Chronic illness, infections and trauma – a survivor sheds light on the physical and mental harm caused by exploitation.
“I’ve lived in a safe house where I’ve seen the severe health issues survivors have,” says a modern slavery survivor supported by Unseen.
“I’ve seen people with chronic pain and back problems because of labour exploitation, and many have ended up with mobility problems.
The survivor quoted above is one of Unseen’s survivor consultants, a group that shares their lived experience to help us campaign for better policies, support for survivors and preventative action on modern slavery.
“Some survivors leave their place of exploitation with infectious diseases and if they don’t have healthcare, they would be in serious difficulty. I’ve seen survivors whose physical problems have quickly led to the deterioration of their mental wellbeing,” they said.
Modern slavery is a widespread problem in the UK, with an estimated 122,000 people at any one time in situations of exploitation including forced labour, sexual exploitation, and domestic servitude. That’s equivalent to the population of York.
How modern slavery impacts the health and social care sector
- Chronic health conditions: many survivors experience long-term health issues such as back pain, infections, malnutrition, and injuries from physical abuse. These conditions can result in high medical and social care costs over extended periods.
- Mental health disorders: survivors often suffer from mental health issues such as post-traumatic stress disorder (PTSD), suicidal ideation, self-harm, anxiety, depression, and substance abuse. These require specialist psychological and physical healthcare, including emergency treatment, counselling, psychiatric treatment, and medication, all of which contribute to NHS, social care and NGO support costs.
- Frequent hospital admissions and medical appointments: due to untreated or undiagnosed conditions sustained during exploitation, many survivors later require more frequent routine appointments such as to GPs, physios, opticians and dentists, as well as hospital visits.
The healthcare challenges faced by modern slavery survivors
Kali Rad, Head of Frontline Services at Unseen, says: “The reality is that modern slavery survivors often need significantly more healthcare than the average patient.
“I remember one male client who had no teeth because of the physical abuse he suffered. One of the big milestones was helping him access the right support to have a denture fitted, which was a hugely positive step in his journey to recovery.
“Dental problems are often an issue for survivors. Some haven’t had access to a toothbrush and toothpaste on a regular basis. Maybe all they had was just some soap – they may not even have had regular access to clean water.
“Some survivors have suffered emotional trauma, such as PTSD, that is in direct correlation to what has happened to them. This can be acute if they were exploited by someone well known to them, such as a family member or a relative.
“Some clients will be heavily dependent on healthcare for the rest of their lives because of what happened in their exploitation. Some of them will even need major surgery following the harm they have suffered.”
How Unseen has supported survivors and raised awareness
Unseen supports and empowers survivors by helping them access health services to support their journey to recovery. An example of this is the dental treatment we facilitate run by Dentaid – The Dental Charity.
In addition to supporting survivors, Unseen has also worked directly with the NHS, equipping frontline professionals with the knowledge to identify potential victims of modern slavery and report concerns.
In 2023, we supported the development of modern slavery training for NHS England’s safeguarding leads, promoting the Modern Slavery & Exploitation Helpline as a reporting mechanism and resource for NHS professionals needing advice.
The Unseen app is also used by frontline professionals in the NHS and other sectors as an information resource and platform to report concerns.
Lack of data on the impact of modern slavery on the health and social care sector
The true cost of modern slavery to the health and social care sector and specifically the NHS remains unclear because of a lack of recent research on the issue.
A Home Office report in 2018 on The economic and social costs of modern slavery, which Unseen contributed to, estimated the total cost to society of modern slavery in the UK at between £3.3bn and £4.3bn in 2016 to 2017. These figures were based on an estimated number of victims of between 10,000 and 13,000, including the costs of victim services, health services and law enforcement.
The total cost of modern slavery to health services across the UK in 2016 to 2017 was estimated at £10.5m. These costs were divided across three key areas of modern slavery: labour exploitation, sexual exploitation and domestic servitude.
Given the government’s acceptance of at least a ten-fold increase in the number of potential victims and the cost of inflation, we now estimate that the costs to health services in 2025 will be in the region of £120m. This figure equates to the cost of paying the salaries of 2,500 nurses or building a new hospital each year.
Huge rise in referrals to NRM
The rapid increase in the number of people being identified as potential victims of modern slavery remains a concern.
In 2017, the National Referral Mechanism, the government system used to identify and support victims of modern slavery and human trafficking, received around 5,000 referrals of potential victims of modern slavery in the UK.
By 2023, this number had risen to 17,000, a 240% increase on 2017 and the highest annual total since the NRM’S inception in 2009.
This significant rise suggests that modern slavery has worsened over time, placing even greater strain on economic and healthcare resources.
The true scale of the cost of modern slavery is hidden
The Centre for Social Justice said ‘nobody knows the true scale and cost’ of modern slavery.
It estimated that the total economic and social costs, based on their estimate of 100,000 potential victims in the UK, could amount to £32.9bn a year.
With the government estimating that the number of potential victims is higher still at 122,000, this could potentially put the total economic and social costs to the UK at closer to £50bn a year, when factoring in inflation.
An additional issue is that many modern slavery victims have likely been accessing healthcare services independently and outside of the NRM. The lack of data on this group of victims increases the challenge of understanding the true cost of exploitation on the NHS and related services.
What next?
The longer someone remains in exploitation, the more expensive their treatment is likely to be.
Andrew Wallis OBE, CEO of Unseen, says earlier intervention is key to reducing the costs of modern slavery on healthcare services and the wider economy.
“Modern slavery is first and foremost an economic crime with a profound violation of human rights, but it is also an insidious financial drain on our healthcare systems and national economy,” Andrew says.
“We can no longer ignore the staggering economic costs of this crime. Our focus must be on action to prevent others from being exploited.
“Survivors often require intensive, long-term medical and mental health support to recover from their ordeal, which places immense pressure on already stretched public services. Through greater investment in earlier identification and prevention, we can protect lives and reduce the significant economic burden modern slavery imposes on healthcare services.”
Highlighting the costs of modern slavery on the economy
The lack of comprehensive and up-to-date data on how modern slavery is generating hidden costs for healthcare services and our economy represents a barrier to informed policy making and resource allocation.
If you are a researcher or funder interested in exploring this issue further, please visit our website to find out more about our policy and research work.
You can also contact our team to explore collaboration opportunities: [email protected]
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