4 days ago
U.K. to cut foreign workers, the ‘backbone' of British nursing homes
LONDON — The 23-year-old Nigerian man handed the 78-year-old British woman her noon pill and, on a sunny June day, sat down for a little chat amid the family photos lining her wall.
'Will you miss me if I leave?' Jeremiah Akindotun asked with a smile.
'Oh, I think it's too sad Jerry,' said Suad Lawy, sitting back in her chair. 'You get so attached. What's going to happen to our carers?'
Akindotun is a health assistant at Hammerson House, a 116-room nursing home in north London where 58 percent of the clinical staff come from 49 different countries. Across the United Kingdom, foreign workers commonly provide intimate care to elderly Brits, with nearly a third of care staff coming from overseas.
But maybe not for long. The British government, struggling to address immigration tensions, announced last month that it was ending the special overseas recruitment program that has been a pipeline for care workers in recent years.
Officials said the move was necessary to make the care system less dependent on foreign labor and to root out fraud and exploitation in the fast-track care worker visa program, which was initiated five years ago to ease a staffing crisis in the care industry, one of Britain's biggest employment sectors.
The plan funneled more than 220,000 workers into facilities around the country, according to a government-sponsored database, but it also faced problems. Most workers landed with legitimate companies, but thousands were scammed in their home countries by fake employment brokers. Others arrived only to be overworked and underpaid, even sexually exploited, under threats of having their visas canceled.
Reputable nursing home administrators, however, said canceling the program outright is a body blow to their efforts to fill more than 131,000 open positions in a system that is creaking under the weight of an aging population. Nursing home care is provided by private companies in the U.K. but largely financed by cash-strapped local governments.
British citizens show little interest in the jobs, which are considered low pay, low status and demanding, providers say.
'I haven't had a White British applicant in a year,' said Jenny Pattinson, CEO of the nonprofit that runs Hammerson House and another London care home.
Underlying all of this is a debate about immigration that continues to convulse Britain, like most Western nations. A decade after its Brexit vote to leave the European Union, the U.K. is still arguing with itself about how multicultural and globally integrated it wants to be, questions that continue to drive politics.
The Labour government, generally considered immigration-friendly, announced the end of the care worker visa program less than two weeks after being crushed in English regional elections by Reform UK, a right-wing, populist party started by anti-immigration activist and Brexit-champion Nigel Farage. Reform UK defeated hundreds of Labour and Conservative incumbents and took control of 10 local councils.
Critics say Prime Minister Keir Starmer is trying to dent Reform UK's appeal by making his own rightward pivot on immigration. Cutting the care-worker visa was part of a broader package of immigration changes, including doubling the number of years required for visa holders to become permanent residents and raising the English-language requirement for skilled workers.
In announcing the measures, Starmer sparked a backlash within his own party by warning that Britain risked becoming 'an island of strangers,' a phrase in which some found echoes of xenophobic rhetoric. In 1968, Enoch Powell was kicked out of the Tory shadow cabinet after saying in his famous 'rivers of blood' speech that White Britons 'found themselves made strangers in their own country.'
Starmer rejected the comparison in an interview with the Guardian newspaper, saying that 'migrants make a massive contribution to the UK, and I would never denigrate that.'
Immigration has bedeviled both Labour and Conservative prime ministers for years. Both legal immigrants and asylum seekers arriving on small boats surged to a peak of 906,000 by June 2023.
The numbers are falling as restrictions imposed by the then Tory government and the new Labour government kick in, with net migration into the country down to 431,000 in measures released in May. But the issue remains divisive as a record 11,074 people arrived in small boats in the first four months of this year.
Care home operators accused Starmer of going after their workers because they are easier migrants to block than those crossing the English Channel without permission.
'In my humble opinion, this is a knee-jerk reaction to the surge in votes for Reform,' Pattinson said. 'The government is saying 'Right, we've got to do something about immigration. Where is the largest body of workers coming from abroad? It's the care sector.'
There aren't many aspects of British life in which immigration plays a larger, or more emotional, role than in health and social care. Migrants from the British commonwealth, and particularly the postwar 'Windrush' generation of workers recruited from the Caribbean, fill the ranks of beloved National Health Service. Nurses of colors danced and flew through the air as part of a tribute to the NHS in the Opening Ceremonies of the 2012 London Olympics.
Lawy, a former secondary schoolteacher from Hampshire, a county that is 90 percent White, who has formed bonds with her Nigerian, South Asian and Filipino caregivers, said she had little experience with multiculturalism before moving to Hammerson House following a stroke. 'It's really opened my mind,' she said.
'My sister used to say she enjoyed living in a diverse community and I really didn't know what she meant,' Lawry said. 'Now I do.'
Hammerson House is a Jewish care home. But Ayesha Khan, a Muslim physical therapist from Pakistan who arrived through the visa program last year, said she has felt welcome and useful. Managers told her to step away for prayers whenever she needed to and the only comment she has gotten about her hijab was from a questioner making sure she was not wearing it against her will.
'It's not just a home for residents here, it's a home for me,' Khan said.
These ties make the new restrictions even more explosive, experts said, even as they acknowledged that there was a need for some reform of the abuse-prone visa program.
'It's a sacred cow, immigration is the backbone of the U.K. care system,' said Rob McNeil of Oxford University's Migration Observatory. 'There is a snap response, 'Oh my god, how terrible.' But if they don't resolve things at a structural level there will be consistent problems.'
The program started in 2020 under Prime Minister Boris Johnson to address a drain of European workers that followed the Brexit vote. A lack of oversight, critics charge, allowed shady enterprises and outright fraudsters to operate alongside legitimate care providers. In a crackdown last year, government investigators revoked the licenses of 470 sponsoring organizations, leaving 39,000 guest workers stranded without jobs.
'A third of our calls now come from care workers,' said Olivia Vicol, head of Work Rights Centre, a legal advocacy group.
Nursing home operators say the government has itself to blame for letting the bad actors flourish and that the staffing crisis will only get worse as a result of cutting the whole program without beefing up training, incentives and pay for British citizen to take the jobs. That could create even more political backlash for the government.
'This program was poorly designed at the outset and it's kind of obvious lever to pull when net migration numbers go up,' said Robert Ford, political science professor at the University of Manchester. 'But there will be an uproar if there is major crisis in care homes.'
The government said it was immediately suspending new overseas recruitment through the program, but that current visa holders could apply for renewals until 2028. The number of family members workers can bring was cut, and they will now be required to stay 10 years for a sponsoring facility, instead of five, before being free to explore other work.
For Akindotun, the health assistant, the changes put his whole future in doubt. With a master's degree in clinical psychology, he and his wife and toddler daughter arrived in the U.K. two years ago with hope that he could eventually work as a therapist. His training has been invaluable in dealing with Hammerson's elderly, infirm residents, he said.
'I have much to give here,' he said before sitting down with a 91-year-old who asks him to draw pictures for her. 'It's very demoralizing to feel that the government don't want us.'
