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Proposed visa changes risk ‘closing off’ overseas nurse recruitment


Recommendations from the UK’s migration advisory committee to raise the minimum salary required to employ overseas staff to £30,000 have sparked concern over their potential impact on nurse recruitment.

The MAC advisors were asked by the Home Office to review the system for allocating general visas to workers from outside the European Union, in a bid to reduce net migration to the UK.

The committee said that increasing the pay threshold – from its current level of £20,800 – would also improve the quality of applicants and encourage wage increases for native staff as well.

“It is extremely unlikely that salaries for nursing staff will be increased to the minimum salary thresholds suggested by MAC”

Howard Catton

However, it recognised public sector pay structures were “inflexible” and that based on numbers of applications from last year, a new threshold of £30,000 would exclude 80% of nurse visa applications.

Therefore, it recommended the threshold should be phased in for public sector employers. But it warned they must not have a permanent exemption and should meet the thresholds “in reasonable time”.

The committee also noted that recently qualified migrant workers were likely to be on lower wages and recommended the minimum threshold for new graduates – those aged 25 or under – should only be raised to £23,000.

The Royal College of Nursing said the government’s desire to cap public sector pay to a 1% annual increase meant the salary thresholds would have a “significant impact” on overseas nurse recruitment.

“It is extremely unlikely that salaries for nursing staff will be increased to the minimum salary thresholds suggested by MAC,” said the RCN’s head of policy Howard Catton.

“If employers in the NHS and social care sector were forced to increase pay for overseas labour this would mean resident workers stand to lose out”

Department of Health

He warned thathealthcare organisations would be unable to fill vacancies if the new thresholds were introduced.

“When acting on these recommendations, the government must take into account patient care in the NHS as well as immigration targets,” he said.

In its response to the MAC’s call for evidence on the proposal, the Department of Health itself also expressed concerns.

“If employers in the NHS and social care sector were forced to increase the rates of pay for the overseas labour force, this would mean that resident workers would stand to lose out, which would create an additional set of problems and might ultimately undermine any government attempts to cap public sector pay rates long term,” said the DH.

The NHS Providers organisation, which represents trusts, “strongly urged” the government not to continue to use salaries as the determining factor in the way it allocates work visas.

It warned that the current nurse shortage was likely to continue due to the time it took to train a nurse and that overseas recruitment must not be “closed off”.

“It is vital that providers of NHS care are fully supported to recruit nurses and other clinical staff from abroad to ensure safe and sustainable care for patients,” said NHS Providers director of policy Saffron Cordery.

Saffron Cordery

Saffron Cordery

Saffron Cordery

In its report, the MAC said its analysis found most non-EU  nurses were recruited at point 16 within band 5 of the Agenda for Change pay system, equivalent to £21,692.

The committee said it recognised the shortfalls of using wages to assess the value of a job role, but noted salary was the “single most objective tool available” and “if the government’s aim is to reduce numbers, then it should be done by price”.

Meanwhile, the MAC was also asked to look into the government’s proposed levy for employers who recruit workers from outside the EU, known as the immigration skills charge.

It concluded the charge would incentivise employers to reduce their reliance on employing migrant workers.

“Raising the cost of employing skilled migrants via higher pay thresholds should…reduce the use of migrant labour”

David Metcalf

The levy, which is expected to be used to fund UK apprenticeships, would also encourage employers to upskill their workers, said the MAC.

The committee recommended the charge be set at £1,000 per migrant worker for every year they are in the UK.

Concerns have previously been raised that the levy would penalise health organisations trying to fill nurse staffing shortfalls, because they would be largely unable to train up more staff through apprenticeships.

Professor Sir David Metcalf, chair of the MAC, said: “Raising the cost of employing skilled migrants via higher pay thresholds, and the introduction of an immigration skills charge, should lead to a greater investment in UK employees and reduce the use of migrant labour.”


Readers' comments (3)

  • NO this should not be phased in, it should be brought in immediately, putting junior doctors and Band 5 nurses on a minimum of £30k is an excellent idea. We might not need to recruit from the developing world if we gave graduates something when they start, it is still 33% less than an Aldi graduate (plus they get a car) but you have to start somewhere.

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  • I agree that a starting salary of 30k is the way to go. Of course, all other NHS salaries would need to be increased proportionately. That might tempt me back to work in the UK - if we also got rid of the damned target culture of course.

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  • Or we could keep student bursaries and train up some people in the uk who'd be happy to work instead of getting benefits. Win win!

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