Government unsure how many NHS staff will be affected by immigration changes
The government has admitted it does not know how many NHS staff will be affected by proposed changes to immigration rules, as consultations on the reforms have concluded.
Health secretary Karin Smyth confirmed her department’s lack of information about the national impact of the plans on NHS workers.
The proposed reforms aim to extend the time it takes for individuals to gain settled status in the UK; Indefinite leave to remain (ILR) is usually granted after only 10 years, subject to certain criteria.
While doctors and nurses directly employed by the NHS are exempt from these new rules, staff in social care and private healthcare will be affected, including those working on cases contracted with the NHS to reduce the backlog.
The policy, announced last year, was framed as an effort to strengthen the government’s stance on immigration and reduce arrivals.
Labor MPs, including Poole’s Neil Duncan-Jordan, criticized the approach as “un-British” and a pro-Reform initiative.
Business bodies have also voiced strong opposition, with the Royal College of Nursing (RCN) calling the plans a “serious mistake” and the Unison union warning it would separate parts of the NHS into “high- and low-skilled” workers.
In response to Mr Duncan-Jordan’s written question, Ms Smyth said: “The Department does not have information on the number of NHS workers available nationally… these may be affected by proposed changes to the rules on indefinite leave to remain.”
The Department for Health and Social Care (DHSC) told the Press Association it was important for the NHS to avoid “over-reliance on international recruitment” and announced that its workforce plan would be published in the spring. Consultations on these ILR reforms are scheduled to conclude within two weeks.
Currently, people living in the UK for five years on certain valid visas are automatically entitled to indefinite leave to remain.
But the new proposals would double that period to 10 years for most people and potentially 15 years for some.
Applicants will also need to meet additional criteria such as language proficiency and demonstrating a “sustained and measurable economic contribution.” The government also plans to make it harder for visa holders to bring dependents.
Home Affairs Minister Shabana Mahmood, who launched the consultation in November, said: “Being a permanent part of this country is therefore not a right but a privilege and something that must be earned.”
Responding to the health secretary’s admission, Mr Duncan-Jordan said: “The government is trying to make sweeping changes to immigration, but the Department of Health and Social Care doesn’t even know how many NHS and care workers will be affected. This should ring alarm bells.”
He added: “We face a disturbing situation where the left hand of government does not know what the right hand is doing, with the Casey Review promising a new strategy for social care while at the same time the Home Office is cracking down on the workers who keep the sector afloat.”
Mr Duncan-Jordan also criticized the policy, stating: “This policy is designed to leave Reformation behind and chase Nigel Farage’s tail when we should be starting from justice and securing the skills our country depends on. It is wrong and un-British to fail to deliver on our promise to people who are already here.”
The number of people applying for a health and care worker visa in the UK almost halved last year, with around 61,000 applications (main applicants or dependents) compared to 123,300 in 2024.
The drop follows changes introduced last summer that ended the recruitment of care workers from overseas and raised the minimum wage for skilled workers to £41,700.
NHS doctors and nurses or those paying higher rates could still be eligible for settlement after five years under the proposals, while lower-skilled workers arriving on health and social care visas during the so-called “Boris wave” in 2022 could face a 15-year wait.
Royal College of Nursing policy director Amber Jabbal said their analysis showed one in 10 registered nurses would be affected.
Ms Jabbal warned that thousands of people could be “removed” from health and care settings at a time when there is a shortage of available staff.
He said: “International nursing staff are vital to the functioning of our health and care services. We should thank them for the sacrifices they make to care for us, not to make their lives difficult.”
Ms Jabbal continued: “While the government has stated that nurses working in the NHS will not be directly affected by the changes, extending the ILR qualification period for the rest of the nursing profession and registered nursing staff in social and primary care would be a serious mistake, causing uncertainty and denying them access to vital support. It is also a disaster for patients.”
Unison chief medical officer Helga Pile commented: “Introducing these life-changing rules when there are so many unanswered questions is nothing short of reckless.”
He added: “If they do not already have residence rights, every overseas worker in the NHS will be affected. This will leave key workers in limbo under these proposals for 15 years and cause chaos over long-term planning in the health service.”
Ms Pile concluded: “NHS staff are all part of a team, but this will be separated based on the Home Office’s view of who is highly or low-skilled. Ministers must carry out a suitable impact assessment on the health and care sector before these plans go any further.”
Dora-Olivia Vicol, chief executive of the Center for Labor Rights, echoed calls for clarity, saying: “We urgently need a detailed impact assessment. Without that, this consultation is a farce.”
A spokesperson for the Department of Health and Social Care reiterated: “We are proud that the NHS has one of the most diverse workforces in the world and we highly value the contribution of our overseas staff.”
But they added: “It is important that we do not over-rely on international recruitment at the expense of giving opportunities to our own local talent.”
The spokesperson confirmed that workforce plans to be published this spring will further detail staffing plans for the NHS.
