New report details acute pressures facing migrant care and explains why Health and Care Worker visa makes matters worse
A new report published this week by the Work Rights Centre (WoRC) presents migrant workers' views on improving conditions in England's adult social care sector.
The 61-page report can be downloaded here.
WoRC's report emphasises the adult social care sector's heavy reliance on migrant workers, with nearly one-third of care workers in England coming from overseas. WoRC notes: "In March 2024, a total of 25% of the entire adult social care workforce were foreign nationals, with 6% being EU nationals, and another 19% being non-EU nationals. The share of foreign nationals was even higher for direct care roles. Foreign nationals accounted for as many as 32% of care worker job roles, and 29% of senior care worker job roles."
A significant number of migrant workers are employed under a Health and Care Worker Visa. The visa was introduced after Brexit to address a significant crisis of staff retention and recruitment following the end of free movement. Between the first quarter of 2021 and the second quarter of 2024, a total of 270,653 visas were issued to main applicants under the route.
As the report details, care workers commonly face unsustainable working hours, low levels of pay, and persistent breaches of employment rights. Matters are made worse for care workers on the Health and Care Worker visa. WoRC calls the visa "punitive", as it effectively ties workers to their employers, making workers fearful of reporting exploitative employers to authorities.
WoRC explains: "The visa works by making a migrant's permission to enter and remain in the UK contingent on, respectively, having a job offer from and thereafter being employed by a business licensed by the Home Office to sponsor them. At the time of writing, the application fee for the visa is either £284 per person or £551 per person, depending on whether the visa is valid for up to 3 years or longer, respectively. Migrants must also demonstrate to the Home Office that they have at least £1,270 in their bank account, to show that they can financially support themselves whilst in the UK (unless their employer certifies maintenance for them in the first month of their employment). In terms of their rights under the visa, sponsored workers can only work full-time for the employer specified by their visa as their sponsor. They may take on additional work in eligible occupations (up to 20 hours a week), volunteer, and study – on the condition that they remain employed by their sponsor. The visa offers a path to permanent settlement, but visa holders cannot access public funds, and they cannot change sponsors unless they make an application to the Home Office (which carries an additional cost). Crucially, if they are dismissed, if they resign, or if their sponsor loses their licence through no fault of the workers, migrants on this route have up to just 60 days to find a new sponsor (from the date their visa is curtailed by the Home Office), make an application, and pay for a new visa."
The report succinctly explains why migrants workers are fearful of reporting their employers under the current visa system, stating:
"The sponsorship system disincentivises reporting. The fear that raising a grievance or reporting externally would prompt employers to retaliate was particularly acute for workers on a Health and Care Worker visa. Several of them described how employers used the threat of visa curtailment to silence grievances, and deflect any attempts to negotiate more favourable conditions. Interestingly, one worker suggested that intimidation was not always explicit, but rather took the form of 'reminders' that the visa could be curtailed at any point. Not only did this contribute to a feeling of entrapment, but it suggests that sponsors themselves are aware of the precarity that workers face and are towing a fine line – being just threatening enough to ensure worker compliance, but not threatening enough to provoke an external complaint.
"The system of sponsorship fundamentally disincentivises sponsored migrant workers from reporting exploitation to external authorities. Even if they could demonstrate that employers were clearly breaching employment law, workers were all too aware that if any action were taken against their employer, their immigration status would be at risk. Emeka, a care worker from Nigeria, found himself working in supervisory roles despite being employed as a care worker. Despite this being a breach of his visa conditions, he could not raise the issue with his employer or externally."
Among the report's recommendations to help raise employment standards for migrant care workers is an urgent call for immigration reform. WoRC calls for the current system of employer sponsorship to be ended, and for more time to be given to migrant workers to change sponsors. To empower migrant workers to report exploitative employers, WoRC recommends introducing a special status that would enable workers to continue their stay in the UK lawfully.
WoRC said: "This should ultimately address the power imbalance between employers and migrant visa workers, by empowering those workers to report non-compliance, leave exploitative roles, and take their labour to businesses that need and value them. The most effective way to achieve this would be by ending the sponsorship system that puts employers in charge of foreign workers' leave to remain. As a minimum, the Home Office should at least update policy to give visa workers more time to change sponsors, and ensure that those who suffered exploitation are given the unrestricted right to work to prevent re-exploitation and destitution."