Immigration Bill Committee

Written evidence submitted by the Royal College of Nursing (IB 17)

1.0 Introduction

1.1 With a membership of more than 425,000 registered nurses, midwives, health visitors, nursing students, health care assistants and nurse cadets, the Royal College of Nursing (RCN) is the voice of nursing across the UK and the largest professional union of nursing staff in the world. RCN members work in a variety of hospital and community settings in the NHS and the independent sector.

1.2 The RCN promotes patient and nursing interests on a wide range of issues by working closely with the Government, the UK parliaments and other national and European political institutions, trade unions, professional bodies and voluntary organisations. The RCN is a politically neutral organisation.

1.3 The RCN welcomes the opportunity to provide evidence to the Public Bill C ommittee on th e Immigration Bill.

2.0 Executive Summary

2.1 The RCN is concerned that any new code of practice governing standards of the English language in the public sector may impinge on those currently being developed by the Nursing and Midwifery Council (NMC).

2.2 The RCN is concerned that the Immigration Bill does not specify the type of workers to which the clause imposing a skills levy will apply and whether it will also include skilled migrants working in publicly funded services. We would welcome greater clarity on this issue.

2.3 The levy, if applied to NHS trusts and other health and care providers, would penalise employers for seeking to recruit international nurses in order to fill th e dangerous current shortfall of nurses .

2.4 I t is unclear how a levy to fund additional apprenticeships in the health sector could address the current shortfall in highly skilled health professionals . This must be addressed through better workforce planning and an increase in nurse training places.

2.5 The current shortage of nursing staff is likely to get worse in the short to medium term even with an immediate increase in commissioned training places due to the time it takes to train a nurse. There is a real risk that the health service will struggle to provide safe nurse staffing levels in the interim.

3.1 Language Controls

3.2 The RCN accepts the principle that all nurses in the UK should have an acceptable command of English in order to communicate effectively with their colleagues and patients. The Nursing and Midwifery Council, in its public protection role, already undertakes language controls for non EEA nurses and midwives seeking to register in the UK and will shortly be introducing measures for all registrants, including EEA nurses and midwives. The RCN responded fully to the language controls consultation launched by the NMC on 1 June 2015 in relation to EEA nurses and midwives and has strongly supported language controls. The NMC will implement the new measures by January 2016.

3.3 The RCN is concerned that the new code of practice proposed by the Bill may impinge on these language control standards currently being developed by the NMC. We question whether it would be appropriate for ministers to set out standards rather than professional regulators, such as the NMC, as is currently the case.

3.4 The Immigration Bill’s explanatory note makes clear that a consultation will be launched in parallel with the passage of the Bill through Parliament on the content of the code of practice. We note that this has now been published by the Government and we plan to respond fully.

4.0 Skills Levy

4.1 The Bill proposes to apply a ‘skills levy’ to employers who sponsor a non EEA migrant worker, and will allow the Government to specify the scope and rate of the levy. The RCN is concerned that the Bill does not specify the type of workers to which this clause will apply and whether it will also include skilled migrants working in publicly funded services. We will seek greater clarity on the scope of this clause.

4 .2 The NHS is increasingly reliant on international recruitment of qualified nurses to make up for the shortage of UK-trained registered nurses in the UK – a direct result of insufficient numbers of UK nurse education places in higher education . This levy, if applied to NHS trusts and other health and care providers, would penalise employers for seeking to recruit international nurses in order to fill this dangerous shortfall . Furthermore, i t is very unclear how using the levy to fund additional apprenticeships in the health sector could address the large shortfall in highly skilled health professionals . This shortfall must be addressed through better workforce planning and an increase in nurse training places.

4 .3 The RCN has expressed concerns for some time about the impact of previous change s to immigration rules which will force all non EEA nurses who arrived from 2011 onwards and are earning less than £35,000 to leave the country from 2017.

4.4 The RCN welcomes the decision of the Home Secretary to place nursing on the SOL in the interim until the MAC produces its final recommendations in February 2016. This means that those overseas nurses currently working in the UK will not be subject to the threshold.

4 . 5 We also welcome the Home Secretary’s decision to commission a further review of this issue by the Migration Advisory Committee (MAC) . We continue to urge the Government and the MAC to include nursing on the SOL in the medium term or to reconsider the earning threshold of £35,000 for nurses, as the failure to include nursing on the Shortage Occupation List (SOL) will exacerbate the current shortage of nurses in the UK.

4 . 6 The RCN predicts that the current shortage of nursing staff is likely to get worse in the next few years before the effects of any measures put in place to remedy the situation are felt. Even if commissions for nurse education places are increased immediately, there will be a shortfall as it takes three years to train a nurse. There is a real risk that the health service will struggle to provide safe nurse staffing levels in the interim.

October 2015

Prepared 27th October 2015