Jonathan Portes argues that the government has flipped from treating migrant care workers as a problem to presenting them as a necessity, but needs to take action to improve their pay and conditions.

The Home Office has identified a new problem with migrant care workers. Having spent months warning that they cost too much, it now fears that giving them more freedom would deprive us of their labour. The people presented as a burden on Britain because they earn too little have become so indispensable that they must be prevented from finding a better or higher-paid job.

According to the Times, the Home Office is resisting an exemption for care workers from proposals that would extend their route to permanent residence from five years to fifteen. The concern is that, once they obtain settlement, they can take work outside the sector. Mahmood’s immigration minister, Jo White, set out the argument at Labour’s conference: “I don’t want us to get into that spiral where people move out of the care sector because they’ve got leave to remain.”

In other words, people recruited legally to look after our parents and grandparents, with a route to settlement after five years, would face another decade of immigration restrictions partly because ministers fear they might otherwise exercise the choices available to British workers to improve their jobs, their careers and their lives.

The principle here is to prolong insecurity in order to ensure continued service, rather than make care a sector in which people choose to stay. Indentured labour is a historical analogy, while the Gulf “kefala” model – essentially, semi-permanent guest workers, with few rights legally and almost none in practice – is a contemporary one.

This is quite a journey from the case Mahmood originally made. In the foreword to her original consultation, she singled out lower-paid health and care migrants with dependants as likely to impose “significant fiscal costs”. In March, she warned of a £10bn drain on the public finances without her changes. The claim was that these workers and their families were an economic liability, with settlement the moment at which taxpayers would be landed with the bill.

That argument was deeply misleading. Data I obtained from the Migration Advisory Committee (MAC) showed that care workers and their adult dependants make positive net fiscal contributions for decades after arrival; their departure in the coming years risks making the Chancellor’s fiscal arithmetic worse, not better. Their estimated lifetime costs are heavily influenced by expenditure in old age.

The MAC data does show that some essential workers can indeed earn too little to make a positive lifetime fiscal contribution. In the case of care workers, that largely reflects – as the Prime Minister has recognised – the inadequate funding and low pay of social care.

The wider figures give some perspective. The MAC estimates that the 2022–23 cohort arriving on skilled-worker visas, including health and care workers and their dependants, will make a net lifetime fiscal contribution of about £47bn. That calculation allows for their use of public services as well as the taxes they pay. Contributions vary substantially between groups, but the overall picture is a long way from the suggestion that work migration simply leaves British taxpayers with an unpaid bill.

The political case raises a different problem. Mahmood linked the scale of recent migration to a country becoming more divided and dangerous for people of migrant descent, invoking her own family: “those who look like me do not have that luxury”. So people who had come here legally to do essential work were made part of an explanation for why others might turn towards racism.

Her department’s latest case pulls in the opposite direction. The Home Office is not wrong about the scale of the contribution made by care workers. Skills for Care’s latest report puts non-British nationals at a third of England’s adult social care workforce. About 150,000 direct-care posts in regulated independent-sector services were filled by health and care worker visa holders in March 2026. There were still 96,000 vacant posts across adult social care. Migrant workers are helping sustain a service that would otherwise leave more people without the support they need.

So, the Home Office now concedes, these people must stay, because the care system depends on them. But the remedy for the social tensions supposedly caused by migration is to prolong migrants’ presence while denying them the security that would help them become full members of society. It is unclear, however, why keeping someone in limbo for fifteen years is supposed to promote integration. Still less, of course, does it reduce the pace of change that has already happened.

When the people concerned are being told that their contribution is insufficient to deserve settlement, yet apparently too important to allow them to leave their occupation, the contradiction becomes clear. They have earned our dependence on their work, but somehow still have not earned the right to decide what work they do.

More broadly, restricting labour mobility is bad for growth and tax revenues. A care worker who moves to a better-paid job may pay more tax, use skills that were previously underused and help fill a shortage elsewhere. Losing that worker creates a problem for their care provider, but preventing the move also has a cost. A government committed to growth should understand that.

Nor is the economic contribution of care confined to the taxes paid by those providing it. Looking after an older or disabled person may enable their partner or adult child to stay in work. Care workers also support hospital discharge and help people live independently. These benefits are poorly captured by treating a worker’s wages as a measure of their value to the country.

There is a straightforward alternative. Fund care properly, improve pay and conditions, and make it a sector in which people want to build a career. Skills for Care reports that the number of posts in England’s care sector filled by British nationals fell by 40,000 over the past year, and by 130,000 since 2020–21. That ought to concentrate ministers’ minds on the attractiveness of the jobs, rather than ways of extending restrictions on overseas workers’ choices.

The latest defense of these proposals makes a mockery of the original case for them. Care workers should not be made to pay the price.

By Professor Jonathan Portes, Professor of Economics and Public Policy, Department of Political Economy, King’s College London.