07 March 2025

Dear Home Secretary,

Internationally educated nursing staff make vital contributions to the country’s health and care sector. The Royal College of Nursing (RCN) is proud to represent many of these people. Without them, many lifeline services that support vulnerable patients, would cease to function.

However, as I raised in my letter dated 13 August 2024, the RCN is deeply concerned by reports of exploitative workplace practices that many international educated nursing staff in the care sector face.

Our members report a range of issues from long working hours, excessive repayment fees to exit contracts, substandard and crowded accommodation, and illegal work finding fees. Nursing staff have shared their testimonies with the RCN including one RCN member who was subject to a repayment fee of £25,000. In many of our members’ cases we have heard reports of employers using staff’s sponsored status to coerce them into paying large fees with threats of deportation.

As you may already be aware, The Gangmasters Labour Abuse Authority has also found evidence of labour abuse in the social care sector. Similarly, The UK’s Director for Labour Market Enforcement Strategy’s assessment of the care sector shows that labour non-compliance has increased in the past year.

Last year, I welcomed the Labour Party’s commitment to an investigation led by the Single Enforcement Body – which the RCN continues to call for - and I urged Ministers to take decisive action to root out these practices. In a Guardian article dated 4 June 2024, you accurately described these practices as “a disgrace” and that the then government had “turned a blind eye to widespread exploitation of migrant care workers, putting vulnerable people at risk and undermining our immigration system and standards.”

The commitment by the Labour Party was an important step in recognising the severity and urgency of this matter. In government, you have power to act and turn this promise in action.

The RCN has constructively engaged with parliamentary scrutiny of the Employment Rights Bill, including with government officials. We broadly support the aspirations of the legislation, in particular the formation of a Single Enforcement Body to stamp out labour abuses. However, I am concerned that based on current timelines, the creation of the Single Enforcement Body – subject to the passing of the Employment Rights Bill - will not be until spring 2026 at the earliest. A subsequent investigation is likely to take several months to conclude.

In the meantime, these exploitative practices will continue, and I fear, will become more frequent. I urge officials in the Home Office and across government departments to launch the promised investigation now to ensure that victims are not let down by lengthy processes.

Alongside this investigation, we believe the Government should review the sponsorship system for the Health and Care Worker visa, where staff are sponsored by a specific employer, to evaluate the risks it poses for exploitation and explore alternative models. We also believe that the current allowance of just 60 days to find a new sponsor should be extended to give staff greater protection. This is particularly important where an employer’s sponsorship licence has been revoked. In Australia for example, visa holders have 180 days to find a new sponsor.

I would welcome the opportunity to discuss this urgent matter with you and your officials to ensure we can make meaningful progress to end these unscrupulous practices without further delay.

Yours sincerely

Professor Nicola Ranger
General Secretary & Chief Executive