Most care workers will be excluded from a new fast-track post Brexit visa scheme for health workers despite fears of staff shortages in the sector, the government has announced.
Boris Johnson denied that care homes, which have been badly hit by the coronavirus crisis, would struggle to recruit enough workers under the new system.
But the Royal College of Nursing said the plans fell short of what was required and would directly affect patient care.
Senior care workers, such as team leaders, will be eligible for the new visa, but most will not.
The prime minister said the new immigration system would be "humane and sensible".
Asked if he thought there would be enough people coming in to work in the social care system, he said: "I do.”
He pointed to the number of EU national living in the UK, adding: "We're seeing huge numbers of people registering for their right to remain and that's great so we have a big, big stock of workers who are helping out in this country who have come from abroad.”
No 10 said ministers wanted employers to invest more in training for care workers in the UK.
The prime minister’s official spokesman said: “Our independent migration advisers have said that immigration is not the sole answer here, which is why we have provided councils with an additional £1.5 billion for social care in 2021/22 as well as launching a new recruitment campaign.”
In an apparent attempt to allay fears over the number of NHS staff affected, ministers also announced that healthcare workers coming to the UK from abroad would receive visa decisions within just three weeks, thanks to biometric technology.
Under the new rules those who want to live and work in the UK will need to gain 70 points to be eligible to apply for a visa.
Points will be awarded for requirements including the ability to speak English, a job offer from an approved employer and a minimum salary threshold.
As well as a separate health and care visa there will also be a graduate route that will allow international students to stay in the UK for at least two years after completing their course.
Under the new rules foreign criminals sentenced to more than a year in jail could also be banned from entering Britain.
The reform would mean EU criminals are treated the same as those from non-EU countries.
Under the current system convicted criminals from the bloc can only be excluded on a case-by-case basis.
Under the plans, those seeking to come to the UK can also be refused entry if they have committed an offence which caused serious harm, are a persistent offender or if their character or associations means their presence is not believed to be conducive to the public good.
Dame Donna Kinnair, the general secretary of the Royal College of Nursing, said: “Once again, we are disappointed to see the Government’s plans for the UK’s future immigration system falling short of what is required to meet the workforce needs of the health and social care sectors, now and in the future.
“The Government is ignoring our concern that we need an appropriate immigration route for social care workers. Arbitrary salary thresholds will prevent key workers from working in the UK, which will directly impact patient care.
“The pandemic has revealed how reliant the NHS is on good social care and vice versa – they cannot be viewed as separate services. The care system has been heavily reliant on international staff, and the proposals continue to ignore the significant risk to this sector, and therefore the entire health and care system across the UK.”
Chief executive of the Joint Council for the Welfare of Immigrants (JCWI) Satbir Singh said: "We've gone from clapping for our key workers to calling them low-skilled in a few short weeks."
Assistant general secretary of the Unison trade union Christina McAnea said the sector was already “desperately short of staff and heavily reliant on the skills of overseas workers. Recruitment will now become even harder."
Rehana Azam, national secretary of the GMB union accused the government of an “embarrassing shambles”.
Martin Green, chief executive of Care England, said social care workers were again being treated as “second class citizens”.
Mayor of London Sadiq Khan said he feared the new points-based immigration system, designed to cut the number of low-skilled migrants entering Britain from January, could damage the capital's economic recovery, causing difficulties for sectors including social care.
"Undermining these sectors will make it even harder to look after our elderly relatives and resolve the ongoing pressures within our NHS and social care system," he said.