02.08.15
Unrealistic and wasteful reforms will kick trained nurses out of the UK
Source: NHE Jul/Aug 15
Tijen Ahmet, immigration solicitor at SA Law, discusses a coming deadline that could force more than 3,000 nurses to leave the country.
The Royal College of Nursing (RCN) has warned that the NHS is on the road to chaos, as a salary threshold for all tier 2 (general) migrants applying for settlement introduced in 2011 starts to be felt in 2017. New research from the body has calculated that 3,365 nurses currently working in the UK will be hit by the measures.
The changes are intended to reduce the demand for migrant labour and will likely hit the NHS hardest, as the threshold is set at £35,000 gross per annum. This figure is significantly higher than the average wage of nurses, who earn – at entry level – between £21,000 and £28,000, meaning many will have to face up to the prospect of leaving the UK.
Tier 2 migrants are skilled workers from outside the European Economic Area sponsored by UK businesses and organisations for their continued employment in the country. This tier of workers can apply for settlement (indefinite leave to remain in the UK) once they have reached five continuous years in the country. If they do not take this option up, they would have to leave the UK before or upon completion of their sixth year. These changes landed in 2011, prior to which the ability to apply for settlement in the UK was dictated primarily by the amount of time the individual had spent in the country.
The salary threshold for applying for settlement will remain in place for two years from April 2016, reaching £35,800 in April 2016 and then £36,200 in April 2020. There are exceptions – workers in jobs that appear (or have appeared) on the list of PhD-level occupation codes or published shortage occupation list are not subject to the new regime. However, the Migration Advisory Committee omitted nursing from the 2015 shortage occupation list (which does include such jobs as engineers, game designers, skilled classical ballet dancers and orchestral musicians).
The government does accept that skilled migrants are needed to work at levels below £35,000. However, the threshold put forward is too unrealistic considering the national average wage stands at £26,500. In some ways it is a wasted investment, after employers have trained workers, who have in turn paid their taxes and adapted to life in the UK. Indeed, the RCN estimates that it will have cost the NHS £20.19m, now effectively wasted, to recruit the 3,365 nurses working in the UK affected by the proposals.
The RCN has emphasised that employers are increasingly turning to overseas recruitment and temporary staff due to cuts to nurse training places. The body is focused on maintaining safe staffing levels at a time when demand for the NHS and other care services is escalating. It remains to be seen whether their concerns will be heard and measures put in place to mitigate the negative impact of the reforms, though home secretary Theresa May and prime minister David Cameron are yet to respond directly.
The move comes as the government presses on with plans to create a seven day a week NHS in England. A seven-day schedule would call upon nurses in the most senior roles – for example, ward sisters and nurse consultants leading teams. However, the groundwork of recruitment and training to widen the talent pool and help junior nurses move up the ranks should take place now. The introduction of a migrant salary threshold would no doubt dissuade foreign nurses from seeking work in the UK, which could potentially cause labour shortages in the NHS further down the tracks. The government has promised extra funds to train-up future leaders and has also pledged to recruit 5,000 new GPs and 5,000 support staff (a figure which includes practice nurses), though it is uncertain how day-to-day hospital operations will be affected.
One option for institutions could be to turn their focus to the European Economic Area; trained nurses can still be sourced from within the Area, where recruitment is not restricted. Individual nurses may be able to seek an alternative visa – applying to remain in the UK with family (a spouse visa), or studying through a student visa.
There may also be scope for administrative errors, including a miscalculation of earnings, which could represent grounds with which to challenge the Home Office’s decision. Further down the line, individuals could be able to seek judicial review, studying the legality of a particular decision.
In any case, institutions need to look at their employment strategies now and implement measures over the coming months and years to retain talented nurses.