IWD: The migrant women of our healthcare system

28 February 2018

As the UK debates immigration, Brexit and the NHS’s workforce crisis, we should educate ourselves on the situation of migrant women moving across the world to fix our ‘care deficit’.

With acute staff shortages in the NHS and in social care, the UK has become increasingly reliant on migrant workers to fill the roles in this sector. This has been met in some quarters with anti-immigration rhetoric and accusations that it is the increase in immigrants accessing UK care services which has caused the pressure in the first place.

What has not been the media’s focus is the vital role played by female care workers travelling across the world to work in the care systems of more developed countries and the barriers they face when it comes to accessing their own health care.

The global reliance on female care workers

Towards the end of 2017, the World Health Organization commissioned a report on the paradox of female migrants making a considerable contribution to healthcare in many countries but at the same time seeing their own healthcare and wellbeing needs go unfulfilled. As populations are living longer and care systems feel the strain, many countries find that they are struggling to meet the demands. This has led to a so-called ‘care deficit’ worldwide and the consequent trend of more developed countries relying on migrant workers, usually from developing countries whose own care systems require advancement.

The care industry is feminized and it is still the case that a vast majority of care workers are women. The UK follows this pattern, with analysis showing that women dominate the industry while men continue to express the view that it is a less traditional role for them and they would not necessarily consciously plan to enter the industry. The stereotyping of caring work as women’s work is in itself a problem that continues to exist in 2018.

With care work positions available abroad and the global stereotyping of women being the gender ‘more suited’ to caring for the elderly, children and infirmed, women are leaving behind their families and personal care obligations back home to help support systems like our NHS. In a country like the UK where care work is frequently underpaid, and subject to long hours working in a high pressure environment, these workers’ own health should not be neglected. Unfortunately the UK is no exception to the paradox of migrant women being relied upon while their own healthcare and wellbeing appear second-class to our own standards.

Underpaid, undervalued and unwelcome

For female migrant workers, the hard working conditions of care work are often coupled with the intense mental strain resulting from anti-immigration attitudes. Over 90,000 EEA nationals work in the UK care industry and many have shared examples of where racism has caused damage to their mental health and put pressure on them to leave the country. Many of them have expressed that they no longer feel safe in the UK.

With increased reported findings of racial assaults on healthcare staff since the referendum, where the NHS recorded incidents doubling in number in 2016 alone, it is essential that we challenge this wholly unacceptable behaviour.  The widespread nature of this issue demonstrates that the UK has a serious problem of migrant women being discriminated against and the increased incidents of racial abuse suggest that individuals are able to discriminate with a level of impunity.  

Undocumented women and vulnerable care workers

Across the world, the high demand for care workers is not necessarily reflected in the number of visas available for the women who make the journey. Consequently, many women enter countries like the UK as undocumented migrants or they become undocumented once they overstay on a visa in order to undertake care work. Due to the vulnerability of these women with their undocumented status, they will not necessarily find fair working conditions.

Undocumented migrant women undertaking domestic work can suffer physically and mentally at the hand of their employer and are too fearful to seek support due to their immigration status. Domestic workers with the appropriate visa also can see their health and wellbeing be neglected. Kalayaan, the UK’s leading organisation for domestic workers presented data that showed 85% of domestic workers under the current domestic worker visa scheme reported psychological abuse.  Domestic workers with or without visas can be subjected to slave-like conditions and in 2018, modern slavery in care work is not limited to private households. As social care providers struggle to recruit in the UK, the forced labour and human trafficking of migrants has now been found to take place in the industry

Instead of protecting the healthcare rights of women found in vulnerable situations, the government has instead cracked down on healthcare access for undocumented migrants. The Home Office can now access NHS patient details and consequently many women are afraid to access healthcare services. This data sharing between the Home Office and NHS is coupled with the introduction of requiring the NHS to charge migrants upfront for their care. Doctors of the World found that as a direct result of this change, pregnant migrant women in the most vulnerable circumstances are only accessing services at a very late stage, risking the health of both mother and child. While victims of trafficking are meant to be able to access the NHS for free, many trafficked women come into contact with the NHS before they have escaped their situation and without the victim being identified formally, they will be subjected to these upfront costs.

Let’s #PressforProgress

When women are travelling across the world to support the care services that we need and will inevitably access at some point in our lives, we cannot ignore their healthcare rights as we benefit from their migration. Discrimination should be challenged and healthcare should be accessible. As we wonder what Brexit will look like and whether the NHS will survive, we must #PressforProgress for those who came here to care and must wonder whether the UK really cares about them.


IWD is an opportunity to build on the progress that has been made towards gender parity and to celebrate the achievements of women on a global scale. This year, #PressforProgress.

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