Indefinite Leave to Remain: Healthcare Workers

(Limited Text - Ministerial Extracts only)

Monday 18th November 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for the Home Department (Seema Malhotra)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank and congratulate my hon. Friend the Member for Folkestone and Hythe (Tony Vaughan), for securing this important and informative debate, and indeed for the work that he and colleagues across the House are now doing in the Petitions Committee. I am grateful to him and to colleagues for taking part today.

I want to start by saying that I totally agree with the sentiment underlying so many of the contributions—that everyone should be able to work free from fear and exploitation, and that there should be absolutely no place for hate crime or sentiments from anybody, anywhere in the country. I am sure that all hon. Members across this House take those issues extremely seriously.

I will address several of the issues raised—including tackling the exploitation that we see regarding this route, taking a preventive approach, ensuring trust, making sure that there are escape routes for people if they feel locked in with their employers, and many others—in my remarks this afternoon. I thank my hon. Friends the Members for Ashford (Sojan Joseph), for Southampton Test (Satvir Kaur), for Bournemouth East (Tom Hayes) and for Congleton (Mrs Russell), as well as the Liberal Democrat spokesperson, the hon. Member for Hazel Grove (Lisa Smart), and the Conservative shadow Minister, the hon. Member for Rutland and Stamford (Alicia Kearns), for their contributions today.

The Government do recognise the vital contribution that health and care professionals from overseas make to our NHS and in social care, and indeed to the wider health and wellbeing of the United Kingdom. Indeed, my hon. Friend the Member for Ashford speaks with great personal experience, having worked as a nurse. I know that he, like me, will want to congratulate our mutual friend, Bejoy Sebastian, a critical care nurse, who was recently elected as president of the Royal College of Nursing. Bejoy is a true example of the incredibly important contribution that is made to our wider health sector.

Hon. Members will be aware that in 2020 the previous Government introduced the health and care worker visa, which recognises the crucial contribution that international healthcare workers make, and this Government have kept that offer. The health and care worker visa provides significantly reduced visa fees, as well as a dedicated Home Office team to process applications. Most applicants can expect a decision within three weeks of enrolling biometrics. Applicants are also exempt from having to pay the immigration health surcharge. Those benefits apply to not only the main applicants but their dependants, which I hope is a sign of how much we value the role that those coming here play in our health and care services.

The United Kingdom’s offer to health and care professionals continues to be strong, competing with those of other countries in attracting health and care professionals who may want to work overseas. However, as several hon. Members have said, it is important in that context that we look at net migration overall. Under the previous Government, net migration trebled in five years, driven by a big increase in overseas recruitment.

Our Government are clear that net migration must come down, and we are committed to tackling skills shortages and labour market failures here in the UK to support that effort. That is why the Government’s approach is to link migration policy and visa controls to skills and labour market policies, so that immigration is not used as an alternative to training or tackling workforce problems in the UK. That will be important in ensuring that people have opportunities to gain new skills and access these important jobs, as part of enabling the Government’s broader agenda.

Although I appreciate the arguments about granting health and care workers settlement after two years, the system must be fair to all users. That is why it would not be right to allow health and care workers to qualify after two years, when skilled workers, including those in other much-needed sectors with global demand, would need to wait until they had completed five years on a work route before they were eligible to apply for settlement.

Settlement in the UK is a privilege and not an automatic entitlement. In determining the qualifying period, the Government have to balance what is fair to all applicants with ensuring that individual applicants are able to continue the skilled work they have been issued a visa for, which often aligns so much with their passions and, in this case, with the deep compassion that so many will bring. We must ensure that the period is of a reasonable length, while also recognising the potential impact on public funds of granting settlement sooner.

On balance, the Government consider that five years is the right length of time for people to demonstrate a reasonable contribution to their sector, as well as their commitment to the UK. That is why we have no plans to reduce the length of time that health and care workers, or other skilled workers, need to complete in the UK in order to apply for settlement.

