Why the UK needs migrant care workers

The UK’s care sector is facing a workforce crisis. Low pay, poor working conditions and job insecurity has resulted in more than 100,000 unfilled roles – a number that far outstrips many other industries. Rising demand and an ageing population means the situation is likely to become even more dire, with more than 400,000 extra jobs needed over the next decade or so. As a result, the industry is increasingly reliant on overseas workers to staff care homes and help provide other vital services.

Now, a major new TBIJ investigation has revealed that numerous migrant care workers have come to the UK only to find themselves exploited and silenced. Existing visa conditions have created a power imbalance between employers and their workers, who are fearful of speaking out about the abuses they face.

Yet migrant workers remain essential to the sector – as they have been for decades.

When did the workforce problems in social care begin?

The problems facing social care are deep-rooted. Some stem from the decade of austerity that began in 2010, which cut council budgets to the bone and left them unable to fully respond to rising demands for support.

The challenges of the job – stressful and sometimes exploitative conditions, a lack of career progression and high turnover – have been cited in reports as far back as 2015.

There were also warnings of staff shortages ahead of Brexit, when the care sector relied on EU nationals. “Shutting off the ‘relief valve’ of EU migration,” the Nuffield Trust said, “put additional pressure” on a system that didn’t have an effective way to train and keep British care workers.

What about the pandemic?

Although many of the issues facing the social care sector existed before Covid-19, the pandemic had a profound impact on care workers. Staff reported higher workloads and stress, struggled to make ends meet and had little support when they needed to self-isolate or take sick leave. A survey commissioned by the Health Foundation found a majority felt undervalued and neglected.

In 2021, TBIJ discovered the extent of home care providers advertising jobs online at less than minimum wage, some as little as £8 an hour. Care workers were struggling to survive financially while risking their health. Many quit their jobs.

While recruitment and retention of staff actually improved at the beginning of the pandemic, as the wider economy reopened, social care vacancies soared. The industry has yet to recover. In 2022-23 alone, about 130,000 people left care work.

How are migrant care workers helping solve the problem?

Migrant workers have been part of the UK’s social care sector for decades. Overseas workers plug vital labour gaps across almost every healthcare profession, while one in four care workers and home carers was born outside of the UK, according to the Office for National Statistics. These carers are most likely to be from Africa, Asia and the Middle East.

Numbers have grown, especially since the government recognised the lingering impact of the pandemic on care worker recruitment and turnover. In February 2022 the Home Office added care workers to its shortage occupations list, a list of the jobs where the government considers there is a shortage of workers. For the first time, any care worker could apply for a health and care worker visa, whereas before only senior professionals were eligible.

The hope was that these additional carers would address the challenges that the pandemic had compounded.

Since then, international recruitment has grown significantly, according to Skills for Care, the body in charge of planning paths into care work across the UK.

In the three years leading to 2022-23, it said, the number of international recruits joining privately run adult social care businesses rose from 10,000 to 70,000. While this has helped lower overall vacancies, the number of unfilled posts is still high.

What working conditions do overseas carers experience in the UK?

Our latest investigation revealed that the UK’s migrant care workers are experiencing widespread abuses including wage theft, discrimination, intimidation and physical assaults. The restrictive and punitive conditions of the health and care worker visa can leave them trapped, exploited and silenced.

Many feel powerless against employers whose threats to revoke their visa or withhold their pay puts their livelihood at risk. For those who have racked up debts and left family behind to come to the UK, returning home is not always an option.

Going home would be like a “death sentence to most of us who have given a life’s work to come to the UK for a better life”, one care worker from Zimbabwe told us.

Many of the care workers we spoke to felt let down or abandoned by the government.

So what next for the social care workforce?

As of 11 March, overseas care workers won’t be able to bring their partners or children with them to the UK.

Ben Brindle, a researcher at the Migration Observatory at the University of Oxford, says the UK may become less attractive to care workers with family members and those travelling alone will become “more isolated” and therefore “more vulnerable to exploitation”.

He added: “On one hand, the government opened the immigration system to social care workers without addressing the underlying driver of shortages, namely the poor pay and conditions in a largely publicly funded sector. On the other, the social care route has been attractive to many overseas workers despite the poor conditions.”

The social care sector will need an extra 440,000 roles by 2035 to meet rising demand for care. However, the resounding message from experts is that international recruitment cannot fix the sector’s chronic problems.

Skills for Care is leading a new workforce strategy to ensure the sector has “enough of the right people with the right skills” – but it is a 15-year plan. To stand any chance of meeting those aspirations, migrant care workers will be essential: the latest data showed an estimated 152,000 vacancies in the social care sector.

But their safety is paramount and shouldn’t be taken for granted as the country strives to build its homegrown care workforce.

Reporters: Vicky Gayle
Bureau Local editor: Gareth Davies
Deputy editors: Katie Mark and Chrissie Giles
Editor: Franz Wild
Production editors: Frankie Goodway and Alex Hess
Fact checker: Emily Goddard
Illustration: Aba Marful (Morganite)

Our reporting on insecure work is supported by the Joseph Rowntree Foundation and is part of our Bureau Local project, which has many funders. None of our funders have any influence over our editorial decisions or output.