Five-point plan to cut UK immigration raises fears of more NHS staff shortages

The home secretary, James Cleverly, has announced a five-point plan aimed at delivering the biggest ever cut in net migration to the UK, prompting fears of heightened staff shortages in the NHS and social care.

Cleverly announced that the minimum salary requirement for a skilled worker visa would rise to £38,700, while a rule that allows for people in professions with the greatest need to be hired at 20% below the going rate will be scrapped.

Care workers will be banned from bringing over their families, while firms will have to be overseen by the care regulator in order for them to sponsor visas.

Cleverly told the House of Commons that these measures, along with increasing the immigration health surcharge to £1,035 and reviewing the graduate visa route, would help reduce net migration by 300,000 after their introduction in spring 2024.

They are much more radical than Downing Street originally intended, owing to pressure from Conservative backbenchers and Robert Jenrick, the immigration minister. Official estimates say net migration to the UK was a record 745,000 in 2022.

Cleverly said the government had already announced measures to reduce the number of dependants of students coming to the UK and the number of students who can switch from education to work.

“Today I can announce that we will go even further than those provisions already in place, with a five-point plan to further curb immigration abuses that will deliver the biggest ever reduction in net migration,” he said. “In total, this package, plus our reduction in student dependents, will mean about 300,000 fewer people will come in future years than have come to the UK last year.”

Cleverly told parliament that in the year to September, about 120,000 dependants accompanied 100,000 care workers and senior care workers. “Only 25% of dependents are estimated to be in work, meaning a significant number are drawing on public services rather than helping grow the economy,” he said.

He did not say how many fewer care workers the government expected to come to the UK as a result of the changes. There are now 152,000 care worker vacancies in England, and care home inspectors often find that a lack of staff means residents receive substandard, and sometimes dangerous, levels of care.

Martin Green, the chief executive of Care England, which represents major private care home providers, said: “The government is making it harder for care providers to recruit foreign workers. If the government now wants to move away from international recruitment as the solution to fixing the social care workforce crisis, it must act swiftly and invest in improving the pay and conditions to drive domestic recruitment.”

The Unison general secretary, Christina McAnea, said: “The government is playing roulette with essential services just to placate its backbenchers and the far right. But if ministers stopped ducking the difficult issues and reformed social care as they’ve long promised, there wouldn’t be such a shortage of workers.”

Cleverly exempted health and care workers from an increase of a third in the level of earnings required for skilled workers to qualify for a visa, to £38,700 from next spring. The sector had feared that the inclusion of care workers would have ruled out foreign recruitment altogether, as care staff in England typically earn £22,460 a year.

Nevertheless, the ban on bringing families is likely to restrict the inward flow of foreign care workers, who in the last year have helped to prevent an even greater workforce shortage. The Conservative former minister George Eustice asked Cleverly what the impact would be on the care sector and urged the government to move away from a “failed” skills-based migration policy.

He said: “Isn’t the problem with a skills-based immigration policy that it gives preferential access to bankers, to lawyers, to accountants, to economists, even though we have no need for such people in this country, we have plenty here, homegrown talent, but it actually makes it very difficult to recruit the people we do need – care workers, people who work in the food industry, in manufacturing, producing things generally, or indeed in the tourism industry?”

Steve Brine, the Tory chair of the health select committee, said vacancies in adult social care had fallen to 152,000 because of entrants using the shortage occupations list while there were 121,000 vacancies in the NHS in September. “Who did ministers consult ahead of today’s legal migration announcement?” he asked.

The announcement goes much further than anticipated and in effect revives the pre-Brexit immigration system, when skilled non-EU workers largely required degrees. Home Office figures showed that visas granted to foreign health and social care workers more than doubled to 143,990 in the year to September. Those workers brought in a total of 173,896 dependants.

The Migration Advisory Committee urged the government to scrap the shortage occupation list earlier this year because of concerns that it was increasingly being used by companies in low-wage sectors to hire cheap foreign labour instead of recruiting domestic workers.

In 2010, David Cameron promised to bring annual net migration down into the tens of thousands. But the figure has remained high and risen significantly since Brexit, with most people coming from non-EU countries.

After fighting a Brexit campaign driven in part by claims the UK would be able to control its own borders, net migration has soared under the Conservatives in the years since the 2016 referendum.

Rishi Sunak has previously put much of his focus on illegal migration, making a vow to “stop the boats” one of the five central promises of his premiership. The relaunch of plans for Rwanda deportation flights, via a new treaty and new legislation, is also expected to be announced. Cleverly is expected to fly to Kigali in the next 24 hours to sign a treaty.

Tory election strategists regard migration as a key battle line with the Labour party, which continues to lead the Conservatives in opinion polls by about 20 percentage points.

The next general election must be held by January 2025 and is widely expected to take place next autumn.