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Nursing immigration policies ‘clearly need a rethink’ – Stevens

Simon Stevens, NHS England’s chief executive, urged the government to “rethink” its new policies on immigration, which will see thousands of lower-earning nurses deported.

Speaking at the Institute of Directors annual convention in London, Stevens said: “Understandably we’re having a national discussion about how to get immigration right.

“My responsibility is to point out that, at a time when the need for nurses is growing, when publicly funded UK nurse training places will take several years to expand, and when agency staff costs are driving hospital overspends right now, we need to better ‘join up the dots’ on immigration policy and the NHS.”

The immigration rules define an earning threshold of £35,000, meaning non-EEA workers who are learning less than that after six years in the UK will have to leave the country. The EEA – the European Economic Area – covers the 28 EU member states plus Iceland, Norway and Liechtenstein.

In June, the Royal College of Nursing (RCN) had warned that the rules would intensify the “severe shortage of nurses”, with figures showing that up to 3,365 foreign nurses currently working in the UK would potentially be affected.

At the convention yesterday (6 October), Stevens said: “Most nurses I speak to struggle to understand why our immigration rules define ballet dancers as a shortage occupation, but not nursing.

“And most hospitals tell me the idea that we would seriously consider deporting some of our most experienced and committed nurses solely because they’re not earning £35,000 clearly needs a rethink.”

The RCN backed Stevens’ comment, pointing to how there now is a “consensus across the health service that the Home Office must make a change”.

Janet Davies, the RCN’s chief executive and general secretary, said: “It is an irrefutable fact that rising demand for healthcare, a shortage of home-grown nurses, and new rules limiting the use of agency staff mean the NHS is reliant on overseas recruitment to provide safe patient care.

“It is illogical for nursing not to be considered a shortage occupation when there is understaffing on wards and in care homes across the country.

“Healthcare providers are telling the government that they need these rules to change if they are to provide safe care. Ignoring this issue any longer would be irresponsible, illogical and bad for patients.”

NHS Employers also welcomed Stevens’ “important intervention in highlighting the value of migrant nurses and doctors in the NHS who have contributed a significant amount to the way we deliver care”.

Its chief executive, Danny Mortimer, said: “NHS Employers has written to the home secretary Theresa May to highlight that many NHS trusts are facing a shortage of nurses going into winter as the Home Office refuses to grant visas to nurses from outside the EU. We have also written to the Home Office Migration Advisory Committee calling on nurses to be added to the shortage occupation list.

“We know there are plans to train more nurses in the UK but it takes four years to deliver the training so we will not see the benefit until 2017. We need to ensure that there is sufficient staffing to deliver good patient care in hospitals across the country.”

NHS Employers added that all NHS organisations are finding it “difficult” to secure a certificate of sponsorship that allows nurses and junior doctors already working in the state system to get a visa.

“Applications are being rejected because the system is weighted towards points for the guaranteed salary an individual will earn. A shortage occupation list is recognised by the government, which bypasses the application (Tier 2) system. Nursing is not presently placed on this list,” it added.

If a job is on the shortage occupation list, an employer can offer the post to any overseas person without fulfilling the Resident Labour Market Test. In June, for example, the Migration Advisory Committee recommended that paramedics should be added to the list for the first time in order to allow positions to be filled “sensibly” with foreign labour.

But a Home Office spokeswoman said that trusts have been given more than 1,400 tier 2 certificates of sponsorship for nurses since April this year, but “over 600 of the places allocated to them in April and May this year have been returned unused”.

She added: “The Independent Migration Advisory Committee, which took evidence from a number of NHS trusts and representative bodies from across the UK, recommended against adding nurses to the shortage occupation list earlier this year.

“We will continue to monitor Tier 2 take-up, but have no plans to change the level of the annual limit of 20,700 places.”

(Top image c. Joe Giddens, PA Wire)