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Care Worker Visa Regime

Volume 837: debated on Tuesday 23 April 2024


Asked by

My Lords, the Government introduced changes to the visa requirements for how carers can be recruited to the UK on 11 March. The Home Office worked with the Department of Health and Social Care to implement these measures. We will continue to keep all visa routes under review, and will consider changes where appropriate.

I am sure the Minister will agree that the already beleaguered and inadequate social care workforce needs extra people. Until we are able to recruit and train them here, they must be found from overseas. There have been multiple failures identified in the Home Office system for awarding care worker visas. It has underestimated demand by a large degree, it applied an inappropriate scheme in a high-risk area, and it has nothing like enough staff to regulate licence sponsors or process applications. As they review this policy, will the Minister commit the Government to working with the social care sector, which is knowledgeable about these issues, to rectify these problems, and to ensure that there is sufficient supply of care workers to meet the ever-growing demand?

The Home Office seemed to bear the brunt of the noble Baroness’s accusations, but this was a cross-government exercise, involving the Department of Health, the Treasury, No. 10, the Cabinet Office and other departments. The fact is that the most recent published statistics, relating to the year ending December 2023, show that we have issued more than 146,000 health and care worker visas. To suggest that we are not supporting the sector would be inaccurate—we are. That includes things such as how to register good applications, explaining the rules around genuine vacancies and addressing the mismatch between the actual job and salary, not things such as anticipated demand. There is a lot of work going on.

My Lords, there are accounts of care workers coming to the UK being exploited, as either the jobs do not exist as advertised or they find themselves in hock to middlemen. Does the Minister agree that people who come here and apply for these visas in good faith should be treated with compassion? Can he explain how many people the Home Office has employed to help those people by going after fraudulent sponsors and exploitative agents?

The noble Lord is right; there has been some abuse of the system, which is readily acknowledged by the sector itself. I noticed that the Skills for Care website points out that this system has been open to abuse in the past, and it provides some helpful links to some of the stories about modern slavery. Of course, the Government will not tolerate illegal activity in the labour market in general. Any accusations of illegal employment practices will be thoroughly investigated, and we strongly condemn offering health and care worker visa-holders employment under false pretences, which partly motivates these changes.

My Lords, the charity Unseen and the union UNISON have compiled substantial evidence of the exploitation of some of these workers, who now find themselves in limbo because they have been hired by agencies that do not have enough hours for them and they are not allowed to switch to any other profession. Will the Minister undertake to look at what quality control the Care Quality Commission used last year when it licensed a very large number of new providers into the market, which is already saturated with providers? Have the Government looked at the churn in the number of those providers and how many of them have already closed? What steps can the Government take to stop these fraudulent recruitment agencies operating in other countries? They are fundamentally misleading good people who wanted to come to our country and have been sorely mis-sold.

The noble Baroness makes a very good point about activities that have taken place in some other countries. Our abilities to influence those are somewhat constrained. I do not know how the Care Quality Commission goes about licensing. I will find out and report back to her on that. I repeat my previous answer: we will of course go after all those who are engaged in fraudulent practices.

Does the Minister agree, on reflection, that preventive measures should have been put in place? Many unions and organisations are now arguing that no business should be able to sponsor care workers unless it has been in operation for at least two years and unless it has had an inspection first, rather than after the event. Also, how are we going to go after abuses in the labour market when there are so few inspectors? For example, 18 inspectors are supposed to deal with an agency sector covering 40,000 businesses.

I am afraid I cannot comment on the number of inspectors because I genuinely do not know the answer to how many there are, but I take the noble Baroness’s points. I reiterate that we will go after people who are abusing the visas and the individuals. We should remember that the employers also need to be supported to recruit staff from abroad in a way that meets the needs of those people. Skills for Care makes that point, and I completely agree.

My Lords, the work of care workers is extremely valued, particularly by those who are dependent on them for their daily living. This extends across the whole age range of the population, not only in residential establishments but in home care facilities. Underlying all this is one of the difficulties: although this care work is highly valued, it is a low-paid occupation. I hope the Government will give thought to a way in which we can improve the status of care workers and thereby their earning potential in this country.

I very much agree with the noble Lord that the care workers themselves need all our support and, indeed, our praise for the very important and necessary work they all do. Of course, care workers are not subject to the same salary cap as other workers, so applicants to the health and care visa are exempted from the new £38,700 salary threshold. They must be paid at least £23,200 per annum, so the system, as constructed, takes into account the relatively low-paid nature of this work.

My Lords, following on from the very good question from the noble Lord, Lord Laming, do we not have a moral duty and a responsibility in terms of public policy not just to import the best people from abroad but, given that we have record numbers of people on out-of-work benefits, to give opportunities, training and skills to our own young people, who would benefit very much from that and enhance that industry, rather than continually looking to foreign nationals to come in and do the jobs that British people could be trained to do?

I agree with my noble friend on that. We remain committed to developing the domestic workforce. We are doing that by investing in retention—there is a high churn rate in this sector, as is well understood—through better workforce training, recognition and career progression. A new career structure is being launched for care workers so that all staff can build their careers and more experienced care workers are recognised for their skills. We are creating new qualifications and a digital skills record to reduce the need for retraining costs. We are increasing funding for learning and development. The Government have made available up to £8.6 billion in additional funding over the financial years 2023-24 and 2024-25 to support adult social care and discharge. I trust that all noble Lords will support the PM’s valiant efforts to mobilise those who are not currently engaged with the domestic workforce.

My Lords, the Minister spoke of fraudulent sponsors and exploitative agents. What assessment have the Government made of the need to tighten up repayment clauses for relocation and visa costs, and requiring compliance with Department of Health and Social Care rules on international recruitment as a condition of gaining a sponsor licence?

The noble Lord develops on a theme explored earlier, in a question I could not entirely answer. I will come back to him with a better answer in due course.

My Lords, given that the Minister in effect embedded the idea of care work being low paid, in the answer he gave earlier about salary caps in relation to visas, does he think that £23,500 is an adequate reflection of the real value that any individual care worker provides through their work?

I did not embed anything; I was just restating a fact. Whether or not I think it is the right number for the sort of work that is done, obviously there is considerable variety in the type of care that is given. I do not think it would be appropriate to comment on the number in its totality.

My Lords, I am sure the Minister will feel, at the end of this, that anyone listening to the totality of this Question will see that there are very serious issues. The Government have failed to address the whole issue of social care. It is a sector that is failing the country, at a time when we know there needs to be a lot more because, as we see around us, we are all getting older and living longer, and need more care. The Government have now had 14 years; when will they actually address the sector as a whole and reform it?

The noble Baroness asks me about the care sector in general; I am obviously here to talk about visas. What I will say about visas is that the Government have in fact clamped down on the abuse of the visa system and once again are endeavouring to protect the integrity of our borders; I am sure the noble Baroness would welcome that.