The government must ensure the system for recruiting overseas workers into the NHS, health and social care services following Brexit is “streamlined” and allows employers to hold onto the “brightest and best” staff, an influential group of MPs has said.
In its assessment of how the UK’s departure from the European Union will affect health services, the Commons health select committee said that, despite recent increases in nurse training posts, it was likely the country would need a swift system for bringing in foreign staff for “many years”.
“The government’s plan… should ensure health and social care providers can recruit the brightest and best from all parts of the globe”
Health select committee
This was a “particularly acute concern” in adult social care, which was highly dependent on EU migrants in some parts of the UK, said the committee today in its new report – titled Brexit and health and social care.
It also noted that the extent to which the NHS would rely on nurses from abroad was uncertain, especially due to the removal of bursaries for student nurses in England from this autumn.
It identified a series of problems that could slow down the process of recruitment from abroad in the future and called for them to be addressed.
According to the head of Health Education England, who gave evidence to the committee earlier this year, plans were in place to ensure the health service’s demand for nurses in the future could be filled by the number of people in training in this country over the next few years.
However, HEE chief executive Professor Ian Cumming said that, if there were a major decrease in the number of EU staff working in the NHS at the same time, there was a possibility that there would not be enough home-grown trainees to fill the gaps.
It has since emerged that, in a worse-case scenario, the NHS could be hit by a shortage of more than 40,000 nurses by 2026 after the UK leaves the EU, after official Department of Health documents were leaked.
Today’s select committee report also looks in particular at how far different areas of England were dependant on EU staff.
It noted that, based on data from NHS Digital, for the country as a whole, around 7% of all NHS nurses were from the EU.
“The existing immigration system is characterised by bureaucratic and financial barriers to recruitment from outside the EU ”
Health select committee
However, NHS services in London and southern and eastern parts of England were found to be more reliant on EU workers than those in other regions.
In London, between 13% and 14% of NHS nurses were from the EU. Across the East of England, Kent, Surrey, Sussex, the Thames Valley and Wessex areas, EU nurses made up between 9% and 13% of the nurse workforce.
For the rest of the country, between 1% and 7% of NHS nurses were from European countries other than the UK.
Within adult social care services, the committee heard that rural regions or those with low unemployment were more reliant on EU staff. This was particularly the case for those coming to work in low-paid posts, they were told by Professor Martin Green, chief executive of Care England, which represents care homes.
The report reiterated concerns about the uncertainty the Brexit vote had created for EU staff already working in the UK and whether they would be able to remain, noting this was “unwelcome”.
But it said it was too early to know if the recent decline in EU nurses registered with the NMC was down to Brexit.
It also noted the “complex” immigration system currently in place for recruiting staff from outside the EU and warned this could cause further issues if applied to European workers in the future.
“The UK has an opportunity to negotiate a more pragmatic approach to the mutual recognition of professional qualifications”
Health select committee
Under the system, overseas workers must meet minimum salary thresholds to gain a visa. This was previously £20,800, but following a review last year has been raised to £30,000 from this month. However, nurses are temporarily exempt from the rules until July 2019, due to staffing shortages.
“The existing immigration system is characterised by bureaucratic and financial barriers to recruitment from outside the EU which do not currently exist for those from inside the EU. If such a system was extended… after Brexit it would create serious problems for the health and care sector,” the report warned.
“The government’s plan for our post-Brexit future should both ensure that health and social care providers can retain and recruit the brightest and best from all parts of the globe and that the value of the contribution of lower paid health and social care workers is recognised,” said the committee.
In addition, the report noted that Brexit provided an opportunity to improve the way nursing regulator ensures EU staff meet the standards required to practise in the UK.
Under the current EU system, the Nursing and Midwifery Council is unable to test European nurses on their clinical skills and whether they are up-to-date.
Instead, legislation – required by the EU’s Mutual Recognition of Professional Qualifications Directive – allows European nurses to work in the UK if they have gained a qualification in nursing that meets minimum standards agreed by EU countries.
“The UK has an opportunity to negotiate a more pragmatic approach to the mutual recognition of professional qualifications directive within the British regulatory mode,” said the committee’s report.
“The committee is right to call for a streamlined process for recruiting health and care staff from overseas”
Commenting, NMC chief executive Jackie Smith welcomed the report and said the regulator believed it was “essential” that any changes made to the registration process for EU nurses “come as part of the UK’s Brexit negotiations and not separately”.
“The opportunity to make such important changes in the future may be significantly reduced once negotiations have concluded,” she added.
The NHS Confederation organisation, which represents NHS providers and commissioners, also welcomed the report and the “wide range of health-related issues in the Brexit negotiations” that needed to be addressed.
“The committee is also right to call for a streamlined process for recruiting health and care staff from overseas, and to make clear that criteria should not just be about pay – it is about valuing public service and being able to recruit the staff we need to deliver safe, compassionate and high-quality care,” said its chief executive Niall Dickson.
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The union Unison repeated its call for the government to confirm that EU nationals working in UK public services would have the right to remain after Brexit.
Its general secretary Dave Prentis said: “The Brexit vote has plunged the NHS and social care into deeply uncertain times. Both the NHS and care services already have too few home-grown staff to meet growing demand.”
Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “Theresa May has been told by this cross-party group that failing to give EU nursing staff and others the right to stay will harm the NHS.
“The report leaves the government with no place left to turn,” she said. “Patient safety and the supply of nurses must not be adversely affected by Brexit.”