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This briefing paper looks at recent policy changes that may affect migrant workers in the NHS. It has been produced by researchers in the House of Commons Library.

£35,000 minimum pay threshold

In 2012, the Government announced that from 6 April 2016 Tier 2 (skilled worker) migrants from outside the European Economic Area who apply for settlement in the UK will be required to meet a minimum annual salary requirement of £35,000 after 6 years. The Coalition Government wanted to introduce more selective criteria for determining which non-EEA nationals can stay permanently in the UK. It wanted to break the link between coming to the UK with a temporary visa and staying permanently, as part of wider efforts to reduce net migration levels.

Concerns have been raised about the impact of the minimum pay threshold on migrant workers in the NHS. The Royal College of Nurses has said it is “highly unlikely” that a nurse will earn at least £35,000 within six years of employment in the UK.

On 15 October 2015, it was announced that nurses will be added to the Government’s shortage occupation list on an interim basis. This means that nurses from outside the EEA that apply to work in the UK will temporarily be exempt from the minimum pay threshold for settlement applications and will have their applications for nursing posts prioritised. The independent Migration Advisory Committee will review the change and present further evidence to the Government by February 2016.

Immigration health surcharge

An immigration health surcharge came into effect on 6 April 2015. The health surcharge is paid by non-EEA nationals who apply to come to the UK to work, study or join family for a temporary period of more than 6 months. It is also paid by non-EEA nationals who are already in the UK and apply to extend their stay. Once they have paid the charge, temporary migrants are entitled to free NHS treatment on the same basis as permanent residents, for the duration of their visa.

The British Medical Association and the Royal College of Nursing both raised concerns about the impact of the health surcharge on migrant workers in the NHS. The BMA – which represents doctors – expressed concerns that the health surcharge could make the UK a less attractive destination for skilled workers from outside the EEA, including doctors and other healthcare professionals.

Language testing for migrant healthcare professionals

Recent changes have also been made to language testing for migrant healthcare professionals. Non-EEA doctors, nurses and other healthcare professionals who wish to register to practise in the UK must demonstrate that they have the necessary English language competence before they can be registered.

The Government recently introduced regulations to also enable language controls for EEA healthcare professionals. In April 2014, the Government introduced regulations to give the General Medical Council powers to refuse a licence to practise in circumstances where the there are concerns about their English language competency. The regulations also created a new “fitness to practise” impairment relating to not having the necessary knowledge of English. Similar regulations were brought in for other EEA healthcare professionals, including nurses, midwives, dentists, and pharmacists, in March 2015.

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