New report calls for 'no recourse to public funds' condition to be ended immediately for migrant workers
In a new report published yesterday, the Royal College of Nursing (RCN) called on the Government to reform immigration policy in order to ease the cost of living pressures for migrant nurses in the UK.
The 15-page report, Without a safety net: The impact of no recourse to public funds on internationally educated nursing staff, can be downloaded here.
In the report, RCN highlights the huge contribution that nurses from overseas make to the UK's health service. It states: "The UK has benefitted enormously from international nurse migration and the contributions of highly skilled nursing professionals from across the globe. More than 1 in 5 (22.7%) nurses on the Nursing and Midwifery Council (NMC) register received their initial training outside of the UK. In the 12 months to March 2024, 49.4% of new joiners to the register were internationally educated (NMC, 2024e)."
However, RCN surveyed 3,000 internationally educated nurses (IENs) for the report and found that 62% said they have considered leaving the UK and returning to their country of training due to the high cost of living. Migrant nursing staff are reported to be twice as likely to be in financial difficulty than domestic colleagues.
The report highlights how immigration rules and policy, such as the no recourse to public funds (NRPF) condition for those without Indefinite Leave to Remain (ILR), continues to create major financial challenges for migrant staff in the National Health Service (NHS).
RCN explained: "A key risk to internationally recruited nurses' financial security is the policy of excluding these staff from accessing public funds. Migrant workers on temporary visas such as the Health and Care Worker visa are subject to a no recourse to public funds (NRPF) visa condition. This means that these staff are unable to access certain benefits that are classed as 'public funds' for immigration purposes, such as housing benefit, child benefit, and Universal Credit. In cases of long-term sick leave, migrant workers may have no income at all as they have no recourse to means-tested ill-health benefits. This restriction is applied even though IENs pay the same taxes and national insurance contributions as their UK-educated colleagues."
The high cost of applying for ILR presents a further barrier for migrant nurses.
"In October 2023, the Home Office under the previous Conservative Government, introduced a 15% increase to the application and renewal fee for the Health and Care visa. The cost to apply for Indefinite Leave to Remain (ILR), which grants the right to reside in the UK permanently, was increased by 20% to £2,885 per person. The increase to ILR applications restricts access to permanent settlement for IENs and their families," RCN said.
The report calls for immigration reform and warns that without direct action, the NHS is risking a mass exodus of international nursing staff.
Four recommendations are made by RCN in the report as follows:
• The no recourse to public funds (NRPF) condition applied to migrant workers on temporary visas must be ended immediately. NRPF is a key risk to the financial stability of internationally educated nurses and their families and to health and social care delivery across the UK.
• The current cost of visa applications and ILR must be reduced. Spiralling visa fees, including the cost of ILR applications, continue to place internationally educated staff under unnecessary financial pressure and make it more likely that they will leave the UK to practise elsewhere, thereby putting further pressure on remaining staff.
• Induction, including pastoral support, must be comprehensive and assist internationally educated staff in building support networks within their new communities. Connecting internationally educated staff with appropriate community groups, diaspora organisations, and trade unions can help them to feel settled and ensure they can access support when needed.
• Enforcement of employment rights, tenant's rights, and rights to access health care for all migrant workers must be strengthened. Governments across the UK should ensure that clear and accessible guidance relating to labour standards, housing and health is made available to all those on temporary work visas.
Patricia Marquis, Executive Director of RCN England, added: "The current system denies migrants access to vital benefits, despite them paying tax and doing the same work as their domestically trained colleagues. The reality is that migrant nursing staff pushed into poverty will simply choose somewhere else to do their nursing – this is a tragedy for patient care. Ministers must lead from the front and show that migrant nursing staff are welcome here and have the same value as their domestic colleagues. The no recourse to public funds condition applied to migrant workers must be ended immediately."