'It will be a crisis': Adult social care pushed to the brink by government's overseas care worker ban

Workers from outside the UK “hold up” the social care system in England – yet government immigration reforms will make it “all but impossible” to recruit staff.

As the government bans visas for overseas care workers, that’s the damning verdict issued by sector leaders.

The end of overseas care recruitment will slash immigration by 7,000 people per year, the Home Office predicts.

For a government staking much political capital on “strong borders”, it’s a good figure for a press release. But the reduction will levy a “devastating cost”, experts have warned.

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“Our social care system has been saved by people who were prepared to up sticks, from their homes, from their families, from Europe, from Africa, from Asia,” John Casson, CEO of L’Arche, told Big Issue. The charity supports people with learning disabilities.

“This [the Overseas Care Worker Visa Route] is one of the most successful government policies you can imagine. They created a specific, rigorous route for people to come and support some of the most vulnerable people in Britain.”

“Turning it off is just the latest example of how social care is a political, policy and moral blind spot in government.”

Overseas workers account for nearly a third of the adult social care workforce.

“Workers from outside the UK continue to hold up the care system in England,” said Lucinda Allen, policy fellow at the Health Foundation.

“Given government measures to reduce immigration, the shrinking domestic workforce raises serious concerns that care providers could struggle to recruit enough workers in the years ahead.”

Why is the UK so dependent on overseas care workers?

In 2019/20, 84.6% of adult care workers were British nationals. By 2024/25, that had plummeted to 70.4%.

Counterintuitively, Brexit is behind this shift. The UK’s exit from the European Union cut off the flow of EU care workers and generated a dire staffing crisis.

There were 165,000 care vacancies by March 2022, an increase of 52% since the previous year.

Domestic recruitment failed to fill the gap: the relatively low-paid sector is often a less attractive choice for job-hunters than easier roles in retail.

Overseas workers “essentially saved the day”, Casson says. The Conservative government created the care worker immigration pathway in 2022; between 2021/22 and 2023/24, the number of people working in the sector rose by 92,400.

That was driven “entirely by an increase in staff from outside the UK and European Economic Area (EEA)”, the Institute for Government explains – a figure which rose by 161,400.

The number of British staff working in the sector declined by 62,400 in that time.

Pratik Macwan came to the UK from India on this visa in 2022. The 37-year-old – who now works as a senior support worker at a L’Arche home in Liverpool – “loves his work”.

“It’s not just a job. You stay with someone that becomes your family… They become a part of our life,” he told Big Issue. “It’s about creating a relationship with them and helping them live independently.”

People like Macwan were a lifeline, says Casson.

“When Keir Starmer said we’re in danger of becoming a society of strangers, I would say these are the very people that make sure we’re not strangers, but we’re neighbours,” Casson said. “The people up and down our streets who need a bit of support are getting it from these people that are investing their love and their lives in supporting vulnerable people.”

But the influx of immigrants the pathway generated was politicly unpalatable. In 2024, then-PM Rishi Sunak tightened rules for care visas, banning workers from bringing independents with them. The number of applications plummeted: from 158,100 in 2023 to 31,500 in 2024.

Labour’s latest policy bans recruitment altogether. While it doesn’t apply to existing workers, Macwan is uncertain about his future.

“When we came here, we didn’t know the situation would change like this,” said Macwan. “We wanted to build a life here – not just come for a short time, care for people, and leave. I would say it like this: we’re good enough to care, to support the community, to blend in – but not good enough to stay?”

“After five years, what if L’Arche might not be able to sponsor us again – not because they don’t want to, but it is more expensive now.”

“When you have an immigration system that seems almost designed to permit abuse, that encourages some businesses to bring in lower-paid workers rather than invest in our young people… you’re actually contributing to the forces that are slowly pulling our country apart,” Starmer told reporters at the launch of the immigration white paper.

It’s true, the Health Foundation’s Allen says, that “recent international recruitment has not always been ethical”.

“The care sector has recruited heavily from ‘WHO red list’ countries which face significant shortages of health and care workers,” she said. “Our recent analysis also highlighted that social care workers from outside the UK face particularly high risks of poverty and exploitation.”

But this pursuit of low-paid workers reflects a brutal domestic reality: the care sector is on its knees, Casson says.

“If the government wanted to say: ‘In the long term, it’d be better if there were a lot more British workers coming into social care,’ we would be fine with that. But then create the conditions where that’s going to happen.”

Why is the social care sector struggling so much?

The sector was hit particularly hard by the recent increase in employer national insurance contributions, he added.

“In 2022 23 we were on real living wage, which is what we want to pay people. Because of the NIC rise, we’re back to minimum wage. They’ve taken away our ability to pay anything more than the absolute minimum. And then they’re sort of implying we should somehow be able to recruit people when we can’t. We can’t afford to pay as much as Aldi pays, or Lidl pays.”

Macwan agrees. He says he “understands” the drive to get local people into the work. But the pay is not competitive.

“If we don’t have competitive pay, how will the local community come and do this work? This is a tough job. You’re helping with personal care, lifting people, staying overnight with them.”

Staff shortages will have a serious impact on “vulnerable” service users, he adds.

“What about these vulnerable people? How they will they live their best possible life, how will they go out and do their activity, how will someone go in the church if they don’t have the support, enough support, how will someone have the epilepsy medication on time?

The government has promised to establish Fair Pay Agreements (FPAs) which it hopes could lead to higher pay for carers. 

But it has ignored the “elephant in the room,” the IFG has found: “paying care workers more will require the government to spend substantially more on the sector,” they report. “That seems unrealistic when the fiscal envelope is so tight.”

The new rules do not impact overseas care workers on existing visas. But with high turnover, the sector will see shortages soon.

“Most social care organisations have up to sort of 20% turnover in a year,” Casson says. “So it’ll be, it’ll come on over a year or so. But in a year to 18 months. I think we’ll be in a real crisis.”

The Home Office has been contacted for comment.

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