Proposals for a national care service are failing to add up without international workers - Jayne Dowle

When it comes to social care, Andy Burnham’s heart is in the right place, but already his proposals for a national care service are failing to add up.

Thanks to a mixture of punitive immigration measures, inadequate pay - typically £12.00 to £13.40 per hour, or an annual full-time salary of around £22,000 to £24,000, according to jobs website socialcare.co.uk - and exhausting working conditions, the industry already can’t get the staff it needs.

And now new analysis from UNISON shows a shocking plunge in the number of international recruits taking jobs in care, dropping from 105,000 in 2023/24 to just 30,000 in 2025/26. That’s a fall of more than two-thirds. Who is plugging that gap? Not, as some might like to think, British workers.

Over the same period, the number of social care jobs filled by British workers has fallen by 70,000, the union finds. Taken together, that’s some serious recruitment crisis and there are no viable plans on the table to fix it.

Indeed, UNISON argues, the government’s own hard stance on immigration is making the situation worse, as it has become harder for migrant care staff to settle in the UK for good. General secretary Andrea Egan is urging Home Secretary Shabana Mahmood to reverse plans to make international health and care staff wait 15 years before they can settle in the UK, instead of the current five.

“If the government’s serious about fixing social care, it should immediately scrap these cruel plans that will make it harder to recruit staff,” Egan says. “Terrible pay and working conditions are creating shortages in the social care sector. These figures make that crystal clear. A massive drop in overseas workers has not led to rising domestic recruitment or higher wages.”

There are already 96,000 job vacancies in the sector, meaning thousands of people who need help won’t get the vital care they need, stretching services further and putting even greater pressure on staff.

Is it any wonder that more than last year (2024/5) 30,000 people died waiting for their local council to arrange a social care home ‘package’, a process which can take months? And that since 2020, there have been a total of 167,900 such deaths?

Again, these are startling figures which the Prime Minister cannot afford to ignore. Local authorities are having to ration support for patients, many of whom have dementia or other serious degenerative diseases. More than half of requests for help are rejected, with the proportion of frail and elderly adults in England supported by social care halving over the past 20 years.

Campaigners say this means many vulnerable people spend their final weeks and months struggling with daily tasks including dressing, washing and eating, worsening their conditions and distress.

These facts are freely available. Knowing them, and having personal experience of the importance of social care in his own family - Burnham’s father suffers from advanced Alzheimer's disease and is in a care home - surely must make the PM appreciate the bigger picture.

UNISON tells of worrying practices, with overseas staff often too scared to raise concerns about excessive hours, poverty wages and squalid conditions in case their employer withdraws their visa sponsorship, meaning they would be forced to leave the UK. A start would be introducing sector-wide sponsorship UNISON argues, rather than tying workers to a specific company.

Tripling the wait time for permanent status will cause further chaos and irreparable damage to a sector that desperately needs international workers, the union believes, adding that it is also morally wrong to apply new rules after workers have moved to the UK.

“Attempts to force existing staff out of the country are wrong by every measure,” Egan says. “If the government doesn’t drop these plans, the prime minister’s hope of transforming the lives of millions through a national care service will never happen.”

Clearly, with 96,000 job vacancies and overseas recruitment falling off a cliff, swift action is required.

Yes, it is true that the failure of successive governments to address social care represents a “major dereliction of public duty”, as Burnham stated, and there will definitely be “difficult decisions” involved in finding the money to fix things.

However, before any of this can happen, people are needed to care for people. It’s as simple as that. Make social care an exception for the new immigration rules, find a way to force private operators to pay above the minimum wage as soon as possible and treat carers as professionals engaged in work that can so often be a matter of life and death.