Elizabeth Barton arrived in the UK from South Africa in September- one of more than 120,000 people who came from overseas to fill vacancies in the struggling health and care sector in the last year.
“It’s hard to get a job at home,” she told me. “Here I can get a job, the salary’s okay. Back at home, even if I finish my courses, there are no jobs around and the salary isn’t compatible with keeping up a family.”
The skilled worker visa scheme was extended to include carers and their dependents in February 2022 after the Migration Advisory Committee – an independent body which advises the government – recommended carers be added to the shortage occupation list to help fill gaps in the workforce.
“As a healthcare assistant I bathe my clients, give them food, administer medication, take them for a walk in the park, do their groceries and sort out all their basic necessities at home,” said Elizabeth, who is now 39.
“I love my job. I’ve always been empathetic so it’s the perfect job for me.”
She is currently living in shared accommodation and has not been able to bring her 13-year-old daughter, Refilwe Phoenix, over yet, though she hopes that will soon change.
“I’m hoping to bring her here because the education is better than back at home, and hopefully soon I can have her here and we can be a family again,” she said.
“We speak on Zoom everyday. I just have to find proper accommodation and then I can bring her here. Sometimes it’s all a bit overwhelming but it will work out for the best.”
Figures from the Home Office released on Thursday showed the number of visas issued to care and senior care workers reached 77,000 in the year ending June 2023 – up from 12,300 the year before.
That is a rise of more than 500% since the expansion of the visa scheme to include entry level care workers – qualified senior care workers have been eligible since December 2020.
And it forms part of the 121,290 total of people came to the UK to work on a health and care visa – a 157% increase on the year before.
Some are concerned about the rise in overseas workers, including the newly formed group of red wall MPs calling themselves the New Conservatives.
Their aim is to pressurise the government into cutting migration by the next general election – from 606,000 to less than 226,000, as promised in the 2019 Conservative manifesto.
And they want the government to scrap the carers visa scheme altogether.
Jonathan Gullis, the Tory MP for Stoke-on-Trent and a member of the group, argued jobs like Elizabeth’s should go to local people.
“I think it’s quite concerning, because ultimately we have 30,000 students studying social care at this time, so that’s a pool of talent we can tap into,” he told me.
“We have a million people unemployed, 700,000 on sickness benefits who have said they want to go to work, and with the right skills and training opportunities on the job, they could easily fill those vacancies.
“My concern with this massive increase in social care is that we are reducing the education threshold for overseas workers – so we’ll have more low skilled low wage labour coming into the country.”
Mr Gullis also said it was one of the key issues raised on the doorstep by his constituents.
“In Stoke-on-Trent, 73% voted to leave the EU and a large part of that was taking control of our borders,” he added.
“Yes we have a problem with illegal migration, which the PM is focussing on and doing a lot to try and resolve, but that also means we shouldn’t divert away from legal migration.”
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Shadow immigration minister Stephen Kinnock agreed the numbers are too high – though neither Labour nor the Conservatives will now give a target figure for net migration – but he put the blame at the government’s door.
“We’ve got too many employers reaching for migrant labour rather than bringing in home-grown talent,” he told me.
“But they haven’t got enough home-grown talent in the pipeline because the apprenticeship schemes, and all the skills and labour market reforms and the reintegration of the over 50s into the workforce, those schemes are simply not working.
“So it’s about government and trade unions and employers working together to maximise opportunities for local home-grown talent.”
However, with an estimated 152,000 vacancies last year, the care industry argues it has no choice but to turn to overseas workers.
“Social care has the most vacancies out of any sector,” says Renate Winkler, co-founder and managing director of Guardian Carers, a home care agency based in London.
“There is a problem, there is a gap. I’ve seen so many people try and recruit locally and it’s not working.
“There are people stuck in hospital for three months who are ready to be released but because there isn’t enough social care they have to stay in hospital – and then other patients can’t come in – so I do believe that recruiting from abroad is a good solution if done the correct way.”
Raj Seghal is managing director of Armscare, which runs five care homes in Norfolk. He has recruited 40 staff from overseas out of a total workforce of 130.
“We were really struggling with recruitment and retention,” he said. “It was a hopeless situation – Brexit left us with a huge void. International recruitment was our only hope.
“It has allowed us to fill our beds – our occupancy rates had fallen to 70%, hospitals were begging us to take people but we just couldn’t get enough staff. Now we can relieve the pressure on the hospitals.”
The process of recruitment is not simple however, he said.
“It’s horrendously complicated and obscenely expensive,” added Mr Seghal. “We have to pay £1,900 for the visa for each employee – that’s nearly £80,000 for all of them.
“It would be much better if we could employ local people as we wouldn’t have to pay this fee. But for us the alternative was not filling our beds and running at a loss.”
Both the industry figures and Elizabeth herself are concerned about the number of fraudulent and unscrupulous recruiters targeting those looking for skilled worker visas.
Sky News’ Lisa Holland reported on Wednesday about the plight of migrants left destitute after paying thousands of pounds for visas, only for no job to materialise on arrival in the UK.
“We’ve seen carers who have unfortunately been taken advantage of,” says Ms Winkler. “They’ve come through agencies and they’re not paid the minimum wage.
“We’ve also seen people accepted on the skilled visa who don’t have the skillset, or who don’t speak English, so we can’t place them.
“I feel really sorry for them. It’s definitely a process the government needs to look at in greater detail.”
In a statement, a Home Office spokesperson said: “The public rightly expects us to control immigration and ensure it works in the UK’s best interests, by filling skills gaps and growing the economy.
“Health and care visas made up the largest proportion of work visas granted. These workers are helping our health and social care sector by providing a much-needed staffing boost.”