Response To The Royal College Of Nursing’s Report ‘international Recruitment 2015 ‘


Health, Migration Trends, Policy

The Royal College of Nursing (RCN, the nursing union) yesterday published a report ‘International Recruitment 2015’. The report generated a number of provocative headlines such as ‘New immigration rules will cost the NHS millions’ (The Guardian) or ‘New Immigration Rules will cause NHS chaos’ (Sky News).

These headlines are misleading for a number of reasons. Firstly, the rules referred to are not new. In 2011 the Home Secretary Theresa May announced that anyone who enters the country on a Tier 2 visa after April 2011 will have to earn a minimum of £35,000 by the time that they are eligible for indefinite leave to remain five years later with the intention of breaking the almost automatic link between work and settlement.   For those earning below this threshold, their visa would be eligible for one more year and then they would be required to leave. Many reports referred to the nurses being at risk of deportation; in fact their visas would merely expire. They’d only be subject to further immigration actionF if they subsequently chose to illegally remain after their visas expired.

Many reports refer to the changes causing ‘chaos’ in the NHS; this seems very unlikely given the number of nurses that would be potentially affected by the changes. Only those nurses from outside the EEA recruited since 2011 are subject to the new rules. Even before the rules were changed in 2011, a majority of foreign nurses were being recruited from inside the EEA and since 2011 just 3,365 nurses from outside the EEA have been recruited to work in the NHS. In 2014/15 there were just 665 nurses recruited from outside the EEA, compared with over 8,000 from inside it. The NHS currently employs over 350,000 nurses so potentially around 1% of current nurses are subject to the rules. All those affected will have been perfectly aware that if they didn’t earn £35,000 after five years they wouldn’t get permanent residence, as would their employers. These are hardly conditions that would create ‘chaos’ and indeed the RCN have had many years to prepare for this point.

While the RCN is opposed to the £35,000 threshold, the main point of the report was that there should be more nurses trained in the UK. Recruitment of nurses from overseas is costly and is estimated by the RCN as being as much as £12,000 for each non-EEA nurse recruited with an average cost of £6,000.

There are also serious ethical questions about recruiting nurses from poor countries. The RCN report itself recommends that nurses are not recruited from countries with ‘fragile health systems’. Many countries from which large numbers of nurses were recruited in the past either have extensive shortages or will do so in the future. India, for example, already had a shortage of 2.4 million nurses in 2012 and this will likely only worsen in the future, according to the World Bank. The Caribbean will likely face a shortage of 10,000 nurses by 2025.

The RCN’s report recommends that the government must increase domestic recruitment levels and end the UK’s dependence on recruiting from abroad.  This is in part due to the sheer number of countries expected to face a deficit of nurses in the long term; the European Commission has estimated a potential shortfall of 600, 000 in the EU by 2020 while other countries like Australia and America plan to recruit more foreign nurses.

One of the main arguments made for importing workers from abroad is that British people don’t want to do the jobs immigrants are willing to do. But last year 37,645 nursing students were turned away from courses they applied to; an increase in places could eliminate the need for costly overseas recruitment.

Many of yesterday’s headlines were a distortion of the facts; the rules referred to aren’t new and the numbers of nurses affected would not cause major disruption to the NHS. 

To read the RCN report in full, click here:

23rd June 2015

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