Indefinite Leave to Remain: Healthcare Workers

Alicia Kearns Excerpts

Monday 18th November 2024 Westminster Hall

[Alicia Kearns (Rutland and Stamford) (Con)]

It is a pleasure to serve under your chairmanship, Sir Edward. It is always a privilege to debate issues brought to us directly through petitions. I join the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) in thanking the Petitions Committee for all the work it does, particularly the Clerks. They are currently fortunate to have Rahul Sindwani within their team, who was my Speaker’s intern for a year. He is very much missed, but I am delighted that he has gone on to find another role within Parliament.

In today’s debate, it has been good to hear about the wide range of work that health and social care workers do on a daily basis. They are integral to our communities, supporting our loved ones during times of crisis, and our beloved older ones. I am deeply grateful for the work they do. The issue brought to us today highlights the broad and interconnected nature of immigration, a policy area with influences far beyond the remit of the Home Office. Few areas feel its effects more acutely than our health workforce, and that workforce is a vitally important matter.

The previous Government understood the importance of developing a strategy for the NHS workforce that extended beyond parliamentary cycles, taking into account its long-term impact. Our proposals aimed to reduce reliance on international recruitment agency staff. Our report stated that in 15 years’ time, we expect just 9% to 10.5% of our workforce to be recruited from overseas, compared with nearly a quarter now. That shift towards a home-grown health workforce is contingent on implementing education and training expansions as set out in our plans. I would be grateful if the Minister could confirm that that target remains and what steps the Government are taking to achieve it.

In Government, the Conservatives created the health and social care visa to facilitate the entry of top global health professionals into the NHS, aligning with the needs of both the institution and the country. Within its first three years, over 61,000 people had taken it up. I would like to clarify that health and social care workers are exempt from the immigration health surcharge, so that would not be a new proposal from other parties— it is the current existing policy.

We should discuss the basis for achieving indefinite leave to remain and why it matters. The standard requirement of five years is designed to allow applicants to build ties and demonstrate an ongoing commitment to the UK. In sponsored work routes, settlement relies on applicants having worked in their sponsored role for five years. Other requirements include demonstrating an adequate level of English. That is essential so that individuals can properly integrate into our communities. Integration is a crucial element of settlement. Delving into the definition of integration is complex, and I would not want to test the patience of the room on that matter. However, the data available is clear that migrants’ English language skills and labour market outcomes improve over time, giving them more opportunities to shape their own futures. That also benefits society as a whole.

While there are some limited circumstances in which individuals can apply for accelerated settlement, most routes leading to permanent residency require an individual to have done those five years. To me, and I am sure to many others, that represents an appropriate timeframe for people to build ties to the UK and their local communities. I am not convinced by the arguments that having two years instead of five somehow reduces the risk of abuse, and indeed slave labour, within the system. We must ensure that work standards are appropriate, and there are many routes for victims of slave labour to receive protections, such as the national referral mechanism, but it is quite fair that if someone cannot find another role within the UK, their visa would no longer be valid.

We did a lot of work when we were in Government to crack down on fraudulent social care companies, which are using this visa route to bring vast numbers of people to this country without social care jobs for them to go to. We have to recognise that, while the majority of people who apply to come and work in this country using the health and care worker visa are coming here for the right reasons, many companies have abused that route. That is why we have had to put in additional restrictions around that.

It is important to note that the rate of settlement in this country is managed thoughtfully, ensuring that those who successfully integrate have the opportunity to remain here indefinitely. Contrary to what was said in the opening speech, individuals can undertake additional paid work on a health and social care worker visa, as long as they continue in their sponsored role. They can also engage in unpaid voluntary work. That, again, helps them to identify alternative routes to employment, should they be unhappy with their sponsor.

As many Members will be aware, grants of settlement have generally increased since 2016, although they remain below the level seen in the early 2010s. While there was a slight decrease in 2023, it was still the second highest year for grants since 2013, with 119,000 granted. Could the Minister kindly set out whether the Government have considered the level of settlement grants they anticipate in the coming years, and how they plan to ensure that those remain sustainable?

All of us here appreciate the work of healthcare professionals, but, in our view, five years is a reasonable timeline to achieve indefinite leave to remain. It ensures that those who come to make permanent homes here have the time to lay down roots, to fully integrate with their neighbours and local community, and to demonstrate commitment to our country. As with all areas of visa policy, it is vital that we find a balance between ensuring robust protections against misuse, ensuring trust in its fairness from UK residents and citizens, and the rights and prospects of those coming here to make new lives and contribute.

The current timeframe for indefinite leave to remain is the correct one, and should not be shortened. Is that also the Government’s view? Are there plans to either review or change the eligibility criteria for indefinite leave to remain? Ultimately, we welcome the ongoing discussion around this issue; indefinite leave to remain is a serious status, and the five-year timeframe reflects the seriousness of that and the opportunities that being in this country offer to those with indefinite leave to remain.