Radical changes to UK migration rules could have a devastating impact on the London care sector, industry bosses have warned.
Under new plans announced by Home Secretary James Cleverly in Parliament on Monday, overseas health and care workers would no longer be allowed to bring dependants with them to the UK.
Union Unison warned the changes "spell total disaster for the NHS and social care" as they could reduce the number of workers coming from overseas.
Professor Martin Green OBE, chief executive of Care England, warned on Tuesday the capital could be particularly hard-hit by the move, which could leave vulnerable Londoners "without the appropriate care and support".
He said immigration has been “saving the social care sector” and that changes for dependants will make it harder for care providers “to recruit foreign workers”.
"London is particularly reliant on overseas staff in the care sector, and they make a valuable contribution to supporting and enabling people with a range of health and social care needs to live well," he said.
"Overseas recruitment is also important in London because of the diversity of the capital's population, and overseas staff often have a good understanding of people's language and culture and can provide appropriate care.
"If there was a significant change to the number of people from overseas who are able to work in the care sector, Londoners may find themselves without the appropriate care and support”.
Charity Care England is the leading representative body for small, medium and large providers in England.
Prof Green added that the government "must act swiftly and invest in improving the pay and conditions to drive domestic recruitment", if it plans to "move away from international recruitment as the solution to fixing the social care workforce crisis".
The Home Secretary told the Commons on Monday the changes to stop care workers from bringing dependants with them to the UK are an attempt at “curbing abuses to the health care visa".
While Mr Cleverly also announced that the skilled worker earnings threshold would be raised by a third to £38,700 from next spring, he said people coming on health and social care visa routes “will be exempt so we can continue to bring in the healthcare workers on which our care sector and NHS rely”.
Mr Cleverly said care firms in England will be required to be regulated by the Care Quality Commission (CQC) in order for them to sponsor visas.
On the changes regarding dependants, the Home Office said no exact timeline has been confirmed but that further details will follow “in due course”.
Mr Cleverly told the Commons: “Approximately 120,000 dependants accompanied 100,000 care workers and senior care workers in the year ending September 2023.
“Only 25% of dependants are estimated to be in work, meaning a significant number are drawing on public services rather than helping to grow the economy.
“We recognise that foreign workers do great work in our NHS and health sector, but it is also important that migrants make a big enough financial contribution.”
Home Office figures published last month showed 143,990 health and care worker visas were granted in the year ending September 2023, more than double the 61,274 for the year to September 2022.
The top three nationalities on these visas were Indian, Nigerian and Zimbabwean, the Home Office said.
The 143,990 figure was just for main visa applicants and does not include dependants.
Meanwhile, in its latest migration release also published last month, the Office for National Statistics said health and care work visas were the most common type of work visa on which dependants came to the UK, adding that this was driving the increase in immigration of those on work dependant visas.
Under current rules, visas last for up to five years and can be extended, while partners and children can also apply to join as the main applicant’s “dependants”.
NHS Providers, which represents health trusts, said it recognised overseas workers alone cannot be relied on to fill staffing gaps, but added that it found changes that could deter people from taking up jobs in the NHS and social care “deeply concerning”.
Miriam Deakin, director of policy and strategy at NHS Providers, said: “It’s vital that overseas health and care staff continue to view the UK as a viable place to work and live.
“With over 120,000 staff shortages in the NHS and over 150,000 in social care, measures that deter people from joining these professions are deeply concerning.”
She said the health and care sectors should be attractive not only to domestic workers but also to those educated internationally, describing the contributions of overseas staff as “vital”.
Unison, which counts health workers among its membership, said the changes “spell total disaster for the NHS and social care”, with general secretary Christina McAnea adding that hospitals and care homes “simply couldn’t function without” overseas workers.
She suggested they may now go to “more welcoming countries, rather than be forced to live without their families” in the UK.
She added: “If ministers stopped ducking the difficult issues and reformed social care, as they’ve long promised, there wouldn’t be such a shortage of workers.”
Caroline Abrahams, charity director of Age UK and co-chair of the Care Support Alliance, said: “We are worried that older and disabled people in need of care, and their families, will pay a heavy price for the Government’s changes to the migration rules from next Spring.”
She said social care “is in pressing need of investment and reform and until we get a Government prepared to face up to that, we’ll continue to be heavily reliant on inward migration, which is not where we should aspire to be”.
