The government’s new immigration measures could ‘accelerate an exodus of migrant staff’, the Royal College of Nursing (RCN) warns today [WEDNESDAY 14 MAY], as a new report shows tens of thousands are already set to quit for countries like Australia, Canada and New Zealand. 

On the third day of its annual conference in Liverpool, the nursing union says the government is creating a ‘hostile environment on steroids’ which will do ‘great damage to key services’ such as the NHS and social care. 

The report, Unreciprocated Care: why internationally educated nursing staff are leaving the UK, is based on a survey of over 3,000 migrant nursing staff, including care workers, nursing support workers and registered nurses [NOTES]. It found just under half (42%) are already planning to leave the country, with two thirds of those intending to move to a country other than their home country. Those who planned to leave were asked what would impact their decision to stay in the UK, with 70% selecting salary and 40% selecting immigration policy. 

It comes after the government announced plans to close the care worker visa route at a time of widespread vacancies in social care and introduce more restrictive immigration measures. Migrant nursing staff in social care and the NHS cannot access public funds until they are granted indefinite leave to remain (also known as settlement), a status they can only secure after 5 years in the country. The situation has left some resorting to food banks and charity assistance to make ends meet, with one telling the RCN they were forced to send their baby back to their home country. The government is proposing doubling the qualifying period for indefinite leave to remain to 10 years.  

Other countries provide nursing staff quicker routes to settlement, with Canada and New Zealand offering permanent settlement on arrival. 

From the RCN’s annual conference, General Secretary and Chief Executive Professor Nicola Ranger will condemn the government’s proposal to close the care worker visa route when there is ‘no credible plan to grow the domestic workforce’, urging ministers to secure the future of social care and the NHS by abolishing the no recourse to public funds (NRPF) rule and granting immediate indefinite leave to remain to nursing staff. 

The RCN says its survey findings could mean up to 55,000 migrant nursing staff are considering leaving the country [NOTES]. This figure doesn’t include those in care worker roles, suggesting thousands more could now also be considering their future in the UK, whilst others cancel plans to come over. 

In NHS services across the UK there are over 34k unfilled registered nurse posts. Meanwhile, workforce vacancies in England’s care sector alone are as high as 131,000. 

The report also details shockingly normalised levels of discrimination faced by migrant nursing staff. Overall, two thirds (64%) of respondents said they had experienced discrimination since moving to the UK. 

As well as providing faster and cheaper routes to settlement, countries like Australia, Canada and New Zealand offer superior pay [NOTES]. Additionally, in the UK, those from overseas must currently wait five years to apply to stay permanently, paying yearly visa renewal costs and then £3,029 per person to apply for indefinite leave to remain. 

International nursing staff in their own words: 

On pay, a nurse from India, said: “My salary has not increased as quickly as my house rent and council tax and, sometimes, I struggle to pay the bills and couldn’t afford even the basic food items by the end of each month, not able to save enough for my family.”   

On racism, a nurse from Trinidad and Tobago, said: “Systemic racism and bullying in the workplace were the most jarring thing for me. Staff appear to be seen as replaceable and expected to tolerate physical, racial, and verbal abuse by patients.” 

On the cost of living and NRPF, a nurse from Kenya, said: “I had to get food and clothing from charity organisations. At the same time, I could not afford childcare as a single parent and I made the difficult decision to fly my baby back home.” 

On leaving the UK, a nurse from the Philippines, said: “I love living in the UK. I love the people. I love my job and my department. I always try to defend it to my other international nurse friends that have moved to the US, Canada or Australia. But somehow, it's too tiring to defend this country when it's not reciprocating you the care and support that we as immigrants deserve.” 

Responding to the release of the report, RCN General Secretary and Chief Executive Professor Nicola Ranger, said:   

“Our report shows thousands of migrant nursing staff are ready to leave the UK. This situation is bad enough, but now the government’s cruel measures could accelerate this exodus, doing great damage to key services. 

“Closing the care worker visa route and making migrant nursing staff wait longer to access vital benefits is the hostile environment on steroids. They pay tax and work in our vital services, they deserve the same rights. Sadly, this government is intent on pushing people into poverty, away from the country, and with no credible plan to grow the domestic workforce in sight. Government must do all it can to get the next generation into nursing. 

"Rather than pandering and scapegoating, ministers should focus on what patients and vulnerable people need – safely staffed services. Without the measures we’re calling for, our amazing colleagues from overseas will continue to leave. ” 

Ends  

Notes to editors  

The report - Unreciprocated Care: why internationally educated nursing staff are leaving the UK – can be provided on request. 

The RCN calculated the numbers planning to leave to a 3rd country as a proportion of the overall numbers of international nursing staff on the NMC register. The calculation was done as follows: 

• According to the latest Nursing and Midwifery Council (NMC) register data, there are 197,664 Nurse, Nurses & Midwife, and Nurse Associate’s on the register who trained outside the UK. Using RCN findings, we make the assumption that of those 197,664, 42% are planning to leave (83,019) and of those planning to leave, 66% are planning to leave to a country other than their home country (54,793). The 55,000 figure is 6.88% of the 796,169 Nurse, Nurse & Midwife and Nurse Associate’s currently on the NMC register. 

NOTE - The full list of recommendations to the UK Government and to employers across health and social care in the UK can be found on pages 3 and 4 of the report. 

NOTE - The numbers of all registrants joining the NMC register from overseas has fallen 16.6% (2,501) in the six months to September, compared to the same period last year. There has been a 33% (1,934) increase in the number of international professionals leaving the register during the same period - Failing nurse recruitment and huge rise in early leavers creating ‘perfect storm for patient safety’, warns Royal College of Nursing | Royal College of Nursing 

NOTE - According to OECD data, nursing pay in the UK is lower than in Australia (where pay is 30% above), New Zealand (where pay 20% above), and Canada (where pay is10% above). This data uses the most recently available data published by the OECD and can be found in Health Statistics Data 2023: Renumeration of hospital nurses, ratio to average wage, 2021 (or the nearest year).  - OECD- Health at a glance 2023. 

NOTE – Additional statistics: 

• For international staff planning to leave, we asked what would impact their decision to stay in the UK; 70% said salary and  40% said immigration policies. 

• Over half (51%) of the internationally educated nurses who responded to our survey had experienced harassment, bullying, or abuse while working in the UK, and reported impacts on their mental and physical health as well as their job performance. 

• Of these, 1 in 5 (18%) told us that they are considering returning to their home country because of how they’ve been treated. 

NOTE -Currently, those on temporary visas like the Health and Care visa are subject to NRPF, which bars them from accessing essential benefits such as housing benefit, child benefit, and Universal Credit.  In the RCN’s survey, 1 in 5 (22%) said the rules have left them struggling with the cost of living and unable to afford food or meet basic needs.