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Unions urge Rudd to exempt NHS workers from immigration charge

The government have been urged to make the NHS and wider social care system exempt from paying an immigration charge that could cost the service millions and worsen already depleted staff shortages.

In a joint letter, written by the British Medical Association (BMA) and the Royal College of Nursing (RCN), home secretary Amber Rudd has been asked to drop the immigration skills charge (ISC) for NHS and adult social care workers that would require an upfront charge of £1,000 to be made by employers for each year of an overseas worker’s tier 2 visa. These visas are offered to skilled workers outside the European Economic Area. 

Had the ISC been applied in 2015-16, it would have cost the NHS £3.5m and lead to NHS employers having to pay £2.1m worth of fees for 2,144 tier 2 visa nurses.

The immigration charge, which formed part of the Immigration Act 2016, is set to come into force from April and has been brought in to “reduce demand for migrant labour”, within the UK economy.

But now health unions have hit back at the government’s change by warning about the negative effects the charge could have on NHS finances which are already stretched thin following Phillip Hammond announcing nothing in the way of new funding in the Budget last Wednesday.

Written by BMA council chair Dr Mark Porter and the RCN’s chief executive and general secretary, Janet Davies, the letter stated: “Given the ongoing pressures on both NHS and social care finances, the sustainability of services and the recruitment and retention of staff, we are asking you to exempt the NHS and the wider health and social care system from the ISC.

“It cannot be appropriate to divert funding away from the budget for frontline health services and the training of health professionals in this way.

“While the government has suggested that funds raised from the charge would be reinvested back into the UK workforce and health system, we have been given no guarantees to that effect.”

The letter also warned that with ongoing staff shortages in health and social care, the NHS will look to its overseas workforce in the foreseeable future and should not do anything to discourage employers from recruiting tier 2 visa employees.

They said: “While the secretary of state for health has outlined proposals to expand the supply of UK-trained doctors, the length of time taken to train a senior doctor will mean that the NHS will continue to be reliant upon doctors from the EU and overseas in the short to medium term.”  

It added: “It is simply not possible to up-skill resident workers or put apprenticeships in place for doctors because of the long and rigorous training process involved and additional regulatory requirements.

“Checks and balances are already in place to ensure posts are first offered to UK and EU nationals through the resident labour market test.”

The unions went on to call the policy “unfair” as it penalised health and social care employers for recruiting a doctor or a nurse on a tier 2 visa to fill workforce gaps because a UK or EU national cannot be found to fill the post.

RCN boss Davies added: “The government risks turning off the supply of qualified nurses from around the world at the very moment the health service is in a staffing crisis like never before.

“Forcing this change on NHS and other services will worsen the funding crisis and harm the standard of patient care.”

She concluded: “Until the government begins to train enough nurses here, it should exempt the international workforce that UK health care heavily relies on.”

A government spokesperson said: "This Government is committed to building home-grown skills and wants to encourage employers to do the same. 

"There are already 30,000 students training to be doctors, and more than 52,000 training to be nurses, and the introduction of the Immigration Skills Charge will help encourage employers to invest in training so that UK workers have the right skills to fill jobs." 

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