A damning report by the Royal College of Nursing (RCN) has uncovered harrowing cases of bullying, racism and financial exploitation of migrant care workers. The report calls for an overhaul of the visa system to end what it describes as "grotesque" abuse.
Power imbalance in visa system
The RCN warns that unscrupulous employers are exploiting a power imbalance in the visa system to demand huge repayments, withhold earnings and allow toxic treatment of staff. The report urges the government to make it easier for workers to escape employers without facing threats and to properly investigate exploitation cases.
In one case, a care worker was told they would have to pay £25,000 to leave their job before their contract expired. The report is based on analysis of 383 cases where migrant health and social care workers sought help from the RCN between 2023 and 2025.
Key findings
Of these, 197 related to repayment clauses - to recover costs from staff wishing to leave their jobs before the end of their contract. More than half of these clauses were over £3,000, with one as high as £25,000. One in five raised issues about pay, with many saying they were paid less than their contracted hourly wage.
The report also unearthed 35 cases where contracts were changed after a worker started - often to reduce pay or force longer hours. There were 68 cases of severe bullying and harassment, with some involving racist discrimination.
Calls for reform
RCN General Secretary Professor Nicola Ranger said: "Just the week after the Prime Minister laid out his plans for social care in England, this report exposes the scale of grotesque exploitation taking place in the sector."
She added: "One of the major causes is a visa sponsorship system which creates a dangerous power imbalance, allowing unscrupulous employers to use withdrawal of sponsorship as leverage to extort money, alter contracts, reduce pay or bully and harass with impunity."
The RCN called for a new umbrella organisation to administer visas, and for the new Fair Work Agency to monitor how staff are treated. It also said staff should be given 180 days - rather than the current 60 - to find a new employer when they move jobs to eliminate the risk of deportation.
Government response
It is estimated that 30% of staff in the adult care sector are non-British nationals. Prime Minister Andy Burnham has promised an overhaul of the social care system, and in a speech last week praised overseas care workers, saying: "Many people from other countries have been caring for my dad [who has Alzheimer's]. I want those carers to know: we appreciate you, we appreciate what you are doing to support people here."
A government spokesperson said: "This government stands firm on our zero-tolerance approach to labour exploitation and abuse of our immigration system by unscrupulous employers. We are taking action against rogue care providers who have used their sponsor license to exploit workers, and we’ve ended overseas recruitment for care workers after unacceptable levels of abuse and exploitation."
