Ministers have allowed England’s creaking social care system to become too heavily reliant on low-paid foreign workers who are vulnerable to exploitation, the government’s migration adviser has warned.
In a strongly worded intervention, Prof Brian Bell, who has just been reappointed by the home secretary, Suella Braverman, as chair of the migration advisory committee (MAC), called the government’s tacit acceptance of exploitation in the sector “appalling”.
He said the failure to tackle chronically low wages suggested the Department of Health and Social Care (DHSC) had “no interest” in improving the lives of care workers.
“They may not say it explicitly, but I think they basically believe that care workers should be paid less than people who stack shelves for Aldi – because that’s what their policy is,” he told the Guardian.
The MAC recommended in December 2021 that labour shortages in social care were so acute that employers should be allowed to bring in staff from overseas using the health and social care visa, previously aimed at higher-paid workers.
Social care was also added to the shortage occupation list, allowing staff to be brought in on lower salaries than the £26,200 floor applied to most jobs.
But Bell and his colleagues insisted migration must be only a temporary solution, and in April last year published a robust report, urging the government to raise wages to attract more UK staff.
Since then, he says, ministers have sat back while the care system has sucked in thousands of low-paid overseas workers – despite the government’s anti-migration rhetoric.
“Unfortunately, we’re now 16 months on and the government have banked the immigration option and it’s now become a crutch on which the social care sector is relying; and they’ve done literally nothing on pay,” Bell said. “It’s becoming a bit of a disaster.”
“We’re seeing this massive increase in immigration into the care sector – it’s now by far the biggest occupation that’s using the immigration system,” he added.
In the year to March, almost 58,000 visas were issued to care workers and a further 40,000 to nurses and other healthcare staff.
Work visas for all other occupations across the economy over the same period totalled 69,000.
Bell said he and his colleagues were concerned about the conditions some of these workers faced. “There are clear problems, in terms of exploitation, both in the home country and when they get here, really bad employers doing quite dreadful things.”
Recent research by the union Unison detailed cases of care workers being charged fees of more than £10,000 for finding them a job and accommodation in the UK, only to find themselves placed in substandard housing, with some even force to share beds.
“Is the exploitation that we’re seeing in the social care sector through the immigration system a result of policy? Yes it is,” Bell said. “It is because we’re not doing anything on the wages front, and until we do that, then we are accepting that exploitation as part of the way that we’re going to pay for social care: and that just seems appalling.”
Unison’s assistant general secretary, Jon Richards, said: “Underfunding, low pay and severe staff shortages have enabled dishonest care employers to exploit vulnerable overseas workers. The government’s been alerted repeatedly to these appalling conditions but has done nothing to give any protection.”
Bell suggested ministers could follow the lead of the Scottish and Welsh governments, both of which have made a commitment to raise pay for social care above the minimum wage – and fund the sector accordingly.
“More money has to go into local authorities and that has to come from central government: that’s just a choice we have to make.”
Politicians have consistently failed to tackle the issue of how to ensure social care receives adequate, long-term funding, despite rapidly increasing demand from an ageing society.
The shadow social care minister, Liz Kendall, said: “For years, the Tories have been warned not to ignore the need for a plan to tackle the crisis in the care workforce. It is sickening that people who come here to care are being exploited.
“Labour will recruit and retain more carers by introducing better rights at work, fair pay and proper training that offers opportunities for progression.”
Bell, a professor of economics at King’s College London’s business school, said that aside from the problems in social care, the post-Brexit immigration system had broadly worked well.
He defended the MAC’s recent advice that chefs should not be added to the shortage occupation list, despite vigorous lobbying from the hospitality sector.
Pointing out that employers were able to bring in chefs on worker visas, as long as they paid them more than the £26,300 minimum, he said: “Don’t tell us it’s a high-skilled job and then pay low wages.”
He suggested hospitality might benefit more from a reciprocal youth mobility scheme with the EU, or specific EU countries – like those in place for Australia and Canada, which allow young people to come to the UK for up to two years. “My sense of this is that the government are probably quite receptive to that,” Bell said.
Braverman recently announced new limits on overseas students bringing family members with them to the UK. Bell has publicly backed that move.
He said Boris Johnson’s decision to open up a two-year post-study work visa – against the advice of the MAC – had encouraged a rapid increase in applications, welcomed by cash-strapped universities, with many students bringing their partners into the UK too.
“The economics became, actually it might be worth paying the one year [of] tuition fees for a masters degree, for two of us to get three years in the UK labour market,” he said.
Even after the crackdown on dependants, he suggested the government might need to look again at the policy.
“What you don’t want to do is create a route that allows people to take minimum wage jobs for three years, just because it’s better than what they can earn back at home. That’s not going to benefit the UK much.”
A Department of Health and Social Care spokesperson said: “International recruitment has a valuable role to play in helping grow the adult social care workforce, while at home we are investing £250m to support staff to develop new skills, get better training and develop their careers.”
They urged anyone affected by unethical or illegal employment practices to report these to the Gangmaster and Labour Abuse Authority, adding that “no staff should feel exploited or harassed”.
