Government plans to make it harder for migrant workers to settle permanently in Britain risk a staffing crunch in care homes for elderly people, where one employee in three is from overseas.Proposed reforms would make care workers wait 15 years to qualify for permanent residency. Many are now debating whether to leave the country, including some who had believed they were close to securing “indefinite leave to remain” (ILR) under the current five-year rule.Prime Minister Keir Starmer’s government is taking steps to address voter concerns by reducing migration to Britain, where tough talk on immigration has helped Nigel Farage’s populist Reform UK party top opinion polls for over a year.Care sector employers and some economists say a 15-year wait for ILR would make Britain less attractive than countries like Australia or Canada, where foreign carers can secure residency after two or three years.But the government says settling hundreds of thousands of workers who moved to Britain in recent years to fill vacancies in the health and care sector would cost too much and weigh on public finances. ILR removes visa renewal fees and confers access to welfare benefits.Indian national Kuldeep Singh runs a care home in southern England. Nearly two-thirds of his staff, who provide meals and personal care to elderly and vulnerable residents, were born abroad.After starting work in the sector in 2023, Singh had expected to be eligible for ILR in 2028 but may now have to wait until 2038. He has put a house purchase on hold and says he could easily move to another country if needed.“Health and care jobs are always in shortage in every country,” Singh said. “I know it is hard to start from the beginning in a different country, but how many people are going to wait for 15 years?”Relying on local workers to fill shortages not viableBetween 2022 and 2024, around 616,000 workers and their dependants moved to Britain on a specific visa for care workers, nurses and doctors. Around 384,000 are expected to become eligible for ILR between 2027 and 2029.Alarmed by rising numbers and what it describes as widespread fraud in the care visa system, the government has tightened rules on overseas recruitment, while still allowing care providers to hire visa holders already in the UK.Rules are also being tightened in other sectors, with a 10-year ILR timeline and proficient English requirement, but the longest proposed wait among workers is in care.According to the left-leaning IPPR think tank, at least 1.35 million people could be affected across the immigration system, including migrants on skilled worker visas who as a group are net contributors to the economy.Without the longer timelines, the interior ministry says around 350,000 workers categorised as low-skilled, and their dependants, would cost about 10 billion pounds ($13.6 billion) in public services and benefits, including pensions, over their lifetimes.However, Jonathan Portes, professor of economics and public policy at King’s College London, said the estimate was “at best deliberately misleading”, as the rule change would not save that amount unless “every single person” modelled in the projection left the country.Britain’s interior ministry did not respond to requests from Reuters for comment.International workers have long filled a staffing gap in the care sector, where salaries of 20,000 to 25,000 pounds a year are well below 2025’s median full-time UK salary of 39,000 pounds. But Singh says those terms can be attractive to foreign workers when the job comes with visa sponsorship that enables them to move to Britain.He says many British workers see little chance of progression in the sector and consider the pay too low, so pursue alternative employment.Migration rules in care may impact other sectorsJob vacancies in the sector already stand at nearly three times the national average – a problem that can affect the running of the National Health Service when it cannot discharge patients into care homes, and a major challenge for Britain’s ageing population.Tushar Shah, who runs six care homes, said some staff were considering leaving while Haris Khan, who runs four care homes, reported a “visible drop” in UK-based international applicants since the government set out its plans.Care home operators said the exclusion of nurses from the longer ILR requirement following warnings of staff shortages could lead some staff with nursing qualifications to leave care jobs.Portes said the clampdown on care workers would send a signal to foreign staff in higher-paid sectors too.“This will have a damaging impact on our ability to attract the brightest and the best,” he said.Some in Starmer’s centre-left Labour Party are also unhappy.Lawmaker Neil Duncan-Jordan told Reuters the retrospective change would be “grossly unfair” while Starmer’s former deputy Angela Rayner branded it “un-British”.The government says it must get a grip on migration and that restricting foreign labour would force care homes to pay higher wages to attract local staff. But that could in turn push up the cost of care homes for private patients and local councils which subsidise fees.Among Singh’s concerns is what any change would mean for his family, including his daughter once she is no longer under 18 and a dependant. He is also aware that Reform’s Farage has pledged to prevent migrants getting permanent residency – and benefits – completely.“This is a slow bleed,” Khan said.