Ministers and NHS bosses criticised over use of overseas nurses

Health ministers and NHS bosses have been criticised for using overseas nurses as a “get out of jailfree” card to ease hospitals’ recruitment crisis.

The government’s migration advisory committee (MAC) says it has “reluctantly” recommended to the home secretary that up to 5,000 overseas nurses from outside of the European economic area (EEA) be given visas each year for the next three years.

But Prof David Metcalf, the MAC chairman, said that there was “no good reason why the supply of nurses cannot be sourced domestically. There seems to be an automatic presumption that non-EEA migration provides the health and care sector with a ‘get out of jail free’ card.”

Metcalf says that the nurse recruitment crisis in the NHS could, and should, have been anticipated by the Department of Health. He says the current shortage of nurses is closely linked to a decision to cut training places in England by almost 20% between 2009 and 2013.

The MAC also cites past evidence that some hospital trusts are paying migrant nurses £6,000 less than UK nurses and are using them to save money rather than address the shortage in other ways.

Overtime differences may bring the gap down to £3,000 or £4,000 but the migration experts say that employers should go through the resident labour market test (ensuring there is no suitable worker within the UK workforce who could do the job) to meet concerns about undercutting. 

Nurses were added to the official list of shortage occupations last October as a temporary measure to help them through the winter crisis subject to a review by the MAC.

Jobs that are listed as shortage occupations can be filled by employers recruiting from outside Europe using priority visas and without meeting a £35,000 minimum income threshold due to come into effect in April. There is, however, a 20,700-a-year overall cap on the recruitment of skilled overseas workers from outside Europe.

The government’s migration advisers say NHS trusts across Britain have told them they need to recruit 14,000 overseas nurses over the next four years and have recommended there should be an annual limit of 3,000 to 5,000 in the first year.

Metcalf said there was a danger that a sudden deluge for work permits for nurses could crowd out skilled migrants from other occupations such as engineers.

He said that health workforce planning took no account of the demand for nurses in the care and private sectors, who in turn make little or no direct contribution to nurse training. The committee’s report accuses the care and independent sectors of taking a “free ride on the back of the government paying for training”.

“The Department of Health should get its act together … You never know who is in charge in the Department of Health,” added Metcalf. “We had evidence from so many different bodies … There is no single authoritative voice to speak for them.”

The Royal College of Nursing told the migration experts that London hospital trusts were running with 17% nurse vacancies but that vacancy rates were lower outside the capital.

Non-UK nurses make up 140,000 of the 630,000 qualified nurses working in Britain, of which 500,000 work in the NHS. Annual recruitment of overseas nurses – including from within the EEA – peaked at over 16,000 in 2001/02 and remained above 10,000 each year up to 2005/06. Over the last 10 years numbers fell to 2,000 in 2009/10 but rose again to 8,000 – the vast majority from within the EEA.