The Homecare Association welcomes and fully endorses the recommendations in today's Public Accounts Committee report on Skilled Worker Visas.
The Committee found that "government moved swiftly to open up the visa system... [but] this speed came at a painfully high cost". This was avoidable.
Dr Jane Townson OBE, CEO of the Homecare Association, said:
"We warned officials from the outset that introducing international recruitment in homecare without fixing the broken commissioning system risked exactly the hardship and exploitation the PAC has now documented. The Home Office chose not to listen to sector experts, and sponsored and UK workers are paying the price for that decision."
Root causes
The PAC report rightly identifies widespread exploitation of migrant workers, but the problem runs deeper than visa administration. In homecare, primary drivers are exploitative zero-hour commissioning at low fee rates by public bodies, which leads directly to zero-hour insecure employment at low wages.
Local authorities compound the problems by choosing to contract with hundreds of small providers, many of whom entered the market after the government opened the shortage occupation list to care workers. This fragments the total hours purchased across too many providers, leaving each without enough work to offer full-time hours to meet visa requirements. Over-supply then means councils give work only to the lowest bidders, regardless of whether these rates enable compliance with employment or care regulations. Providers must choose between accepting low fee rates which do not cover costs or having no work at all. This leaves sponsored and UK workers with insufficient and insecure hours and wages. UK workers can leave to find work in other sectors but sponsored workers cannot.
Dr Townson commented:
"What we're seeing isn't just immigration policy failure - it's the inevitable consequence of a care system that systematically under funds providers leading to exploitative commissioning and purchase across too many operators. When you force providers to compete on price rather than quality, it creates the conditions for unsafe care and labour exploitation. Absence of effective regulation allows unethical practices to continue."
Sponsored workers face severe hardship
The impact on sponsored workers is particularly severe because they cannot access welfare services to bridge gaps in income.
The International Recruitment Hubs are focusing on displaced workers whose employers have lost their licences but are not supporting those who simply need more hours to survive. As a result, many are being forced into cash-in-hand employment to make ends meet.
We have heard deeply disturbing stories of unscrupulous employers making sponsored workers give them the cash they have earned from additional work and putting it through "fake payrolls" to avoid losing their sponsorship licences. Workers are terrified of blowing the whistle through fear of deportation or other retribution, creating a climate where labour abuse can continue undetected.
"The stories we're hearing are deeply shocking - workers having their own earnings taken from them and processed through fake payrolls while living in fear of deportation," said Dr Townson. "This isn't happening despite the system - it's happening because of how the system is designed."
This level of exploitation would be much harder if local authorities commissioned care ethically, with sustainable fee rates and guaranteed hours that enable providers to offer secure employment, and regulators were monitoring and enforcing regulatory compliance effectively.
Understanding Adult Social Care
The PAC highlights the Home Office’s lack of understanding about the Adult Social Care sector. Current policy-making processes demonstrate a disconnect between government decision-makers and the operational realities facing social care providers. This undermines evidence-based policy making for a sector facing acute workforce shortages.
"The Home Office does not understand adult social care. This pattern of exclusion is not just frustrating – it’s dangerous. We saw during the pandemic what happens when social care is treated as an afterthought. Yet the government continues to make policy in a vacuum, detached from the frontline reality. If we want a resilient, high-quality care system, that starts with evidence-based policy shaped by those who know the sector.”
The need for fundamental reform
We agree with the PAC's call for cross-government coordination to tackle exploitation, but this must address the root causes. We need a fundamental change to the way local authorities and the NHS commission and purchase homecare.
Our recommendations for change
Building on the PAC's findings, we call for:
- Processes that enable protection and redeployment of sponsored workers without enough hours as well as those who are displaced.
- A National Contract for Adult Social Care - Legally binding minimum fee rates that prevent the underfunding that drives exploitation
- Shift-based commissioning – Paying workers for shifts, moving away from minute-by-minute purchasing to provide workers with guaranteed hours and more security of income
- Geographic commissioning zones - Ending the fragmentation that results in inadequate hours for each provider, threatening worker income and provider sustainability.
- Multi-year funding settlements - Enabling sustainable workforce planning and development
- Coordinated regulatory response - Ensuring all agencies work together to identify and prevent exploitation
A test of government commitment
The PAC report represents a watershed moment. The question now is whether the Government will act decisively on well documented solutions to enable reform of commissioning practices and properly fund social care, or continue to operate a system that can only be described as state-sponsored labour exploitation.
Reform without adequate funding remains rhetoric. The Government must invest the £1.6 billion needed to address the homecare deficit and create a system that protects workers whilst delivering safe, quality care.
Dr Townson concluded:
"The Government can no longer claim ignorance about what's happening in social care. The PAC has laid bare a system of state-sponsored exploitation. The question is whether ministers have the courage to invest properly and reform commissioning, or whether they'll continue to look the other way while vulnerable workers suffer."
The choice is stark: continue with a broken system that enriches exploiters whilst failing those most in need, or build a sustainable, ethical care system worthy of both the workers who provide care and the people who depend on it.
This is the moment to act.
