The government’s top immigration adviser has attacked plans to prevent overseas care workers from bringing family members to the UK, warning that to do so could be “very dangerous” for the social care sector.
Prof Brian Bell, who chairs the Migration Advisory Committee, said policies being pushed by immigration minister Robert Jenrick, which also include a cap on overseas care worker numbers, risked worsening the chronic staffing shortage. The end result, he warned, could be “lots of people won’t get care”.
“You can’t encourage enough British people to do the work in social care because it’s so badly paid. If you make it harder for migrants to come in on the route … that might begin to reduce the number who are coming in. That will reduce net migration, and so the government might be happy with that,” he said.
“But I think you have to ask the question, if you do it from the migration perspective, and you achieve that policy objective, aren’t you massively harming the social care sector?”
He said that before introducing policies that would lead to a fall in people coming to work in care, the government needed to address workforce issues, including increasing funding and improving pay to attract and retain more UK staff.
“The fundamental way you solve this problem is to pay care workers better. And the government has done absolutely nothing [about] that,” he said. He added that “until that missing piece” of solving workforce issues was addressed, it was “very dangerous to be playing around with the numbers on the social care route”.
The comments come after new figures showed net migration to the UK reached a record high of 745,000 in 2022. In the year to September 2023, 143,990 people came under the health and care worker visa route, 58% of whom were care workers. They brought with them 173,896 dependants.
Jenrick is understood to have drawn up a five-point plan for curbing the numbers, including banning workers from bringing dependants, or restricting them to one relative. It is not yet clear whether any restrictions on dependants, if introduced, would apply only to care workers or to other health workers too.
His other proposals include increasing the minimum salary threshold for skilled workers and a cap on overall care worker numbers. The plans are being considered by Downing Street, which is yet to comment.
Proposals to limit dependants have been condemned by migrant rights groups, which said they were “cruel” and would “rip families apart”, while care sector bosses warned that Jenrick’s proposals could lead to unsustainable staffing and financial pressure on care providers, forcing some to close. Mike Padgham, the boss of St Cecilia’s care home chain, said raising minimum salary thresholds without significantly increasing funding would be a “double whammy” for the sector, which he warned was “already on its knees”.
Last week in its report accompanying the chancellor Jeremy Hunt’s autumn statement, the Office for Budget Responsibility (OBR) highlighted the growing financial pressures faced by local authorities, which are responsible for social care provision.
It made clear that as a result of central government funding cuts, spending by local authorities had fallen from 7.4% of GDP to 5% since 2011, and that this was expected to drop to 4.6% by 2028. The OBR suggested that this would create additional pressures on councils which are responsible for managing adult and child social care in their area.
Hunt used the autumn statement to claim that the economy had “turned the corner”. But economists pointed out his tax cuts had only been possible because he had squeezed already tight departmental budgets, in a way that would affect public services particularly in areas where demand is growing, such as social care.
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While the government hoped its £20bn of tax cuts would revive Tory fortunes, the latest Opinium poll for the Observer shows no bounce for the Conservatives. Labour has extended its lead by 3 points to 16 points since last weekend. Keir Starmer’s party is on 42% (up two on the week), while the Tories are down 1 point on 26%.
Prof Bell, who was appointed to chair the MAC by former home secretary Priti Patel in 2020, and reappointed in July by another former home secretary, Suella Braverman, said his committee had not been asked for advice on Jenrick’s proposals to reduce healthcare worker numbers. But he told the Observer that plans briefed to the media indicated a lack of a “joined-up” approach within government.
While the changes might help the Tories reduce net migration, the knock-on impacts could be severe without reforms to attract UK workers into social care jobs. There are about 150,000 vacancies in the sector. “Are they going to force British workers to do it? It’s magical thinking,” Bell said. “Fundamentally, it means that lots of people won’t get care. That’s the net result.”
Any changes affecting social care would also hit the NHS, which works closely with the sector. Sir Julian Hartley, of NHS Providers, said the wider health system was too “reliant on highly valued staff from overseas to keep it going” and that this wasn’t sustainable. But he said the government must also ensure that “international professionals consider the UK a viable place to work and live”, as well as “turbo-boosting” the numbers of domestically trained health and social care staff, including increasing funding and improving pay.
Bell has also hit out at exploitation on the care worker visa route, warning that the evidence he has seen suggests the problem is “very serious”. There are widespread reports of care workers being charged thousands in recruitment fees, being underpaid, overworked, having unlawful deductions from their salaries, and being tied into contracts for several years. Exploitation cases in the care sector rose 606% between 2021 and 2022, according to Unseen UK.
“It beggars belief for me that we treat people who go into social care so badly that we don’t think that we should regulate whether the companies that work there are good. It’s terrifying,” Bell said.