Last week, the government announced the biggest shake-up of immigration policy in decades.
In investigating this new post-Brexit points-based immigration system, we look at the potential impact on the NHS.
At a time when the health service is seriously underfunded, it is the overworked and underpaid staff that keep the NHS ticking over.
They face impossible workloads amid a large number of vacancies — the latest figures show the NHS has more than 100,000 unfilled roles. And it’s estimated that if current trends continue, this figure could balloon to 250,000 or more within the next decade.
Against this backdrop of severe labour shortages, the NHS relies heavily on filling in the gaps with health staff from abroad. In June last year, 13 per cent of NHS staff in hospitals and community services in England reported being of a non-British nationality, with about 5.5 per cent hailing from the EU. Nearly 10 per cent of doctors are EU nationals, as are about 7 per cent of nurses.
But with EU freedom of movement set to come to a decisive end and replaced with a new ‘points-based’ system next year, the NHS will face yet another hurdle as it struggles to fill a growing number of vacancies.
The government has said it will implement NHS ‘fast-track’ visas but so far there is no indication that this will include NHS workers from across the spectrum, including vital support workers that keep the health service running.
From next year, any EU migrant worker will have to score at least 70 ‘points’ on different criteria, ranging from having a job that’s considered skilled to meeting English language requirements.
They can score more points if, for example, they have a job in a shortage occupation. While most migrant workers will have to earn at least £25,600 to work in the UK, all migrants are barred from any job that pays less than £20,480. This fact alone could be potentially disastrous for lower-paid NHS support workers.
‘Things will get a lot worse’
Biomedical scientist Ian Evans, who also serves as Unite’s healthcare scientists chair, knows first-hand the recruitment struggles the NHS is now facing.
“I’m in charge of recruitment in my department and I can tell you already we simply can’t recruit the staff we need. Jobs in pathology support services are generally low-paid and with the rising cost of living in Brighton, we struggle to find people to fill these roles as it is.”
In Ian’s department, about 12 per cent of the workforce hails from abroad, with the majority coming from the EU. He points to roles such as phlebotomists, who collect blood samples from patients, as particularly difficult to fill.
“It can be an upsetting and stressful job. Phlebotomists have to carry out very invasive procedures, and it’s not unusual to be attacked by patients,” Ian explained. “In addition to being low-paid, the job often requires part-time working. There just aren’t enough native British workers who want to take on a job like this.”
Despite the challenges faced by staff in NHS support services, the government has deemed such jobs ‘unskilled’. Once the new points-based system comes into effect, this will mean in practice that both EU and non-EU migrants will not be eligible for these roles.
Ian said that combined with severe lack of funding in the service, he has very real fears for patient safety.
“We’re being set up to fail. The NHS functions only because of the goodwill of staff. But we are now at breaking point. Without being able to recruit from a larger pool of labour, and with no new funding, patient care is at serious risk – and things are going to get a lot worse.”
He called on the government to “listen to front-line workers like me and not people who sit behind desks all day making stupid decisions based on not a single shred of evidence about the actual needs of the health service”
Even though other health workers such as doctors and nurses will be able to come to the UK from the EU under the new points-based system, sky-high visa fees could deter many from the prospect.
At present, health workers from the EU can flock to the UK freely, but after the new system is implemented next year, individuals will face visa fees of up to £5,000 for three years. A nurse bringing a partner and three children, for example, would be slapped with visa fees totalling £21,299.
“With this sort of outlay, are you going to attract the Spanish nurse or are they going to go to Germany which doesn’t charge anything?” immigration lawyer Lisa Roberts told the Guardian.
Adding insult to injury, all new migrant workers from the EU, including health staff, will from next year have to pay the NHS surcharge – a fee levied on migrant workers to use the health service.
Unite national officer for health Jackie Williams argued that the new points-based immigration system is simply not fit for purpose.
“The system totally ignores the needs of the health service and the safety and wellbeing of patients and staff,” she said. “Migrants from both the EU and the rest of the world are vital contributors to the NHS, especially at a time when the health service is on its knees from staff shortages.
“We should be doing everything we can to encourage more staff to come work for the NHS wherever they come from, not erecting needless barriers to give the appearance of having ‘taken control’ of our borders.
“That the new system will also make it extremely difficult to recruit care workers will also have a knock-on effect on the NHS,” Williams added. “It is essential that we have a robust social care system in place to alleviate pressures on the NHS in the long-term. Without the hundreds of thousands of care workers we need, we will never be able to achieve this goal.
“We call on the government to for once think of the bigger picture. If they are committed to addressing the shortage in staffing numbers within the NHS then their immigration policies must be revised.”