Migrant care workers in the UK: How to tackle their exploitation

Justine Carter, Unseen Director, calls for a complete overhaul of the health and social care visa system to tackle the exploitation of migrant care workers.

For many of us, the image of a care worker evokes a sense of quiet heroism. These individuals dedicate themselves to some of our most vulnerable citizens, providing comfort and vital support. Yet a disturbing truth exists: the very system designed to nurture our loved ones has resulted in the exploitation of migrant care workers.  

Migrant care worker exploitation

The 2020 health and social care worker visa scheme, intended to address staffing shortages, has become a gateway to abuse. Data from Unseen’s UK Modern Slavery & Exploitation Helpline, paints a concerning picture. Since 2022, my team and I have witnessed a significant rise in reports of potential exploitation linked to the care sector. Our most recent Helpline Annual Assessment, one of the most detailed reports on modern slavery and human trafficking in the UK, revealed a 30% increase in potential victims in 2023. 

A labyrinth of deception: how the UK visa fails carers  

For overseas workers, navigating the visa process is akin to entering a bureaucratic maze. Unfamiliar with UK regulations and their employment rights, they become easy prey for exploitation, forced to pay exorbitant recruitment fees – sometimes to care providers themselves – just to secure a job.  

These fees, sometimes exceeding £40,000, stand in stark contrast to the actual cost of a three-year health and social care visa – a mere £284. To raise these life-changing sums, many resort to desperate measures, selling their homes or incurring crippling debts. 

Many migrant care workers arrive in the UK with the hope of a better job. But promised work hours can quickly vanish, and those who do get work can find themselves subjected to gruelling overtime shifts with no legally mandated breaks.  

Debt incurred from excessive recruitment fees hangs heavy, compounded by substandard or unsafe accommodation, often tied to the job. Wages are further eroded by disproportionate deductions for rent and transportation, or a lack of work hours altogether. 

Our Helpline has heard stories of carers being forced to buy cars to ensure they can travel between patients’ homes, and thereby maintain their jobs. This adds to their already precarious financial situation. 

Contracts that trap, not protect 

Our Helpline has encountered situations where workers are made to sign contracts with clauses demanding significant sums of money simply for leaving that employer to seek better working conditions elsewhere. These contracts make it difficult, sometimes financially prohibitive, to leave even the most unbearable situations.  

UK migrant care worker contracts

Such unethical practice effectively traps workers in abusive situations, creating a power dynamic heavily skewed towards the employer. Recent reports of racial, physical, and sexual violence, with employers wielding the threat of deportation to silence their victims, exemplify this horrifying reality. 

This isn’t just about employers. Some care users and their families, who directly employ migrant carers, contribute to the exploitation by pressuring workers to perform tasks beyond their job descriptions, like domestic work. The unspoken threat? “Comply, or lose your visa, your job, your life in the UK.” 

A flawed licensing and sponsorship process: how dodgy providers slip through the cracks 

The care provider licensing process is riddled with flaws. Inadequate due diligence by UK Visas and Immigration has allowed some unscrupulous care providers to exploit the system. Some agencies have received approval to recruit overseas workers, despite lacking proper safeguarding measures. Local authorities, heavily reliant on the UKVI’s list when commissioning adult social care services, often fail to conduct further checks, perpetuating a cycle of neglect.  

To work in the UK, carers need both a health and social care visa and a certificate of sponsorship from their employer. Previously, the UKVI granted these certificates based on the number of jobs providers claimed to have available. However, some care providers received more certificates than actual vacancies When the UKVI discovered these discrepancies, the provider’s licenses were revoked, but with devastating consequences for migrant care workers. They lose their jobs, their accommodation, and have only 60 days to find a new job or face deportation.  

UK migrant care worker visas

Although the UK government are taking steps to improve the situation, for example; only providers registered with the Care Quality Commission (CQC) will be issued sponsor licenses, the impacts of the previous lack of due diligence are still being felt. Local authorities are now under huge strain to fill the gaps left in care by revoked licenses, in a time of nationwide care worker shortage. In addition, where modern slavery is identified, local services are putting immense resource into responding, making this issue hugely costly to the public purse. New issues are also arising. Some agencies are firing overseas workers unjustly, in order to capitalise on the recruitment fees they receive for new staff, creating further vulnerability and job insecurity.  

