Labour’s plans for sponsored migrant care workers (Must read for all migrant health care worker)

LONDON Nov 27: Work Rights Centre, a registered charity dedicated to supporting migrants and disadvantaged British residents to access employment justice and improve their social mobility has come out with a series of publications seeking to document and expose issues faced by migrant healthcare workers and making policy recommendations that can end migrant worker exploitation for good.

Read below the summary findings, recommendations and Labour’s plan for reforming the healthcare sector published by the Work Rights Centre

FINDINGS

Drawing on 21 interviews and 71 survey responses with migrant care workers, Work Rights Centre find that migrant care workers are facing acute pressures:

Unsustainable working hours. More than half (55%) of survey respondents were dissatisfied with their work schedules. Interviewees revealed a toxic dynamic whereby working hours were either all-consuming, with little time for family and self-care, or low and unpredictable, with barely enough hours to cover living costs.

Low levels of pay. Three quarters (75%) of survey respondents were unhappy or very unhappy with levels of pay, and almost half (45%) of those who needed to drive between appointments were unpaid for travel time. Interviewees reported experiencing a demoralising cycle of financial insecurity, which failed to represent the complexity and social value of their work, and made it difficult to imagine staying in the sector long-term.

Persistent breaches of employment rights. Nearly two thirds (65%) of survey respondents disclosed an alleged employment rights breach in the last 12 months, including health and safety breaches, bullying, and discrimination. More than a third (39%) of these respondents did not raise a complaint with their employer or make a report to an external agency, and interviewees reported that social pressure, mistrust of authorities, and fear of employer retaliation left them disempowered to raise grievances.

A punitive visa regime. Research participants on the Health and Care Worker visa were particularly at risk. Interviewees feared that reporting their employers to authorities risked having their visa curtailed, and several carers described instances where employers used the threat of visa curtailment to silence grievances. Switching out of exploitative work situations was also problematic. While many workers (38) had tried to find a new sponsor, fewer than half (16) were successful.

RECOMMENDATIONS

To help raise employment standards for migrant care workers, Work Rights Centre recommend that the government pursues two major strands of reform:

1. Sector level reform. This should start by including migrants’ voices in the planned Negotiating Body responsible for the Fair Pay Agreement, and continuing with reforms that increase baseline levels of pay, invest in a career progression framework and training, and fix historic injustices relating to payment for travel time, sick pay and overtime pay, and the right to regular hours of work.

2. Immigration reform. This should ultimately address the power imbalance between employers and migrant visa workers, by empowering those workers to report non-compliance, leave exploitative roles, and take their labour to businesses that need and value them. The most effective way to achieve this
would be by ending the sponsorship system that puts employers in charge of foreign workers’ leave to remain. As a minimum, the Home Office should at least update policy to give visa workers more time to change sponsors, and ensure that those who suffered exploitation are given the unrestricted right to work to prevent re-exploitation and destitution.

Here is Labour’s plans for sponsored migrant care workers published in the Work Rights Centre report

The Labour Manifesto included a pledge to reform the points-based immigration system (which underpins the system of employer-sponsorship behind the Health and Care Worker visa and most other work visas), so that it is “fair” and does “not tolerate employers or recruitment agencies abusing the system”. Separately, in June 2024 the then Shadow Home Secretary Yvette Cooper backed calls for a full investigation into the experience of people who say they have been left trapped in the UK with soaring debts, and little or none of the work they were promised. At the time this report was published, Work Rights Centre were yet to receive detail regarding the delivery of these two important proposals, beyond an announcement that businesses who break work visa rules would be banned from sponsoring migrant workers (which was already enshrined in existing rules).

At an operational level, however, a few things are of note. Firstly, the Home Office has ramped up its enforcement action against sponsors in the form of licence suspensions and revocations. In the second quarter of 2024, 524 Skilled worker sponsors had their licence suspended, while 499 had their licence revoked. This is the highest number of suspensions and revocations in a quarter since records started in 2012. Secondly, according to an answer from the Home Office to a written question by Olivia Blake MP in February 2024, the Home Office is working with local authorities to time the revocation of sponsor licences to delay the cancellation of workers’ visas and to allow them the opportunity to find new sponsors.

Additionally, the main approach to protect sponsored migrant workers appears to be the provision of £15million to regional partnerships to “support them to prevent and respond to unethical practices in the sector”. This “includes funding support for international recruits to understand their rights, and establishing operational processes with regional partnerships to support individuals to switch employers and remain working in the care sector when they have been impacted by their sponsor’s licence being revoked”.

