Today, Prime Minister Boris Johnson has pledged a new ‘NHS visa’ route in a bid to attract more doctors and nurses from abroad to tackle the growing workforce crisis in the sector. However, to what extent is the proposed route ‘new’ and why could it potentially leave NHS staff worse off? This article has been written by Olivia Bridge.
The current rules for international doctors and nurses
The UK immigration system is already points-based. Non-EU international workers are subjected to a set of increasingly stringent rules and criteria – and exorbitant fees.
At the moment, overseas doctors and nurses can come to the UK under a Tier 2 Work Visa. Doctors and other healthcare professionals must meet the £30,000 financial requirement, whereas nurses can benefit from a lower salary threshold. Both, however, are prioritised a place in the event of the Tier 2 cap being reached – a rule which came into effect as it emerged the Home Office turned away 2,500 NHS workers due to the cap. (This cap is supposed to be scrapped entirely after Brexit anyway).
Another key benefit for nurses, paramedics, medical practitioners and medical radiographers specifically is that they all feature on the UK Shortage Occupation List (SOL). When a job is listed as in shortage, it grants applicants with a visa discount while making life easier for employers who can recruit directly from abroad.
“This policy is full of holes, with nothing to say about the nurses earning below their income threshold, as well as all the cooks, cleaners, hospital porters and others who are vital to hospitals”Diane Abbott
Being on the SOL marginally reduces visa fees. This means that, while a Tier 2 doctor could expect to pay £1,220 to £1,408 for their visa alone, a Tier 2 nurse would only need to pay £928. To bring a child or dependent over, Tier 2 workers would normally pay £1,220 per person while an SOL Tier 2 applicant would pay £928 each. There are no discounts for second and additional children.
However, these fees are before ‘behind the scenes’ charges even come into play. There are lawyer fees, the English language test, registering biometric information and the largely controversial Immigration Health Surcharge that all non-EU migrants must cough up for in order to enter and work in the UK.
The health surcharge has been in constant dispute in recent years, especially since it doubled last January. Healthcare bodies and organisations argue that the £2,000 five-year and upfront fee is not only unfair for international doctors and nurses who keep the NHS afloat but acts as a deterrent and barrier to recruiting talent.
By contrast, European workers under Free Movement do not need to meet or pay for any of the above requirements – until 2021 when the skills-based immigration rules come into effect and apply to all EU entrants.
The ‘NHS Visa’
The only emerging benefit that jumps out from the ‘NHS visa’ is that the Home Office plan on axing the fees even lower than the SOL. It will reduce it from £928 to £464 for all healthcare workers. Presumably, one would hope, this courtesy is also extended to children and other dependents – or it definitely should be.
The NHS visa doesn’t really scream encouragement. While the new route relaxes the rules slightly for international NHS workers, it piles on the pounds and paperwork for European doctors and nurses.
NHS workers will also receive preferential treatment with extra points granted to score in the points-based-system. This rule isn’t so new since, as we can see above, nurses already receive preferential treatment by having their roles on the SOL. However, at least this commitment will now be extended to doctors.
However, rather than scrap the Immigration Health Surcharge (which didn’t even exist until 2015 – and was then unnecessarily doubled in January 2019), the Tories will now deduct the £400 per year fee from their wages. NHS trusts will still need to pay the £1,000 immigration skills charge for every new recruit – which will evidently hike significantly when this also applies for every new European recruit.
Although the skills-based immigration plan comes into effect in 2021 – burdening EU entrants with the stringent rules and fees – the Conservatives pledge to bring the NHS route in even earlier. This suggests it is not part of the new plan at all, but an amended discount on the current Tier 2 rules.
The NHS visa doesn’t really scream encouragement. While the new route relaxes the rules slightly for international NHS workers, it piles on the pounds and paperwork for European doctors and nurses who still have frictionless – and free – mobility within the remaining EU members states.
Christine Jardine, Liberal Democrat Home Affairs spokeswoman said the NHS visa is essentially an imposed “nurse tax” on EU staff:
“The Conservatives have effectively created a new nurse tax. It is an insult to the thousands of people who dedicate their lives coming to work for our health service from the EU.”Christine Jardine
Diane Abbott, Shadow Home Secretary said the Tories “use dog whistle anti-migrant rhetoric but are forced to accept we need migrant workers for key sectors, not just the NHS, but many more besides”.
“This policy is full of holes, with nothing to say about the nurses earning below their income threshold, as well as all the cooks, cleaners, hospital porters and others who are vital to hospitals, and nothing at all about their right to bring family members here.”
Current Home Secretary, Priti Patel, said:
“These measures are part of our plan for an Australian-style points-based immigration system that allows us to control numbers while remaining open to vital professions like nurses.
“That means the best of both worlds – attracting talent from around the world so our NHS continues to provide brilliant service while ensuring that it isn’t put under strain by opening Britain’s borders to the entire world.”