Recent measures have also restricted migrant care workers from bringing their partners or children with them to the UK. This further isolates these workers and may make them more financially dependent on their employers without the safety net of a partner’s wages, potentially limiting their ability to change sponsors in practice. Even finding a new job comes with the burden of a new visa fee. 

A call to action: building a system worthy of our caregivers 

The UK has a moral obligation to do better, and incoming Government must ensure that addressing this costly and damaging issue is a priority. We need a complete overhaul of the health and social care visa system, ensuring transparency and alignment with the ‘employer pays principle’, which mandates that employers, not workers, shoulder recruitment costs. This ensures that workers are not burdened with exorbitant recruitment fees, and have clear information on their rights and entitlements from the outset.  

While adopting – and enforcing – the ‘employer pays principle’ across all sectors is vital, it’s not a standalone solution. Stricter licensing procedures with thorough due diligence can significantly minimise the risk of exploitation by unscrupulous providers. Equally important is empowering overseas workers with easily accessible information in their native language about their rights and how they can report issues once in the UK. This information must be linked to an independent and confidential reporting system like the Modern Slavery & Exploitation Helpline, giving them a voice and a lifeline. 

Local authorities must also take responsibility, ensuring only ethical providers that adhere to specific guidelines and codes of conduct are commissioned. Unseen, for example, has been working extensively with local authorities in England’s eastern region to raise awareness, strengthen due diligence processes, and establish effective reporting processes. 

Why we need overseas workers 

Some may argue against these visas altogether. But the reality is, the care sector simply couldn’t function without these dedicated overseas workers. We face a critical shortage of domestic workers willing to undertake these vital jobs. Without these individuals, both UK nationals and international recruits, we wouldn’t have the workforce needed to care for our loved ones.  

The problem lies not with the workers themselves, but with a broken system. We can, and must, do better. By working together, we can create a safe and supportive environment for overseas care workers, allowing them to carry out their vital roles with dignity and respect.  

About Justine 

Justine Carter, a Director of Unseen, led the development of the 2015 Modern Slavery Act and set up the Modern Slavery & Exploitation Helpline in 2016. She also established Unseen’s business services in 2017. She regularly presents at national and international conferences on modern slavery and exploitation. In addition, Carter works extensively with UK ministers to influence government policy, encouraging action to tackle modern slavery, in particular across business supply chains. 

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Justine Currell

As I came to understand more about the issue, including through a visit to an Unseen safehouse, I knew I needed to do more to stop this abuse and exploitation.

For the last five years of my Civil Service career, I was the Modern Slavery Senior Policy Advisor in the Home Office and led on development of the Modern Slavery Act, including the transparency in supply chains provision and business guidance.

I joined Unseen to lead the development of the Modern Slavery & Exploitation Helpline, and Unseen’s work with businesses. I am regularly called upon to present at national and international conferences and use my experience of working with Ministers to influence other governments internationally to take action to address modern slavery and, in particular, business supply chain issues.

In my spare time I enjoy keeping fit, music, reading and travelling.

Andrew Wallis

What ultimately compelled me to act was a report on how people from Eastern Europe were being trafficked through Bristol airport to the USA. Kate Garbers, who went on to be an Unseen Director, and I wrote to all the city councillors, MPs and the Police Chief Constable challenging them on the issue. The challenge came back to us: this city needs safe housing for trafficked women. And so Unseen began.

But we never wanted Unseen to be just about safe housing. We wanted to end slavery once and for all, and that remains our driving focus.

I chaired the working group for the Centre for Social Justice’s landmark report “It Happens Here: Equipping the United Kingdom to Fight Modern Slavery”. This is now acknowledged as the catalyst behind the UK’s Modern Slavery Act of 2015. It was a great honour to be awarded an OBE in the Queen’s Birthday Honours that year. On the other hand, I’ve also been described as “the loveliest disrupter you could ever hope to meet”.

This job has taken me from building flat-pack furniture for safehouses, to working with businesses to address slavery in supply chains, to delivering training, raising awareness and advising governments around the world.

When not at work, I enjoy travelling, spending time with my dog Harley, cooking, supporting Liverpool and Yorkshire CC, music (I’m a former DJ) and endurance events such as the Three Peaks Challenge and Tribe Freedom Runs – which I vow never to do again. Until the next time.