Nuffield Trust response to new UK points-based immigration system

John Appleby responds to the announcement today of a new migration system for the UK from the end of this year.

Press release

Published: 19/02/2020

Responding to the Home Secretary’s announcement today of a new migration system from the end of this year [1], Nuffield Trust Chief Economist John Appleby said:

“Migration has been a crucial safety valve for crisis-stricken social care services, with workers from overseas filling vital roles helping people with basic tasks like washing, dressing and personal hygiene. Stopping migration for social care risks pushing a sector on which many vulnerable people depend over the edge.

“Our own analysis shows that to actually provide help to everyone who needs it, as the Prime Minister has promised, we will need 90,000 more workers [2]. Yet at the moment we have rising vacancies, even with rising numbers of European migrant staff [3]. It’s no coincidence that Australia and other countries with points-based migration systems have found they need to make special exemptions for care workers. [4]

“Increasing the wages of social care workers to make social care a more attractive career for domestic workers could be one answer. But with the sector on the verge of bankruptcy, this is a non-starter unless the government stumps up extra funding way beyond the extra annual £1 billion already pledged for this parliament. And this would need to be on top of money to reform or expand the help people are offered.”


  1. The new proposals can be seen in full here. Jobs which bring new migrants into the country are required to be at a “medium skill level”, and generally pay more than £20,480, ruling out migration for most social care roles.
  2. Our briefing “Social Care: the Action We Need” last year calculated that 90,000 extra home care workers would be needed just to give two hours of care a day to people over 65 who currently need help but go without it.
  3. Rising vacancies, and increasing reliance to date on staff from the European Economic Area, are shown in Skills for Care’s State of the Adult Social Care Sector report.
  4. Our recent article on lessons for social care migration from overseas shows that many countries with points based systems often discussed as a model for the UK have in fact had to make some kind of special allowance for social care and similar sectors.
  5. The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  6. For any queries or to arrange an interview, please contact Mark Dayan 0207 462 0538 / or Leonora Merry 0207 462 0528 /