In terms of examples elsewhere, France offered frontline workers fast-track citizenship in 2020 during the covid-19 pandemic, and other countries have offered short-term visas for roles in high-demand sectors. The French offer appeared to go wider than those just in health and social care, but the scheme appears no longer to be operating. So there are examples where there can be short-term changes, but those changes may also come to an end.

However, it is right that we tackle the issues underlying the sentiment behind the petition, which my hon. Friend the Member for Folkestone and Hythe powerfully outlined. In my remaining remarks, I want to tackle some of those issues, and particularly those related to displaced workers and exploitation.

I was asked what the Government are doing to more effectively tackle some of the exploitation we have seen, and it is worth laying out some of the protections that are now in place. In March 2024, there was rightly a change to sponsor guidance so that sponsors would need to be carrying out regulated activity and be registered with the Care Quality Commission. The Home Office has continued to act against unscrupulous sponsors and has highlighted bad practices to the sector. It continues to share concerns and intelligence related to bad practice, and since July 2022 has revoked 452 sponsor licences in the care sector, for reasons including underpayment of salary and failing to provide workers with enough hours to maintain salary levels.

For those individuals whose employer’s licence has been revoked, the Home Office has established a joint venture with the Department of Health and Social Care and with directors of social care operating in regional hubs in England, whereby the Department has funded a process allowing the hubs to find alternative employment for those in that position. Further information can be found on the Government website. The scheme has been implemented on an exceptional basis because of the exploitative practices that have been identified in the sector, and to provide protections to victims of those practices. Concerns regarding potentially unethical and illegal employment practices should be reported to the Gangmasters and Labour Abuse Authority, which will investigate fully. Information on reporting those issues can also be found on the GLAA website.

Colleagues on both sides of the House raised the important issue of having a single enforcement body. In their plan to make work pay, the Government set out a significant and ambitious agenda to ensure that workplace rights are fit for a modern economy, that they empower working people and that they deliver economicgrowth. The Government also introduced the Employment Rights Bill on 10 October 2024. It is important that we talk about this issue in the context of improving rights and protections for all workers.

It is also important to recognise that workers may want to change employer because of exploitation, even though their sponsor may not have lost its sponsor licence. Any worker on the health and care worker visa is able to seek alternative employment, provided they have a job offer from a Home Office-approved sponsor, and to make a new application. They are free to do that at any time, and they do not need their employer’s permission to move jobs. We strongly encourage health and care worker visa holders who think they are being exploited—whether they have concerns about pay, working rights or working hours—to come forward and report those concerns to us using the pay and work rights complaints section on the Government website. First and foremost, any worker who believes that they may be in danger should also contact the police.

If a migrant working in care has left their job because of exploitation, they should contact their regional support officer, so that they can help them try to find alternative employment. That includes people who have yet to have their visa cancelled.

In the context of some of the protections we have in place and the ability to move employer, the Government have no plans to extend the period allowed to workers who have lost their jobs, as that could leave them unable to work and support themselves for longer, increasing the risk of destitution or of becoming trapped in illegal working situations.

It is also important to recognise the point raised by my hon. Friends the Members for Congleton and for Bournemouth East, among others, that staff retention in the care sector remains a long-standing issue that the sector needs to address. That is why we are committed to ending long-term reliance on overseas recruitment by linking our migration, skills and labour market policies, as I mentioned. That includes improving working conditions and bringing in workforce and training plans for sectors such as health and care. That is why it is important that we have introduced the Employment Rights Bill and are looking at the fair work agency becoming a single enforcement body. However, I recognise that there is still much more to do.

The Government will continue to monitor care worker access to the immigration system and act to stop exploitation in the care sector. We do not plan to make any changes to the immigration system at this time, but we will act if needed.

In closing, I thank my hon. Friend the Member for Folkestone and Hythe for securing this valuable debate, and all those who have spoken. There is no doubt about the important role that health and care staff, and the sector in which they work, play in all our constituencies in supporting communities. This is a matter about which Members on both sides of the House care passionately, as has been demonstrated today. I assure Members that we will reflect carefully on this debate and on the points that have been raised. We will continue to do all we can to support those in our health and care sector and to ensure their safety.