The annual congress of the Royal College of Nursing opened on Sunday, and it began with a warning. New UK government immigration rules, that requires that people gaining a work visa to the UK will need to be earning in excess of £35,000 after five years, will mean most migrant nurses from outside of the EU would be sent home. £35k is the equivalent to a Band 7 on the Agenda for Change scale, a far more senior position than most nurses could achieve within five years.
The RCN estimates this could mean the loss of over 3,300 nurses in 2017, and considerably more in the years to come. With over 20,000 nurses from the Philippines, over 15,000 from South Asia and over ten thousand from Sub-Saharan Africa, this could mean a loss of significant part of the nursing workforce, unless exemption are made.
The reason we are recruiting so many nurses from overseas is simple – we do not train enough nurses in the UK – not least because the number of training places has been cut in recent years. We have significant shortages in many areas of nursing, particularly in the care homes sector, but there are real problems in many sectors with the right skill mix and staffing level.
Furthermore, proposed cuts in the number of agency staff also means that there is pressure to recruit permanent staff, and the biggest markets are in Asia and Africa (especially as English is used widely in many of the countries from which we are recruiting, unlike the EU countries whose nurses would not be affected by this legislation).
What concerns us is that many of these nurses are Christians. The average profile of a Christian nurse in the UK is African, South Asian or Filipina. They are not only the backbone of the NHS, but also of nursing homes and community care services. Their presence is not only vital to the provision of care, but I would argue that they are increasingly a vital part of the spiritual life and infrastructure of our nation. As the mainline churches decline, immigrant churches are growing. As British nationals Christians become a minority, African, Asian and Latin Christians are a growing, vibrant community. We need them! This is not just a workforce issue, this is a church issue – and one we need to wake up to.
Of course, it is a matter of concern that the NHS has effectively been poaching nurses from developing countries. While nations like the Philippines train more nurses than they need specifically so that they can work overseas, in many African nations this does create a real shortage. Yet at the same time, the nurses that come here are remitting money back home that has a benefit to their families and the national economy, and are gaining skills that in time they can transfer back to their own health system. This is a complex issue, but it requires serious, joined up thinking and planning – ensuring that we are enabling expatriate nurses to gain skills and experience to take back to their own nations in a planned manner, rather than just arbitrarily removing their work visa after five years. And recruitment in developing nations should be planned and controlled in a manner that seeks to reinvest skills into national health systems rather than deplete national nursing workforces.
The RCN has resolved to lobby government for an exemption for the nursing workforce from the new immigration rules. I believe that the church and the Christian medical and nursing community needs to join with them – these are our colleagues, brothers and sisters in Christ, and we should be supporting them. We also need to fight for more training places for student nurses in this country – we simply are not training enough nurses to meet the growing needs, especially with so many nurses leaving the profession or taking early retirement. And we need to lobby for a more just approach to recruiting nurses from developing nations.
Above all, this is an issue of justice – in a globalised world. What we do here in the UK affects people in many other parts of the world, and we have to hold our governments, professional bodies and employers to account for how they manage global recruitment and national training and staff retention.