Details of how these processes can be accessed by sponsored migrant workers are yet to be revealed. Anecdotally, Work Rights Centre contacts within regional partnerships have indicated that the “displaced worker rematching” service is still being piloted, as local authorities and their contractors grapple with (1) the complex problem of conducting due diligence on thousands of small employers, to ensure that workers are not exploited again; and (2) the separate issue of encouraging law abiding, but risk averse, employers to recruit visa workers.

It is fair to acknowledge that the government has only been in post for a few months. While delivery is in its early stages, in this time ministers will have had the chance to understand both the acute crisis of sponsored care workers’ exploitation, and the chronic issues experienced by the adult social care workforce as a whole. What is also important for the government to grasp is that sponsored workers are a major stakeholder on both levels.

In the same way that foreign carers are not a temporary fix to the problem of recruitment, but have propped up the sector for years, their views on what it takes to make care work sustainable are not limited to the abuse by visa sponsors, but are pertinent to conditions in the sector overall.

With a 32% share of care worker roles in England, and a 20% share of the UK workforce as a whole, the voice of migrant workers is key to ensuring that the Negotiating Body delivers for the adult social care sector, that the Employment Rights Bill is inclusive of the most vulnerable workers, and that the immigration system does not put employers in a dangerous position of power. It is this voice, that of workers themselves, that Work Rights Centre seek to bring forward in this report.

Labour plans for reform

The Labour Party promised fundamental reform of the adult social care sector. In its manifesto document, Labour included an aim to create a National Care Service to deliver consistent standards across the UK, with a focus on supporting people to live independently for as long as possible. After the general election, Prime Minister Keir Starmer announced that his government was building a “10-year plan” for healthcare reform, which would include shifting care from hospitals to communities, and integrating health and social care. The plan is expected in spring 2025, following a period of consultation.

The government also announced a raft of policy proposals aimed at the social care workforce, and at workers more generally. The much-anticipated Employment Rights Bill, published on 10 October 2024, paves the way for the creation of an Adult Social Care Negotiating Body, with a remit to negotiate terms and conditions of employment, pay and training standards across the adult social care sector. The Negotiating Body is the first step towards the delivery of the manifesto promise of a Fair Pay Agreement for carers.

Other notable proposals in the bill include pledges to give zero-hours workers the right to guaranteed hours reflective of their usual schedules in a 12-week reference period; grant shift workers the right to receive notice and compensation for cancelled shifts; entitle workers to rights, such as parental leave, from the first day of work; and facilitate union representation.

Notably, the bill also proposed unifying the complicated network of agencies involved in labour rights enforcement within a single Fair Work Agency, and establishing an Advisory Board of trade unions, employers, and independent experts to inform the government’s labour market enforcement strategy. In many ways, these proposals constitute an important political recognition of the fact that the social care sector requires an urgent and fundamental rethink, including on its workforce. The Employment Rights Bill has been widely regarded as the biggest uplift in workers’ rights in a generation.

EMPLOYERS TOO FACE BIG CHALLENGES

Systemic roots of the workforce issue

The workforce crisis in England’s adult social care sector and the erosion of work conditions did not happen in isolation. An underfunded budget for social care has led to intense price competition in the commissioning process across the country. The result of this competition has ultimately been passed onto workers who, in a fragmented system, have lacked the bargaining power to challenge poor conditions and secure better protections.

Cuts to local authorities have been devastating. Social care is the biggest area of council spending in England after education, accounting for 16.1% of local authorities’ net current expenditure in 2022/23. However, in the context of severe cuts to local authority budgets and an ageing population, spending per person on social care has fallen significantly in real terms. Analysis by the Health Foundation found that between 2009/10 and 2024/25, age-adjusted spending per person fell by 5% (although there has been a continuous recovery in spending since a trough in 2014/15).59

The combination of budget cuts and rising demand has left local authorities with little choice but to pass austerity measures of their own. The UK Homecare Association, a membership body dedicated to supporting homecare providers, reported in late 2023 that fee rates offered by local authorities to independent providers of homecare services were on average 25-35% lower than what was required to pay workers fairly and deliver high-quality, sustainable services. Trends like this have meant that an increasing number of care providers are struggling to stay in business. In spring of 2024 the Association of Directors of Adult Social Services (ADASS) reported that 90% of directors of adult social care in England either had no confidence or were only partially confident that they could meet their statutory duties in 2024/25.

Furthermore, 65% of directors had reported that providers in their area had closed, ceased trading or handed back council contracts in the past 6 months. This, in turn, has a knock-on effect on other services. As noted in the recent Lord Darzi review of the NHS in England, the pressures felt by social care impacts the entire health ecosystem, with as many as 13% of NHS beds occupied by people waiting for social care support or care in more appropriate settings.