Health secretary warns of NHS ‘overreliance’ on international recruitment

The NHS would ‘collapse’ without nurses from overseas, but efforts are needed to reduce reliance on international recruitment into the healthcare workforce, the health and social care secretary has said.

Appearing before the Health and Social Care Committee, Wes Streeting was questioned about the tension between the health service’s dependence on nurses from overseas and proposals from the Home Office to restrict migration.

Last month, the Royal College of Nursing (RCN) warned that tens of thousands of international nursing staff could leave the UK if government proposals to double the qualifying period for Indefinite Leave to Remain (ILR) go ahead.

Meanwhile, latest data from the Nursing and Midwifery Council (NMC), published earlier this month, saw an almost 50% collapse in the number of international professionals joining the register compared to the same six-month period last year.

Mr Streeting said the government recognised the ‘enormous contribution’ made by migrant workers across health and social care, adding that he planned to attend a Unison rally later in the day to personally thank overseas staff for their contribution to the UK workforce.

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‘I want to underscore my appreciation, and this government’s appreciation, for what they do,’ he said.

However, Mr Streeting also said there had been an ‘overreliance on international recruitment’, pointing to competition for training places between UK-trained doctors and international medical graduates as evidence of workforce imbalance.

He also rejected what he described as a cultural attitude that treats care work as low-paid, low-status labour to be filled by overseas workers.

‘What is effectively being said is that care work is hard work and low-paid work, and therefore that’s not for us – that’s for people from overseas. I really reject that,’ he told MPs.

Mr Streeting said the government’s response was to improve pay, conditions and career structures in both the NHS and social care, with the aim of making care work a ‘profession’ offering progression and job satisfaction for all workers, regardless of background.

‘Whether you were born in Brixton or you’ve come from overseas to work in our health and care services, you deserve good pay, good conditions and the opportunity to progress in a career,’ he said.

Until pay and conditions improve sufficiently to attract more domestic workers, Mr Streeting acknowledged that the health and care system would remain dependent on migrant workers.

Pressed on what assurances he was seeking from the Home Secretary to ensure recruitment was not cut off, Mr Streeting said the government was working closely across departments.

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He said the home secretary’s approach was based on controlling migration ‘so that we are recruiting the people that we need – no more, no less’, while also reducing illegal crossings and abuse of the asylum system.

Mr Streeting also acknowledged that racial inequality and discrimination remains widespread across the NHS, affecting both patients and staff.

‘Racial inequalities and discrimination are actually quite endemic across the NHS,’ he told the committee.

He said the service had a ‘widespread cultural problem’ and indicated support for cultural competency being included in mandatory training for all NHS staff, while signalling that further discussions were needed on how best to implement this.

Turning to workforce planning, committee members also raised concerns about staffing in community services, particularly district and community nursing, where many staff remain on Agenda for Change (AfC) Band 5 despite high levels of responsibility.

The health secretary said discussions were ongoing with unions and professional bodies about reforming the pay structure, including progression from Band 5 to Band 6.

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In May, the government announced plans to end the recruitment of care workers from overseas in its Immigration White Paper – detailing its plans to ‘bring down historically high levels of net migration’.

Last year, data showed a 65% annual decline in the number of Health and Care Worker visas granted following the government’s move to ban direct overseas care workers from bringing dependents to the UK on their visa.

The RCN has previously warned that almost two-thirds of migrant nursing staff are considering leaving the UK because of cost of living pressures.