A new “hostile environment” for immigrants is putting off NHS and care staff from applying for jobs in the UK while forcing others to return home, health and legal experts have told i.
Just 2,900 people applied for a health and social care visa in July, down 82 per cent compared with the same month in 2023, latest immigration figures have revealed.
The sharp decline follows rule changes, introduced by the Conservative government, which banned most international students and health and social care workers bringing family to the UK.
The number of visa applications from health and care worker dependants fell to 22,200 between April and July 2024 – down from 75,300 for the same period last year. Social care leaders said the tightened rules would have a devastating effect on efforts to fill the 125,000 vacancies that still exist in the sector.
Caroline Abrahams, charity director at Age UK, told i: “This latest decline in health and care visa applications undoubtedly puts paid to the prospect of a fully staffed and functioning social care system, and highlights the bind the Government is in as it juggles two conflicting policy objectives – reducing immigration on the one hand, and staffing up social care on the other.
“In the absence of the greatly improved pay package everyone in social care knows is needed to make roles attractive to workers already based here, we have become dangerously reliant on staff from overseas to keep things running smoothly.
“With immigration such a politically sensitive issue, this steep decline highlights the risk to the care system when the supply of essential care workers from abroad is reduced to such a trickle making staff vacancies soar once again.
“This situation is incredibly difficult for care providers and for local authority commissioners too, but above all for older and disabled people who are likely to find the task of securing good care even harder than it already is.”
The previous government had also proposed raising the salary someone would need to earn to bring family members to the UK from £18,600 to £38,700. Following a backlash it reduced the threshold to £29,000 and said further increases would be introduced at an unspecified date.
Last month, Home Secretary Yvette Cooper said the new Labour Government would keep the threshold at £29,000 until a review by the Migration Advisory Committee was completed.
Nadra Ahmed, chair of the National Care Association (NCA), said tightening up immigration rules had come at a time when the sector had just begun making inroads into record vacancy rates. The figure has been brought down to around 125,000 from 165,000 in 2021-22, but was now in danger of creeping back up again.
“The latest figures are worrying as we’re not out of the woods yet,” she said. “We still have a workforce problem, but now we’re also starting to see the international recruits who have come in under those visas starting to go back home because they are feeling unwelcome.
“I just heard this morning of a migrant worker who was attacked after she came off [a care home] shift over the last few days. This is getting more so because the rhetoric has been stronger over the last six months.
“We also hear from recruiters going abroad that the narrative is very different. For example, in India people are being directed to other English-speaking countries where there are workforce needs as the UK isn’t being very welcoming. Other options, such as Australia and New Zealand, Canada are being suggested as those countries are much more open to immigration with dependants. It’s a very unwelcoming and quite a hostile environment to come to.”
The NHS has also been struggling to significantly improve high vacancy rates in recent years. The total number of NHS vacancies in March was 100,658 – a vacancy rate of 6.9 per cent. This is a decrease from March 2023, when the number of
vacancies was 112,498 and the rate was 8.0 per cent.
The previous Government published a long-term workforce plan last year which promised to recruit an additional 300,000 NHS staff over the next 15 years in an attempt to wean the health service away from a reliance on overseas staff.
Ms Ahmed said the NCA’s preferred option “will always be a domestic workforce”, but that will become harder to maintain with staff now no longer able to bring dependants.
“It is quite a challenge for people to stay here in the UK if they come without dependants, without support, without family and friends, and we still need migrant workers [in the care sector],” she said.
“The demographics suggest we need another 400,000 by 2030, which is not that far away, and there isn’t a real slowing down in the vacancies. It has come down to 125,000 from 160,000, but you have to count in the 70,000 migrant workers that have come through the visa route. So even if 50 per cent of those chose to go back home the vacancies would be straight back up again.
“The improvement would be a bigger domestic workforce, but for that to happen we need to pay staff more and that would require more investment.”
As far-right violence spread between towns and cities last week, two Filipino nurses were attacked as they travelled to work for emergency cover during unrest in Sunderland. The pair were said to be “terrified” after the ordeal which saw their taxi reportedly pelted with rocks, although they were unharmed. The incident led Health and Social Care Secretary Wes Streeting to say anyone being racist to NHS staff can expect to be turned away.
Usha Sood, a barrister at Trent Chambers in Nottingham who specialises in immigration visa cases, said she was “horrified” at the “unprecedented” fall in health and care visa applications.
“Even immigration lawyers like myself are taken aback because they do lead to the fear that we are going to have a crisis in care homes this winter, I would suggest,” she said.
“There is no question that the hostile environment is part of the backdrop to this and it hasn’t helped that there has been certain inflammatory behaviour recently, as you saw when the two Filipino nurses were attacked on their way to work.
“When people are looking whether to come and work in the UK, they are going to take into account this kind of atmosphere – at work and in general at the level of respect for their contribution, and also in terms of their safety and welfare…. now it’s a question of what’s going to fill that [jobs] hole, and that hole has to be filled. If we have another winter crisis, what is the management of those vulnerable care home residents going to be like?”
Net migration hit an all-time high of 764,000 in 2022 and inflows remained higher than historical averages at 685,000 last year.
Labour has announced plans for legislation to improve pay and conditions in the social care sector.
A spokesperson for the Home Office said: “We have set out a clear plan to bring down historically high levels of legal migration by tackling the root causes behind high international recruitment. By linking immigration, labour market, and skills systems we will ensure we train up our homegrown workforce and address the shortage of skills. Immigration brings many benefits to the UK, but it must be controlled and delivered through a fair system.”
A Department of Health and Social Care spokesperson said: “There has been a strong uptake in international recruitment in the care sector since workers were made eligible for the Shortage Occupation List.
“Ultimately, however, we need to reduce the reliance on international recruitment and ensure we have sustainable workforce growth at home. We recognise the scale of reform needed to make the adult social care attractive as a career and are determined to ensure those who work in care are respected as professionals.”
A survey by the National Pharmacy Association has found over half of community pharmacy teams have felt unsafe over the last week due to recent riots across the country,
The snap poll, representing an estimated 350 community pharmacies, also found that one in three pharmacies had considered closing due to safety concerns and 13 per cent of pharmacy teams had faced racist comments over the last week.
Over 40 per cent of pharmacists are from a South Asian heritage, black or from another ethnic minority and it is thought that the majority of independent community pharmacy owners are of South Asian heritage. Riots had seen businesses vandalised, with some pharmacies choosing to reduce their opening hours or close altogether in light of advice from the police and local authorities.
Police have been advised to be on high alert over the weekend, despite a reduction in disorder over the last few days.
Paul Rees, chief executive of the National Pharmacy Association, said: “The last two weeks have been tough for so many people working in community pharmacy – especially for those who are of South Asian heritage, black or from other ethnic minorities. We should not expect community pharmacy teams, under any circumstances, to accept being subjected to intimidation, harassment, racism or Islamophobic abuse.”
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