Between June 2022 and June 2023, almost 78,000 people secured long-term visas to work in UK social care after the Government eased immigration rules for the sector. The immigration minister said at an October 2023 Conservative Party conference event that care worker visa numbers are now very high. 

Expert advisers had recommended allowing care staff to be sponsored for these visas to address labour shortages. But there are now concerns including among those same experts that migrant care workers are being exploited. 

Migrants have helped to fill social care labour shortages

Social care faces longstanding workforce challenges, with high vacancy rates and rising demand. 

In 2019, around 17% of care workers in the UK were born outside the European Union. Top countries of origin included Nigeria, India and the Philippines. Another 6% were from EU countries like Poland and Romania. 

Migrants were not typically sponsored for visas to work in social care, as it was not an eligible occupation in a system geared towards graduate-level jobs. Employers instead hired migrants already in the UK with the right to work, such as spouses of British citizens or overseas students, as well as EU citizens. 

Foreign carers can now be sponsored for work visas

Free movement of workers from the EU ended on 31 December 2020. Under the post-Brexit visa system, workers cannot be recruited from overseas to fill jobs considered lower-skilled. The list of roles eligible for work visa sponsorship included ‘senior care workers’, but ruled out entry-level care workers and home carers. 

The Johnson Government asked the Migration Advisory Committee (MAC), an independent group of experts, to investigate the impact of this on the social care sector. 

The MAC has long taken the position that worker shortages in social care are due to underfunding and low wages. Nor does it believe that liberalising immigration rules can solve the sector’s workforce problems. 

But its interim conclusions, published in December 2021, were that the end of EU free movement had contributed to a “significant worsening” in the workforce situation. It recommended that care workers be made eligible for the Health and Care visa and placed on the shortage occupation list. The visa allows long-term residence leading to settlement in the UK, at a minimum salary of £20,960 per year. 

The Government accepted the recommendation and social care workers became eligible for work visas from 15 February 2022 

Overseas recruitment has increased since Brexit

The Home Office granted 60,000 visas to care workers between June 2022 and June 2023. Another 18,000 went to senior care workers. On average, each worker on a Health and Care visa brought one immediate family member on a ‘dependant’ visa. 

Taken together, social care accounted for 65% of Health and Care visas issued (the category also caters for doctors, nurses and other healthcare workers). Over one third (37%) of all long-term work visas issued over that period went to carers. 

The quarterly number of care worker visas has risen from 3,700 at the start of 2022 to over 25,000 in 2023

The Migration Observatory at the University of Oxford says that although the policy was intended to compensate for a lack of EU workers, the number of visas issued “appears to have greatly exceeded the number who would have come annually under free movement”. Only 100,000 EU citizens were working in the entire English care sector in 2021. 

As migrant worker numbers increase, so have allegations of ill-treatment

Some newly arrived carers are reportedly experiencing poor working conditions or exploitation. Trade union UNISON has recorded “shocking abuse” of migrant workers in social care, while Professor Brian Bell of the MAC says there are “really bad employers doing quite dreadful things”. The Gangmasters and Labour Abuse Authority told the BBC it had 17 ongoing investigations in the social care sector. 

Health and Care visa holders are tied to their employer, although they can in principle switch to another company licensed to sponsor visas. But  some employers may be contractually entitled to claw back the significant upfront costs of sponsorship if the person leaves (this is legal but unions want tighter regulation). Some workers may also be in debt to overseas recruiters. 

Such factors can reduce workers’ bargaining power and leave them more vulnerable to poor conditions than British workers or those without tied visas.  

Will the visa policy be adjusted?

The MAC’s final report on social care (April 2022) reiterated its call for higher wages while maintaining the recommendation to make visas available for the time being. Social care organisations say immigration has helped reduce vacancies but agree it is not a long-term solution. 

In October 2023, the immigration minister remarked that the “very large number of people” issued with care worker visas “needs careful attention”. 

Meanwhile, an investigation by the immigration inspectorate is underway. It will cover, among other things, whether rules for sponsoring employers “safeguard employees from exploitation”. The inspectors are likely to submit their report to the Home Secretary by January 2024. 

About the author: CJ McKinney is a researcher in the House of Commons Library specialising in immigration.

About the author: Georgina Sturge is a researcher in the House of Commons Library specialising in immigration statistics.

Photo by: (© By Ascannio 

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