Indefinite Leave to Remain: Healthcare Workers

Tony Vaughan Excerpts

Monday 18th November 2024 Westminster Hall

[Tony Vaughan (Folkestone and Hythe) (Lab)]

I beg to move,

That this House has considered e-petition 631412 relating to indefinite leave to remain for healthcare workers.

It is always a pleasure to serve under your chairship, Sir Edward. The petition we are debating today was created by Thomas Thulani Mthetho, and this is what it says:

“Healthcare workers are meant to have lived in the UK for at least five years before they can apply for indefinite leave to remain. With the work they do and the demand for their skills worldwide, they deserve to get residency status much quicker. Most healthcare workers are working under extreme pressure in the UK.

Many countries offer immediate residency status for occupations that are in high demand or extremely short. The UK has been a destination for most foreign nurses and doctors, and it is time for the Government to show they care and also appreciate the workers by making some of the restrictions in terms of residency more favourable. This could also reduce the number of care workers leaving the country for other countries that offer better conditions.”

The petition has attracted 52,962 signatures nationally. Before the election, the Petitions Committee decided that Thomas’s petition would be debated, which has led to the debate taking place today. I am leading the debate as a member of the new Petitions Committee. Before I get into the issues raised by Thomas’s petition, I want to tell Members a little bit about his experiences and what led him to make the petition. I have changed a few aspects of his story.

Thomas is a qualified nurse. While living in South Africa, Thomas approached a recruitment agency seeking healthcare staff in the UK. He had to sit English exams and, if he passed them, he would be able to enter the UK to work in the private healthcare sector. The contract was for three years. If he left before that, he would have to pay back the exam fees and the flight to the UK, which he understood would have been about £1,500. Thomas passed his exams and came to the UK on the health and care worker visa to work in a private nursing home. He worked mainly as a carer, and his contractual hours were 38 hours a week on minimum wage. He was sending money back to his family in South Africa, who depended on that money.

After starting work, he found that his employer required him to work 20 hours over his contractual hours, and regularly worked 60 hours a week. He would work five 12-hour shifts, five days in a row. He asked his employer if he could work less, but it refused. He approached the Royal College of Nursing, which told him that he had the right to refuse to do extra hours, but he felt that he was in an impossible situation. If he insisted that he do fewer hours, he was jeopardising his job, and so he did not feel able to seek legal advice about his situation.

After 11 months, he decided to leave, but his employer told him that he could not, and that if he did, he would be reported to the Nursing and Midwifery Council. It also said that he would have to pay £6,000, even though according to the original agreement, it was only £1,500 if he left before three years. He said he would not pay, it said it did not care, and that he would pay anyway. When he eventually left, it managed to deduct the £6,000 from his new wage packet.

Thomas knows of scores of people who have had an experience like his. All of them accepted breaches of their contract and employment rights for fear of jeopardising their job. Some had allegations fabricated against them by their employer to justify an abusive dismissal when they refused to accept breaches of their rights. Thomas believes that employers all over the country are abusing the Home Office system for sponsoring workers and are subjecting their employees to modern slavery, and doing so with impunity.

Thomas’s petition is about the qualifying period for indefinite leave to remain. He believes that if a qualifying period for healthcare workers was two years instead of five, the window in which the employee is locked in with their employer, and in which the potential for abuse is the highest, would be reduced. Thomas’s solution to the problem of which he has been the victim deserves careful thought, and I ask the Government first to review the qualifying period for those in his position. Thomas’s awful experiences show that there are gaping holes in the enforcement of employment rights standards in this country, especially in sectors such as healthcare. In a report published this month, the Work Rights Centre found that migrants working in adult social care, who constitute as much as 32% of care workers in the UK, face unsustainable working hours, low levels of pay and persistent breaches of employment rights. They fear that if they report their employers to the authorities, they risk having their visa curtailed, as some employers use the threat of curtailment to silence grievances. The report also found that non-compliance by visa sponsors—employers—is widespread. The most common employment rights breach is unfair dismissal, followed by unauthorised deduction from wages and discrimination, so it is clear that proper enforcement of labour standards is needed urgently.

I was encouraged to see that part 5 of the Employment Rights Bill, which the new Labour Government recently laid before Parliament, deals with the enforcement of labour market legislation. Under the Government’s plans, an agency will be set up to enforce employment rights, including on the national minimum wage, holiday pay, gangmasters licensing and modern slavery. The agency will consolidate enforcement bodies, such as His Majesty’s Revenue and Customs minimum wage enforcement team, into a single agency with greater powers, including powers to require that information be given, and powers to enter employers’ premises and require undertakings backed by criminal penalties. The Government hope that the agency will be a recognisable single brand so that individuals know where to go for help, as that would lead to a more effective use of resources.

