British care industry using foreign students as cheap labour

Unemployment stands at close to 2.5 million in the UK, but the care industry is still failing to attract the necessary workforce because of the harsh working conditions in the sector. Employers in privately run nursing homes, care homes, and care agencies are more and more dependent on students from the National Vocational Qualification (NVQ) in Health and Social Care as their main source of cheap, skilled and flexible labour.


Many employers recruit NVQ students directly from recruitment agencies and colleges and do not advertise vacancies. In this way they can avoid employing better-qualified and established workers who would have more rights. Employers are also using this to avoid paying higher wages to foreign workers with work permits or holding Tier 2 certificates (shortage occupations) under the Home Office’s new Points-Based System of work-related immigration. Even with this paperwork the wages are low enough. Employers would have to pay £7.80 per hour for a Senior Care Assistant, according to Home Office regulations. NVQ students working in the same capacity earn only £6 or less per hour from most employers.

Around 1,500 institutions, including universities, colleges and schools, bring thousands of nurses and allied professionals from poverty-stricken countries like Nigeria, the Philippines, India, Pakistan and Sri Lanka to study an NVQ in Social and Health Care. They are a small fraction of the students brought into the UK. Most choose to come as NVQ students simply because it offers an opportunity to earn some money, even though it is often far below the qualifications they already hold. Some think that it might be possible to obtain registration on the Nursing and Midwifery Council (NMC) and become nurses.

Recruitment agencies and colleges do not have any concern about the fate of the students once their work placements are provided.

Under enormous pressure from their employers, students are compelled to do whatever they are told, even though they have been recruited as care assistants. A number of students from the south coast have spoken to the World Socialist Web Site about the ruthless exploitation they face in the UK care industry. To avoid reprisals from their employers, most of the students wished to remain anonymous.

An NVQ student from the Philippines who works in a care home told the WSWS: “I worked as a physiotherapist in my country. I work as a care assistant here while studying for NVQ in Social and Health Care. My current placement is not bad compared to what I had four months ago. That was an awful experience of more than one year. There were 27 residents with dementia and only two carers worked during the night and three carers during the day. There was no time to change the pads of the incontinent residents, but I had to do an awful lot of ironing, folding clothes, cleaning, hoovering, and sometimes painting the walls during the night.”

He was paid £6 per hour, but explained, “Sometimes we had to work without pay when there was a party or other event. Every so often we ended the shift hours late although we were paid only for the shift. Manager and the proprietor considered us as slaves.”

Another NVQ student who works in a residential care home said, “I have worked as a nurse in both the Philippines and Saudi Arabia and this is the worst experience as a worker. Residents and students are both being abused and exploited for the profit requirements of the owner. Although there should be one carer to look after four residents with dementia, we have to look after nine with a terrible amount of other work, including doing daily laundry and bed making.”

She described the desperate financial situation she faces. “I paid $2,300 for the school before I came here,” she said, “and spent lots more for visa processing and other things. My air ticket cost me $1,100. I earn only £6 an hour here. I have to pay £150 a month for my college for another 32 months. It is difficult to save even £200 to send back home for my family’s expenses.”

A highly experienced Sri Lankan nurse who came to the UK as an NVQ student at a school in North London said, “It has been nearly two months since I came to the UK. I have applied for so many jobs in nursing and care homes as my work placement. I haven’t been able to find one yet. That is not what the College told us before we were brought here. We have got to do any work for survival. Some of our Filipino girls do cleaning in the college. Some distribute cards and leaflets for £3 an hour and walk 10-12 hours since early morning while workers already employed in the job get £5 an hour. I did not think earlier that there exists such shocking exploitation in the UK. Minimum wage and other labour laws are only limited to the books.”

Students without work placements are often lodged with people associated with the college, and are charged twice the going rate for London accommodation, he said.

“Some share one room with four or five people. One Nigerian male nurse who has come as an NVQ student like us does not even have a proper place to sleep and to keep his belongings. He sleeps in a small space near the kitchen.”

The situation is not much better for students with work placements: “A Filipino who has already got a work placement in Nottingham receives only £5.80 an hour.”

“The other students’ fate is no different. I know one boy who came from Sri Lanka to study a different degree. He works in chicken shops owned by someone originally from Sri Lanka. They are facing intolerable working conditions too and get even less than the minimum wage in UK. This employer gets work from the students without paying a penny for one week, and then fires them saying their work is not good. The workers in these shops do not get a proper break for their meals and they are nagged by asking why they are eating while the shop is busy.”

Another NVQ student described her experience. She works for a care agency in south London. “I expected a better life when I left my job as a nurse in Sri Lanka,” she said. “I did not come here simply to study for an NVQ, but to earn money. I have borrowed a lot of money to pay for the college and now I pay only the interest on the loan.”

“I start at 6 a.m. and come back around midnight. I work six days per week to earn just more than £1,000 a month. To work half an hour to one hour I sometimes travel by bus for one to two hours. Carers are not paid for the travelling time. Although I am at work or on the road for nearly 17 hours I am paid only for working time. I sometimes walk miles to get to my clients.

“Working on Sunday is difficult as some routes have limited transport services. Some days I walk more than 10-12 miles and spend all my day on the road. I cry sometimes because of fear, tiredness and when I feel sorry for myself. I go to college on my off day.

“Although we are paid meagre salaries I know that the agency earns a lot at our expense. We work in very stressful conditions. They only give us a bus pass. There is no job security for anyone who works here. The managing director takes all the decisions about our jobs.”

Mohamed Sali said, “I finished my NVQ studies, and I now do NQF [National Qualifications Framework], paying double the money. I worked in Poole, Dorset more than one year. We were treated very badly by my previous employer. We got the national minimum wage and had to do everything, though most of [the things we did] were not in the job description. I had to look after more than 20 residents—most depended upon staff to meet their activities of daily living—with one more carer during nights. It was so difficult, with an awful lot of other domestic work.”


A care assistant working in North London said, “I receive £6.50 an hour and work under terrible conditions. Two of us have to look after 21 residents with other domestic work. Early morning we have to wash and dress nearly 14 residents. We have two students working with us and they get only £5.80 an hour.”