Health and social care issues were prominent in the election manifestos of all three major parties. Throughout the campaign, voters expressed significant concerns about the state of the UK's National Health Service (NHS) and social care.
On 5 July 2024, Keir Starmer led the Labour Party to a decisive victory, succeeding Rishi Sunak as Prime Minister and ending 14 years of Conservative rule.
The new Labour government is expected to address its manifesto promises quickly. However, those anticipating a dramatic shift from the previous administration may be disappointed.
In its final year, the Conservative government adopted a mixed approach to immigration and the health and social care sectors. They imposed stricter regulations on the social care sector while maintaining preferential minimum salary rates for the health sector.
Of particular note, in April 2024, the Government implemented changes to its Immigration Rules aimed at reducing immigration in the social care sector. These changes included stricter sponsorship requirements for social care providers and the removal of the ability for care workers to bring dependants to the UK.
This blog explores the anticipated impacts of the 2024 General Election on the UK's Health and Social Care Sector and immigration throughout the coming years.
Labour Party manifesto
Linking immigration and skills policy to address
skills shortages and upskill resident workers
Reintroducing the Resident Labour Market Test (RLMT),
previously discussed by the Labour Party when in opposition, could
pose challenges. Previously, this had a substantial impact on
processing times from both an immigration and recruitment
perspective.
Companies were required to scrutinise each applicant to ensure that they were a good match for the role based on their skills and prove that the role could not be filled by a person already settled in the UK, such as UK or Irish citizens, or those who hold permanent residence status in the UK. Whilst this is speculative, it is something companies may need to consider ahead.
Currently, there is a significant shortage of medically trained professionals, forcing private care homes and the NHS to recruit internationally or hire recent graduates on Student visas. Health and Care Worker visa applications surged from 4,100 to 18,300 between February 2022 and August 2023 but then dropped to 2,800 by June 2024.
This 75% decline reflects the fluctuating nature of immigration trends. As the Labour government aims to reduce reliance on overseas workers a large increase in Health and Care visa applications is unlikely.
The Immigration Salary List (ISL), which replaced the Shortage Occupation List (SOL) on 4 April 2024, lists the skilled jobs that are in short supply of workers. Included in the list are:
- Care workers and home carers – occupation code 6135
- Senior care workers - occupation code 6136
Where applicants under the Skilled Worker/Health and Care visa are applying under a role that appears on the ISL, the minimum salary requirement is reduced.
The ISL is currently restricted to care workers and does not include roles like nurses, doctors, paramedics, pharmacists or midwives. The Labour government has not indicated plans to expand this list, which may make the sector less attractive to overseas workers.
However, care workers remain on the ISL, allowing lower salaries for these positions. With visa applications for care workers dropping to 12,400 in April 2024, the decline may be linked to recent changes but could rise as political conditions stabilize.
Applications for dependants under the Health and Care Worker route peaked at 23,300 in August 2023 but fell to 4,800 in June 2024 after the removal of dependants' eligibility. This reduction may deter overseas workers from migrating permanently but could lower immigration fees for employers, potentially increasing funds for filling vacancies. If the UK offers attractive salaries, it may still draw overseas applicants despite the lack of dependants' visas.
The NHS faces staffing shortages and high stress, leading to more departures. Although the Labour government aims to reduce net migration, addressing workforce gaps is crucial if domestic recruitment does not meet demand.
The government's commitment to hiring 8,500 new mental health staff with £410 million in funding suggests a focus on increasing UK domestic workers. Balancing domestic recruitment and skilled overseas workers will be essential to address staffing needs effectively.
New conditions for employers: Linking visa usage to domestic worker training efforts
Due to the implementation of these new responsibilities on sponsors and employers, it is recommended that the necessary budgetary controls be put in place to prepare for the rising costs of hiring international talent.
Additionally, internal protocols and measures may also be required to train domestic talent to prove that companies are actively trying to upskill their workforce and reduce the reliance on overseas workers who already have the required skill set to fill the roles.
Stricter penalties and bans for employers and recruiters exploiting the immigration system
Modern slavery has become an unfortunate issue within the Health and Social Care sector with labour abuse and exploitation becoming a substantive consideration when employing overseas workers.
Data from Unseen's Modern Slavery & Exploitation Helpline have confirmed that 918 potential victims were identified in 2023, a 30% increase from 708 in 2021.
This will ensure the responsibility lies with the employers to adhere to employment laws and will give them a financial burden should they commit breaches whilst simultaneously incentivising compliance.
Looking forward
Reduce net migration
Net migration is the difference between the number of
immigrants and the number of emigrants.
Continuing the focus to reduce net migration by the Conservative
Party, the new Labour government also intends to reduce net
migration with workforce and training plans to end the long-term
reliance on overseas workers in various sectors.
A sharp decline in net migration is expected from 2024 following
the restrictive measures introduced by the Conservative government
between January and April, to which the Labour Party has not
objected.
The significant reduction in net migration will likely make it
difficult for the UK government to fill vacancies in the Health and
Social Care sector, particularly given the lack of increased pay
and current working conditions, making the roles less appealing to
the domestic workforce.
Urge for 'radical change'
Healthcare leaders are demanding a 'radical change' from our new Labour government, particularly for NHS staffing, working conditions and funding. Without these changes, the Labour government will struggle to attract NHS staff both domestically and internationally.
Recommended changes
- Since 11 March 2024, overseas care workers and senior care
workers are no longer able to bring dependants with them to the UK.
The Labour government may want to reconsider this approach to allow
new applicants to be able to bring across their family as their
dependants.
This would increase the appeal of working in the UK in the Health and Social Care sector and applicants are more likely to view their role in the UK as permanent. - Expand the ISL to include other healthcare staff outside of care workers. This will help the UK Government tackle chronic short-staffing.
- Promote international recruitment for those Skilled Workers abroad to fill posts, decrease vacancy rate, increase turnover and increase diversity.
Immigration brings positive contributions to the Health and
Social Care sector. International recruitment is crucial to help
tackle staffing shortages as the health service struggles to fill
vacancies from recruitment only within the UK.
Holistic changes are not expected soon following the recent
election of the new government. The Labour Party's intentions
appear positive, aiming to improve the Health and Social Care
system.
These improvements could lead to better working conditions, higher pay and a more attractive work environment for overseas workers, potentially increasing their numbers in the UK.
If the manifesto is implemented, the sector may enhance its appeal, making previous immigration rule changes and costs less of a barrier. This could help sponsors and employers retain both domestic and migrant workers for longer periods.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.