Up to 50,000 nurses could quit the UK over the government’s immigration proposals, plunging the NHS into its biggest ever workforce crisis, research suggests.
Keir Starmer has vowed to curb net migration, with plans to force migrants to wait as long as 10 years to apply to settle in the UK instead of automatically gaining settled status after five years.
The measures, which also include plans to raise foreign workers’ skills requirements to degree level and raise the standards of English language required for all types of visa, including dependents, are seen as an attempt to combat the rise of Nigel Farage’s Reform UK party. A public consultation on the plans is expected imminently, sources said.
Nursing leaders told the Guardian the plans were “immoral” and treated highly skilled migrants as “political footballs”. They said a mass exodus of nurses would threaten patient safety and derail government efforts to cut waiting times.
Under the proposals, migrant workers in every sector of the economy would be hit. However, the most serious impact would be in the health service, which is already buckling under the strain of soaring demand for care amid staff shortages.
A survey conducted by the Royal College of Nursing (RCN), seen by the Guardian, found the plans have sparked profound distress among foreign NHS and social care staff.
There are more than 200,000 internationally educated nursing staff, about 25% of the UK’s total workforce of 794,000. The government’s proposed changes to indefinite leave to remain (ILR) have triggered alarm, with many now considering leaving the UK for good, the survey suggests.
Almost one in 10 of all nursing staff working in the UK could be affected by the proposed changes. According to government figures, 76,876 have gained a visa since 2021 and would currently be entitled to settled status after five years. However, the plans to double that period to a decade have thrown their futures into jeopardy.
In the RCN survey of more than 5,000 migrant nursing staff, 60% of those who do not have ILR said the shake-up was “very likely” to affect their plans to stay in the UK. The finding suggests more than 46,000 could permanently quit the UK.
Prof Nicola Ranger, the general secretary and chief executive of the RCN, said: “These proposals are not just immoral, they would be dangerous for our patients. No minister who has any interest in the success of our health and social care system would press ahead with extending the qualifying period for ILR.”
She called for the plans to be dropped and said otherwise they risked deepening the NHS workforce crisis, threatening patient safety and derailing efforts to reduce treatment waiting times. “At a time when the government is failing to grow the domestic nursing workforce, it risks pushing tens of thousands of highly skilled nurses out of the UK,” she said.
The proposals also amounted to a “betrayal” of migrant nursing staff, Ranger said, with many of those without ILR having come to the UK to support the response to and after the Covid-19 crisis and now facing uncertainty.
“Many of those who will soon be applying for ILR came to the UK during the pandemic, at great personal sacrifice. This is no way to repay them and amounts to a betrayal. Our international colleagues deserve clarity over their futures, not to be used as political footballs by politicians and left unable to access state support despite working in public services and paying taxes.”
Without ILR, migrant nursing staff are unable to move easily between jobs, with their visas tying them to their employers, which Ranger said had led to exploitation in the social care system.
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The proposals would also leave them unable to access state support such as child benefit and disability support payments for a decade, despite paying taxes. “If the government continues to show nursing staff they aren’t welcome here, they shouldn’t be surprised when they decide to leave.”
Graphic of top 10 nationalities working for NHS England
The proposals have provoked serious distress among migrant nurses, according to the survey. It found that 53% were “extremely concerned” about their financial security, 52% were extremely concerned about the toll on their family and 49% were extremely concerned about the impact on their career.
The plans could reduce the pool of foreign workers willing to come to the UK in future, the survey suggests. Only 11% of respondents said they would still have migrated had the route to settlement been 10 years.
The RCN is also calling on the government to cut the application fees for ILR, which remain £3,029 per person, despite an estimated processing cost of £523. In 2003, the fee was just £155.
A government spokesperson said: “We are grateful to our overseas frontline healthcare workers, who bring compassion, deliver high-quality care and strengthen our health service, but net migration must come down.
“As the Home Secretary has set out, under our proposed new settlement model, individuals will have the opportunity to reduce the qualifying period to settlement and citizenship based on contributions to the UK economy and society. We will launch the consultation shortly and encourage health and care workers to take part when it launches.”
