A new immigration skills charge which comes into force on Thursday could take “desperately needed money” from the health service for years to come due to the service’s continuing reliance on foreign staff.
Employers will have to pay a £1,000 annual charge for skilled workers from outside the European Economic Area newly applying for the two main categories of Tier 2 visas. There were more than 6,000 such applications for non-EEA doctors and nurses in 2015 alone.
Smaller businesses and charities will pay a reduced charge of £364 per employee per year. The charge is on top of the fees already in place.
The employers of Tier 2 skilled visa holders who are already in the UK and those currently outside the UK who were assigned a certificate of sponsorship before today will not have to pay the charge.
The British Medical Association and Royal College of Nursing have raised concerns that the £1,000 annual charge could have a “damaging impact” on health and social care funding.
They jointly wrote to the home secretary in March expressing concern that the charges would take millions out of the NHS budget each year. However, their call that the NHS and the wider health and social care system be exempted from the charge has not led to a reversal in the government’s position.
BMA council chair Dr Mark Porter said it was “unthinkable” that trusts should be penalised for trying to fill staff shortages from overseas who it requires to maintain safe staffing levels and safe patient care.
“The government’s poor workforce planning has left it struggling to cope with huge and predictable staff shortages,” he said. “The introduction of this charge could take desperately needed money from an already under-funded health service, worsen the current staffing issues, and impact the level of care that hospitals are able to provide to patients.”
The chief executive of NHS Employers, Danny Mortimer said the immigration skills charge meant recruiting new non-EEA staff in future will become more expensive.
“Because of the workforce shortfalls faced by the NHS, and the time it takes to train new clinical staff, we anticipate employers will still need to recruit more non-EEA staff in the short to medium term,” he said.
Current exemptions only apply to PhD-level occupations and specific categories of trainee graduates and those switching from student visas to skilled work visas.
Detailed figures provided by the Home Office under the Freedom of Information Act show there were 87,280 applications for Tier 2 visas for non-EEA workers in the UK in 2015, an increase of 52% compared to 2011.
Among that figure there were 3,702 applications made on behalf of doctors, including consultants, specialists, GPs and surgeons. The highest number of these were Indian (820) and Pakistani (795) nationals.
There were 2,535 applications for skilled visas for nurses in the same year, the majority of them from either the Philippines or India. A further 130 Croatian nationals also appear on the list of nationalities recruited as nurses due to restrictions on Croatian nationals’ access to the UK labour market.
Health is not the only industry that will be affected by the charge. The IT industry uses skilled visas more than any other: almost 35,000 tech professionals applied for Tier 2 visas in 2015, 40% of applications.
The vast majority of those who applied for positions in IT in 2015 were Indian citizens, almost 30,000 in total, followed by US citizens.
Programmers and developers are in highest demand with more than 12,300 applications for skilled visas while business analysts, architects and systems designers accounted for almost 10,500 applications within the sector.
Charlotte Holloway, policy director with techUK says that, while larger companies will be able to absorb the cost and additional bureaucracy the charge will bring, that the new charge was an extra burden on business which would disproportionately affect SMEs.
The business, research and administration sector also relies heavily on the visa scheme, making up 11% of skilled visa applications in 2015, most commonly for management consultants and business analysts and accountants.
In the same year almost 5,000 engineers applied for the skilled visa programme making it the third most reliant industry on non-EEA labour.
Other smaller industries such as speciality restaurants may also see an impact. There have been repeated warnings in recent years of a curry house crisis with the industry warning that a third of curry houses are at risk due to rising costs many of them connected to changes to immigration rules.
This is borne out in the figures provided by the Home Office. The number of non-EEA chefs and cooks applying for visas fell from 1,860 in 2013 to 745 in 2015.
A government spokesperson said income raised from the new immigration skills charge will be used to address skills gaps in the UK workforce.
“For too long there has been an under-investment in training for UK workers but this government is committed to building homegrown skills and wants to encourage employers to do the same.
“The introduction of the immigration skills charge will help encourage employers to invest in training so that UK workers have the right skills to fill jobs.”