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2024 General Election – Spotlight on Immigration in the Health and Social Care Sector

The care sector has been severely impacted by recent changes in immigration policy and with the general election now less than three weeks away, we are looking ahead to the future of international recruitment for the sector.

The Home Office has previously reported concerns that migrant workers applying for Health and Care Worker visas are being exploited by unscrupulous employers and recruitment agencies and as a result it is likely that this increased scrutiny will remain.

Since the end of 2023, the Conservative party has implemented its strategy to reduce net migration by 300,000 in 2024 and to safeguard vulnerable migrant workers applying to high-risk sectors (such as the Care sector).  The steps taken have included:

  • restricting most overseas students and all care workers and senior care workers from bringing family members to the UK;
  • requiring care providers in England to be registered with the Care Quality Commission, in order to sponsor carers and senior carers;
  • increasing the general salary threshold for those applying for the Skilled Worker visas from £26,200 to £38,700;
  • replacing the Shortage Occupation List with a new, reduced Immigration Salary List and abolishing the salary discount previously enjoyed for roles on this list;
  • increasing the minimum income requirement to sponsor someone for a family visa from £18,600 to £29,000 and confirming the future increase, by early 2025, to £38,700; and
  • instructing the Migration Advisory Committee (MAC) to carry out a review of the Graduate route and proposing action to regulate the recruitment of international students.

These steps are achieving the Conservative party’s desired effect and so far, have resulted in:

  • 25% less Skilled Worker, Health and Care and Study visas being applied for in the first quarter of 2024 when compared to the same period in 2023;
  • a decrease of 79% in Student dependant visa applications in the same period; and
  • Health and Care dependant visa applications decreasing by 57% in April 2024 in comparison to April 2023.

Cap on migration

The upshot of this is that the labour pool for care providers to recruit from is shrinking and may shrink further if the Conservatives remain in power.  They have pledged to introduce a “binding, legal cap on migration” for work and family visas.  It isn’t clear whether this would apply to the Health and Care visa as yet.  What we do know is that this cap would be set by parliamentary vote (following the MAC’s recommendation) and would fall every year of the next Parliament.  This could see a return to years gone by where there was a limit set on the number of Skilled Worker visa sponsorships from outside the UK, making the system a lottery and often causing employers with lower paid roles, such as care assistants, losing out, despite meeting all eligibility criteria for a visa.

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The Labour party doesn’t intend to introduce a formal cap but rather use alternative strategies to cut migration.  Such strategies will include improving training of resident workers in key sectors, which includes health and social care, by reforming the Apprenticeship Levy to create a flexible Growth and Skills Levy and implementing a “workforce plan“.  If Labour wins the election, it will remain to be seen whether this plan would come to fruition as a key concern is that the UK simply doesn’t have the volume of willing and able resident workers to make a material impact on the vacancy levels in the sector.  Labour also intends to establish a new body to enforce employment rights and to investigate the exploitation of migrant workers in the social care sector. It intends to hold employers accountable for employment law breaches and bar such employers from sponsoring migrant workers.

Dependant visas

Labour has also suggested that it will utilise the MAC to consider the Conservatives’ decision to restrict care workers and senior care workers from bringing family members to the UK under their visa but has not made any commitments. The Liberal Democrats have gone one step further and announced that they would reverse the ban on carers and senior carers being accompanied by their family members which would make the UK more attractive to overseas talent.

Salary increases

The Conservative party wishes to increase the Skilled Worker salary further, with an automatic inflationary increase whereas the Liberal Democrats would prefer to eradicate the minimum salary requirement and replace it with “a more flexible merit-based system for work visas“.  The Labour party has not set out any specific detail regarding salary proposals but would request a review by the MAC.


Under the Conservative government we have seen sizeable increases to the fees charged by the Home Office, notably, the Immigration Health Surcharge which is not payable when applying for a Health & Care visa and there is no suggestion that this will be changed by any new government.

The Conservatives are however set to increase the fees payable to the Home Office when making a visa application for a work visa, student visa or visitor visa by 25%.  In contrast, other parties have not made any significant announcements regarding their position on immigration fees, but these may come shortly.

Reform UK intends to raise the National Insurance rate to 20% for migrant workers in an attempt to incentivise businesses to employ British citizens, although essential health and care workers would be exempt from this tax.

There has been no mention from Labour or the Conservatives of the Immigration Skills Charge which is currently levied on employers looking to recruit Skilled Worker visa holders.  Although the Liberal Democrats would exempt NHS and care workers from the Immigration Skills Charge, saving employers thousands of pounds.

Interestingly, there has been little mention regarding illegal working penalties which were increased from £20,000 per illegal worker to £60,000 in February 2023, save that the Reform party has referred to implementing “significant penalties” but have not said whether this would result in an increase to the current level.

The above is only a snapshot of the current proposals from some of the political parties but clearly demonstrates the continued unpredictability for care operators.  Having experienced a difficult time in the last 6 months at the hands of the Home Office, with lengthy delays, increased information requests, compliance visits and salary increases, anything could happen, and a period of stability and certainty would be welcomed.

If you would like to know more about international recruitment, please do get in touch with our expert Immigration Lawyers.