For years I worked as an NHS manager, seeing first-hand the consequences of Britain’s broken social care system spill over into hospitals. Elderly patients, who no longer required medical care, were frequently marooned on wards because there was no one to support them at home. Behind every delayed operation or jammed A&E corridor was the same bottleneck: a care sector too understaffed to function.
The government’s decision this week to abolish the care worker visa may please Labour strategists wary of Reform, but it’s incomplete. Ministers are killing off a flawed solution without putting anything in its place. The plan, set out in a white paper, is to move the UK away from dependency on overseas care workers by establishing Fair Pay Agreements – a form of collective bargaining intended to improve pay and conditions for British carers. It is meant to attract domestic workers back into the sector.
To keep costs sustainable, many care homes will undoubtedly turn to the black market for labour to stay afloat
However, local councils will have to bear the financial burden. Many have already been pushed to the point of bankruptcy by social care costs. To keep costs sustainable, following the change, many care homes will undoubtedly now turn to the black market for labour to stay afloat.
The government has not got a serious plan to build a domestic workforce. There’s been no reckoning with how unattractive Brits find care work and no appetite for radical change, such as cutting university places or reshaping the labour market, that would make their plan feasible.
Yes, the care visa process was flawed. In the two years to December 2024, 470 care companies had their licences to sponsor workers revoked for serious compliance breaches. Migrant workers were recruited under false pretences and charged illegal fees. In some cases, they were dumped without work on arrival. But the majority of overseas care workers have been able to work in reasonable, if somewhat difficult, conditions. What replaces it will be worse, as the system becomes even more reliant on the black market.
The Home Office’s independent investigation from last year has already identified rising levels of labour exploitation within the care sector. The abolition of the legal visa route, which for all its faults vetted, documented and theoretically protected workers, will worsen this situation. Illegal workers are less likely to complain, more likely to accept abuse and are harder to trace. The whole enterprise becomes more precarious and more dangerous. In trying to clamp down on exploitation, we may be about to engineer more of it.
It’s one thing to close a failing scheme. It’s quite another to do so without replacing it. If you’re going to take away the flawed mechanism propping up the sector, you need a plan for what comes next. That’s the real scandal: not that the care visa is going, but that no alternative is being created.
Care providers will be left with rising demand, unfillable vacancies and no legal way to recruit. The end result won’t be a care system that’s cleaner or more ethical, but one that’s harder to regulate.
The UK doesn’t have enough people willing to work in social care. The latest Skills for Care figures show that there are more than 130,000 vacancies in England (about 8.3 per cent of the sector). This is a modest improvement on the vacancy rate at the height of the crisis – which reached 10.7 per cent in 2021/22 – and the change was brought about almost entirely by international recruitment. In 2023 more than 58,000 foreign care workers were hired under the now-doomed visa route. Now they’re gone, who fills the gap?
The government insists British workers will. But that confidence is misplaced. Wages in care remain low, often lower than supermarket work. Conditions are poor, with limited training and career progression. The job itself is demanding and thankless.
Creating a domestic care workforce requires far more than tinkering around the edges. It would mean reshaping the UK’s entire approach to education and labour-market participation. These are difficult, politically toxic choices. If the government wanted to build a large, stable labour pool to staff care homes and deliver personal care, it would need to begin by drastically reducing the number of people going to university.
Every year, hundreds of thousands of school leavers go into debt to take up degree courses that offer little wage premium or vocational value. They do so because successive governments, Labour and Conservative alike, have insisted that higher education is the route to personal advancement.
Sectors like care, meanwhile, have been left to pick from a shrinking pool of domestic workers and an expanding pool of reluctant international conscripts.
If the university intake were halved and young people were channelled into vocational routes such as care, we might begin to see a viable alternative to mass immigration in low-wage sectors. Yet that would require a great deal of political will and ideological clarity. It would mean taking on the university sector, which has become as bloated and protected as the NHS.
The government has chosen the worst of all worlds: it is ending the compromise without adopting the alternative. It’s curing a limp by cutting off a leg. This approach may satisfy headline writers for a week or two, but the consequences will last far longer. And they will not be felt by ministers in Westminster, but by patients waiting to be discharged, families trying to arrange care for their parents, and the invisible, overworked staff who prop the system up.
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