It will be critical for the agency to take a preventive approach and address workers’ rights violations before they deteriorate to the level of slavery. Workers need to be able to trust it and come forward, so secure reporting needs to be embedded into it. It makes complete sense for employment rights to be enforced across the board, including alongside modern slavery, so my second question is: will the Government confirm that the new agency will police employment standards for those subject to immigration control, including those working in the UK health system under the UK health and care worker visa?

When I spoke to Thomas before this debate, he said that one of the things about the health and care worker visa he was most concerned about was being locked in with his employer because, putting the fees issue aside, his visa would be at risk if he left. At the moment, somebody in Thomas’s position who leaves their employment has a 60-day grace period to find a new employer. After that, they are illegally present in the UK. There appears to be no published policy that says that if somebody has faced exploitation or fraud by their sponsor, they are given a longer period to find a new job. Other countries have a bridging arrangement. For example, Australia has a migrant worker justice visa, so if somebody finds themselves in a position of exploitation or fraud, the Government can support them to leave it. In the UK, if somebody does not find a new employer after 60 days and becomes illegally present, there is no way back into the immigration system. That, in turn, creates pressure to go into the already overloaded national referral mechanism where that may not be necessary.

There is another barrier to leaving an exploitative healthcare workplace. If the worker leaves their main sponsoring employer or is unfairly dismissed, they are not allowed to work in a temporary job while they look for a new sponsor. There is a right to work for up to 20 hours a week in supplementary employment, but not if somebody leaves the main sponsor employer or is dismissed. The right to work up to 20 hours may apply where the employer loses their licence, but that is not enough to pay bills in the meantime while a new sponsor is found. A migrant justice visa that dropped the requirement to work only for the sponsoring employer in an exploitation situation would remove that barrier to leaving the exploitive situation, so my third question to the Government is: can any consideration be given to providing greater clarity and flexibility on the bridging arrangements when a worker on the health and care worker visa finds themselves in an exploitive situation?

We want all workers to be treated fairly, with rights and protections, so everybody can contribute fully to society without extra hurdles and financial pressures. We want people to be able to contribute in the long term. It goes without saying that all workers should be free from fear of exploitation. Thomas’s petition proposes one way in which those objectives might be addressed, and I have asked the Minister about others. There are many other sides to this debate and there is much more to be said, but I have set the scene and look forward to hearing other Members’ contributions.

--- Later in debate ---

[Tony Vaughan]

The debate has underlined that the UK desperately needs care workers from abroad. As I said earlier, about 33% of our care workers come from abroad, yet they are leaving in their thousands, as other hon. Members have pointed out. They are also being exploited because the system does not currently enforce labour rights. All the while, there is a recruitment crisis in health and social care.

I would like to declare an interest: my mother worked as a care worker for decades before she retired two years ago. She came from the Philippines in the 1970s and worked as a carer in the NHS and in nursing homes, and I know from her experiences that the work was hard. I also know that that is not the chosen career for many younger people, and I thank and congratulate everybody who works in the care sector to provide that vital public service.

I completely agree with other Members about the need to encourage apprenticeships, improve conditions and not treat immigration as an alternative to training. The reality at the moment is that we need the 33% of care workers who come from abroad, and a lot of work needs to be done to make sure that the care profession is seen as attractive to those not already working in it.

I welcome the acknowledgment from the Government of the need to prioritise tackling exploitation. I also welcome the actions to enforce labour standards that the Minister outlined, but I wonder whether there is another way of doing that. Ongoing contact between the Home Office and employers would ensure that employer non-compliance was addressed before breaches become so serious that revoking the sponsor licence is the only option. It would avoid other employees being left out in the cold and losing their jobs. I would hope that the fair work agency will provide the powers, resourcing and enforcement officers to ensure that there is ongoing contact, so that the extreme step of revoking sponsor licences is not the only tool in the box.

I note the point made by the Opposition spokesman, the hon. Member for Rutland and Stamford (Alicia Kearns), about the 20-hour period. My understanding is that if someone is in a situation of exploitation and they lose their job, either by termination or resignation, the immigration rules are clear that they are not allowed to work at all in the 20-hour period. That barrier to leaving an exploitative situation is very real.

I finish by thanking everyone for their contributions to the debate. I also give particular thanks to Thomas for putting himself out there and starting this petition. The number of signatories shows that this is an issue of concern for many people, and I hope this debate has given Thomas some reassurance that our system has considered it carefully. I encourage everyone to continue to use the petitions system, which is a great way of participating in our democracy.

Question put and agreed to.

Resolved,

That this House has considered e-petition 631412 relating to indefinite leave to remain for healthcare workers.