there has not been rapid migration to the area – just 6% of the population of Cheshire East is born abroad – and migration is not a particularly salient local issue. But they also believed that local jobs depended on access to the single market.  AstraZeneca manufactures pharmaceuticals in Macclesfield and employs nearly 4,500 people. This company’s former research and development site at nearby Alderley Park is now home to many bioscience start-ups. Most of these jobs pay well, with pharmaceuticals and bioscience making a big contribution to the local economy.

Both big and small local businesses in Macclesfield want the best they can get in the Brexit negotiations. The citizens’ panel understood and supported this. They saw the migration-market access trade-off in concrete terms that related to local employers and the wellbeing of their local area.

In all the National Conversation discussions so far we have found that detailed and abstract economic arguments about the fiscal and macro-economic contribution of migration do not resonate with members of the public. When talking about the impact of Brexit, most people cannot conceptualise GDP projections of billions and trillions. Rather our citizens’ panels have seen migration and Brexit through a ‘common sense’ fiscal and economic lens and through concrete and everyday examples. Local economic and business voices also hold more sway than London-based groups such as the CBI when making arguments about Brexit. This is something that business groups need to understand as the Brexit negotiations continue.

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