International nurses: A report Ministers had better read

Internationally educated healthcare staff have been working in the UK health and social care nursing for many decades.  These didn’t arrive here by accident. British Governments (of all political persuasions) have actively encouraged immigration of doctors, nurses, midwives, social care staff and other skilled staff without whom the NHS and social care would collapse.

The introduction of the dedicated Health and Care Worker visa route facilitated the process of recruiting internationally for both the NHS and independent sector with the NHS in England especially reliant on international recruitment to fill workforce gaps.

A new, and rather good, report from the Royal College of Nursing on their experience should be required reading for Ministers. https://tinyurl.com/59m25drr This report explores those challenges using the research findings of an RCN survey of over 3,000 international nursing staff and qualitative insights from 25 in depth interviews.

Just 1 in 3 of those who responded to the survey said they planned to stay in the UK permanently. Two thirds of those who plan to leave intend to go to a country other than their home country, signalling that the UK is fast becoming an unattractive destination for internationally educated staff.

The report details the obstacles they face faced from visa applications, finding accommodation and starting work. It follows a previous RCN report  Without a Safety Net https://tinyurl.com/3xwvf7kt and together they paint a picture of many internationally educated nursing staff facing racism and discrimination in the workplace, and this in turn is playing an influential role in whether these staff decide to leave their nursing careers in the UK.

But the latest immigration statistics show a steep fall in visa applications from internationally educated nursing staff The reasons why are set out in the report

Most internationally educated staff do not intend to stay in the UK permanently and many staff are looking at opportunities in countries other than their home country.

Only one third (34%) of survey respondents reported they intended to stay in the UK permanently. Of those that said they intended to leave the UK two thirds (66%) intended to move to a country other than their home country.

During the recruitment phase, internationally educated staff have to pay fees to secure jobs in the UK. 15% of respondents paid fees to secure a job, and over half of these were illegally charged fees by a UK based recruitment agency. A hostile immigration system, including the no recourse to public funds condition (NRPF), barriers to indefinite leave to remain, and restrictions around family visas, is having a devastating impact on staff: 1 in 5 respondents (22%) with a no recourse to public funds condition struggled to buy enough food or meet basic needs. and nearly 2 in 5 (38%) struggled to pay utilities bills such as energy. 1 in 3 (35%) respondents who faced challenges in bringing family

The negative impact of low wages and restrictive immigration rules are exacerbated by the report’s finding that more than two thirds (64%) of internationally educated staff report facing discrimination or bias in the UK/workplace, a figure much higher for nurses and care workers of Black, Black British, African or Caribbean ethnicity.

Some health and social care employers – and staff - make a determined effort to welcome and support these staff and try to address discrimination when it occurs. But others tend to look the other way.

Efforts to welcome and support overseas trained staff are undermined when Ministers talk about immigration risking the UK becoming an “island of strangers”. When they do so, it would be helpful if they accepted this risks replacing “Stop the Boats” with “Stop the overseas doctors, nurses and care workers”.

This report suggests that the invaluable contribution of overseas trained health and social care staff cannot be taken for granted. Whether intended or not, phrases like those used in recent speeches about immigration will undermine the contribution of these staff, undermine the efforts of those who welcome and support such staff, and make the trends identified in this report even more likely to occur.