International experience holds compelling lessons and points to important risks.
Australia is grappling with the consequences of an aging population. The government last month put forward a $4.3 billion home care package, which, from July 2025, will support hundreds of thousands of Australians with home-based care, whether nursing, occupational therapy, or support with everyday living.
A significant proportion of the workers who will deliver this care are migrant workers, who currently comprise about 40% of the aged care workforce, many on temporary visas. And there are not enough.
Despite raising wages up to 28.5% across the sector, Australia’s workforce shortage in aged care will probably still reach 110,000 by 2030 according to some estimates. Migration will have to play a central role, something that the government appears to have recognised in proposing a new “Essential Skills” visa pathway (focusing on aged care and disability workers).
But Australia is also competing with other developed countries when it comes to safe migration of low-wage care workers in this sector. Their experience holds important lessons.
Historically, many care workers, particularly aged care workers, were considered “low skilled” and excluded from temporary labour migration programs in OECD countries.
An exception, in Canada, was the Live-In Careworker scheme introduced in 1992 but mired in accusations of worker exploitation and discontinued in 2014.
In most other countries, the sector attracted numerous low-wage migrant workers through back doors, employing workers already in the country whether refugees, migrant spouses or even international students, and often informally.
However, since the pandemic and rapid demographic changes, OECD countries are increasingly toying with dedicated migration channels for such workers.
In 2022, the UK added low-wage care workers to the shortage occupation list, granting them the ability to apply for a visa up to five years that could lead to permanent residence. The number of applications sky-rocketed, however, it was not long before media and UN investigations began to expose severe exploitation of care workers, including instances of wage underpayment, debt bondage, and sexual and physical harassment.
A damning report by the UK immigration watchdog, found that the Home Office protections on the scheme were “totally inadequate”.
Countries including Italy have announced plans to recruit more care workers (10,000 workers in 2025), but are looking warily at the UK experience. Other OECD countries have taken a more heavily regulated approach. In 2019, the Canadian government launched pilot schemes which allowed migrants to be issued an “occupation-restricted open work permit” to work in the sector. Capped at 1650 applications, increasing to 2750 per year, it nonetheless faced major issues including the major delays to transition workers to permanent residence despite their eligibility.
Japan, while often seen as having a very restrictive migration system, has also recognised aged care as a shortage sector, launching a new visa category in 2019 that covers 14 industries including nursing and aged care.
Migrant workers, recruited largely from southeast Asia, can stay up to five years, with the right to change employers and an opportunity to transition to permanent residency. Employers have a large range of obligations in recruiting and supporting migrant workers, including their integration.
After a slow start, around 27,000 nursing workers had been granted the visa by end of 2023 with discussions underway to open the pathway to home-based care workers.
The Australian government has taken a different route to recruiting migrant workers, in 2023 introducing the Aged Care Industry Labour Agreement and the aged care stream of the Pacific Australia Labour Mobility (PALM) scheme. Over a year into implementation, the take-up by industry has been lower than expected.
There were expectations that the Labour Industry Agreements, signed between industry unions and individual employers and currently numbering around 66 agreements, would result in more than 22,000 aged care migrant workers being sponsored towards permanent residency over five years.
One year in, just 84 migrant workers were recruited from abroad under all the agreements combined (out of a total of 418 visas total, majority already in Australia).
Some in the industry blamed low employer demand due to the perceived role of unions in the agreements. If so, then this is a worrying perception – in reality, unions scarcely have new powers under the agreements that could present a “threat” to employers.
Likewise, employer take-up on the PALM scheme is also slow – there were 1245 aged care PALM workers in Australia, as at 30 July 2024 (just 4% of the overall PALM workers).
Moving away from statistics, what can we say about the actual experience of migrant workers?
Too early to say. On PALM, a recent study of a small number of PALM aged care workers in NSW, found significant labour issues, including long working hours, lack of sick leave, as well as intimidation and threats of deportation by some employers. This is consistent with risks faced by low-wage temporary migrant workers in aged care in the UK, signalling similar challenges to come.
It seems that even if employers are not yet feeling the urgent need to recruit migrant workers from abroad, the tipping point is quickly approaching.
This may cause a rapid take-up of a future “Essential Skills” visa as envisaged in the government’s overhaul of temporary skilled migration and which – in comparison to the Aged Care Labour Industry Agreement and the PALM scheme – might be seen by industry as “low-regulation”.
But, as the UK experience shows, robust regulation is critical for employer-sponsored visas, particularly for low-wage workers, to avoid a power imbalance that results in labour exploitation and even modern slavery.
To avert the UK scenario, it is important that schemes such as the Aged Care Industry Labour Agreement and PALM are reviewed and improved – they are still innovative and important mechanisms for rights-based migration.
Additionally, it is critical that the Australian government ramp up its plans to introduce a national labour hire scheme, provide a stronger role for unions to monitor working conditions and organise workers in the sector, ensure funding for more labour inspectors, and guarantee that workers have full ability to change employers if they wish (something that PALM aged care workers currently don’t have).
It is a delicate balancing act, but one which will ensure that both vulnerable recipients and the workers who support them, have their rights protected.
Sophia Kagan is the Principal Policy Adviser on Labour Migration with the Office of the NSW Anti-slavery Commissioner. She previously worked for 12 years with the International Labour Organisation in China, the Pacific and the Middle East, including as a Chief Technical Adviser of an interregional labour migration program.
This article first appeared in The Interpreter, published by the Lowy Institute. Read the original article here.