A week after Prime Minister Andy Burnham announced plans for a National Care Service and praised the migrant workers who cared for his Alzheimer disease-stricken father, the Royal College of Nursing (RCN) has highlighted how many employers are exploiting migrant nursing staff in social care by taking advantage of their precarious visa status.

The RCN is calling on the UK government to change its immigration policies to stabilise the sector. This includes ending the control of employers over visa sponsorship that allows them to use immigration status as a sword of Damocles over workers.

A recent report analysed nearly 400 cases of health and care staff in adult social care who had sought RCN help as victims of exploitation and extortion in 2023–2025. The union recognises this will be a small fraction of those in a similar situation due to low union membership among migrant workers and widespread fear of speaking up. Most RCN members are registered nurses but others are nursing staff, including nursing support workers.

Employees’ precarious immigration status makes it easy for bosses to illegally demand huge repayments, underpay, rewrite contracts to alter their pay and conditions, as well as ignoring dangerous sub-standard working practices.

At present the visa system ties overseas nursing staff’s ability to live and work in the UK to their specific employer. Therefore, the threat of removal of their visa sponsorship and potential deportation keeps disgruntled workers silent.

RCN Chief Executive and General Secretary, Nicola Roger, said: “A National Care Service meeting the needs of an ageing population with complex conditions will need to be registered nurse-led. We’re the ones with the skill and expertise to make it work, but that cannot happen while so many of our migrant colleagues are being exploited.”

The report highlighted many cases of bosses using repayment clauses to recover costs from staff wishing to leave their jobs before their contract ended. Even worse, most of these cases involved demands from employers above the maximum £3,000 recommended by NHS Employers, with one case being as high as £25,000. A fifth of the cases involved pay, with many being paid less than their agreed contractual hourly wage. What a surprise.

Over half reported rampant sub-standard workplace practices, with a third of these cases involving severe bullying and harassment, including some cases of discrimination based on race.

The RCN wants visas to be administered by an umbrella organisation or industry body so that staff can move more easily between employers without facing threats of deportation. It places hope in the new Fair Work Agency to monitor employment practices, go after unethical employers and deliver on the promise to launch a Government investigation into the sector.

As befits the only trade union with a royal patron, it does not call for prosecution of erring bosses, nor even hint at the possibility of nationalisation.

By New Worker