Certificate of Common Sponsorship

Katie Lam Excerpts

Wednesday 22nd January 2025 Westminster Hall

[Katie Lam (Weald of Kent) (Con)]

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Poole (Neil Duncan-Jordan) for securing this important debate.

We are all deeply grateful to our doctors, nurses and care workers. They do rewarding jobs, but their roles can be difficult and gruelling, too. It is true that many people in that workforce are not British but have come to this country to do that work. We must thank them for helping to keep us and our families healthy and cared for. However, it is our role in Westminster to look at the whole picture, informed—but not led—by individual cases, and there is a wider question to address.

As my right hon. Friend the Member for North West Essex (Mrs Badenoch) has said, the public have consistently asked successive Governments to lower migration and successive Governments did not deliver. Migration has been far too high for decades, and remains so. That is relevant today, because the volumes of people on the health and social care visa are eye-watering. Since 2021, more people have come to this country under the health and social care route than live in the city of Manchester. Why is that? Because those jobs are tough, yes—but fundamentally because those jobs are underpaid.

The Migration Advisory Committee says,

“the underlying cause of these workforce difficulties is due to the underfunding of the social care sector…immigration could not solve these workforce issues alone.”

This situation is economically self-defeating. There is no question that money the Government save in the short term by underpaying salaries in health and social care is dwarfed in the medium and long term by the costs to the state. After five years, a person who has come here on a health and social care visa can apply for indefinite leave to remain. If they get it—95% of ILR applicants are successful—they will qualify for welfare, social housing, NHS care, everything. All that costs money, far more money than those on these sorts of salaries will ever pay in tax and or than they will save the state with their artificially low wages. This cannot go on.

As the hon. Members for Poole, for Congleton (Mrs Russell), for Bristol Central (Carla Denyer), for Montgomeryshire and Glyndŵr (Steve Witherden), and for Truro and Falmouth (Jayne Kirkham) have noted, those individuals are at risk of exploitation. That is a result of the poor pay and conditions across the sector, which have been allowed to endure through bringing in workers from abroad who are willing to accept them as the price of coming here. A certificate of common sponsorship will simply not solve this fundamental problem.

The next related issue with the visa is the degree to which it is abused. The MAC describes “misuse” of the visa as

“a significant problem and greater than in other immigration routes”.

All these issues raise massive concerns about the safety of patients and vulnerable people that the system is charged with caring for. It is awful that that system built up under a Conservative Government.

The change of rules to limit dependants is insufficient to fix the whole problem, but was a substantial step in the right direction. Numbers in the most recent year fell by two thirds. The rules around the health and social care visa need to be tightened further, not loosened through a certificate of common sponsorship, and actually enforced. That is for the good of not only those healthcare workers themselves, but—as should be the primary concern of hon. Members here—for the good of their patients and of this country.

Can the Minister please confirm that that reform is not under consideration? Can she please set out the discussions she is having with her Treasury and Health Department counterparts about the problem of underpaid jobs in health and social care? Can she please tell us how many migrants on care worker visas the Home Office expects to apply for ILR when eligible? Can she tell us, based on demographic level of income and number of dependants, what the Government expect this to cost?