Government unsure how many NHS staff will be affected by immigration changes

The government has admitted it does not know how many NHS staff will be affected by its proposed changes to immigration rules, as a consultation on the reforms draws to a close.

Health minister Karin Smyth confirmed her department lacks information on the national impact of the plans on NHS workers.

The proposed reforms seek to extend the period required for individuals to gain settled status in the UK, with indefinite leave to remain (ILR) typically granted only after 10 years, subject to specific criteria.

While doctors and nurses directly employed by the NHS are exempt from these new rules, staff in social care and private healthcare – including those working on NHS-contracted cases to reduce backlogs – will be impacted.

The policy, announced last year, was framed as an effort to strengthen the government’s stance on immigration and reduce arrivals.

Labour MPs, including Neil Duncan-Jordan for Poole, have criticised the approach as “un-British” and an attempt to pander to Reform.

Trade bodies have also voiced strong opposition, with the Royal College of Nursing (RCN) labelling the plans a “grave error” and the Unison union warning they would divide parts of the NHS into “high and low skilled” workers.

In response to a written parliamentary question from Mr Duncan-Jordan, Ms Smyth stated: “The department does not hold information on the number of existing National Health Service workers nationally… who could be affected by proposed changes to the rules on indefinite leave to remain.”

The Department for Health and Social Care (DHSC) told the Press Association that it is important the NHS avoids being “over-reliant on international recruitment” and announced its workforce plan would be published in the spring. The consultation on these ILR reforms is set to conclude in a fortnight.

Currently, individuals living in the UK on specific valid visas for five years automatically qualify for indefinite leave to remain.

However, the new proposals would double this to 10 years for many, potentially extending to 15 years for some.

Applicants would also need to meet additional criteria, including language proficiency and demonstrating a “sustained and measurable economic contribution”. The government also intends to make it more difficult for visa holders to bring dependants.

Introducing the consultation in November, Home Secretary Shabana Mahmood said: “To become a part of this country, permanently, is therefore not a right but a privilege – and one that must be earned.”

Responding to the health minister’s admission, Mr Duncan-Jordan said: “The Government is pushing through sweeping immigration changes, yet the Department for Health and Social Care does not even know how many NHS and care workers will be affected. That should ring alarm bells.”

He added: “We have the troubling situation where the left hand of Government does not seem to know what the right is doing – with the Casey Review promising a new strategy for social care at the same time the Home Office squeezes out the very workers keeping the sector afloat.”

Mr Duncan-Jordan further criticised the policy, stating: “This policy is designed to out-Reform Reform and chase Nigel Farage’s tail, when we should be starting from fairness and securing the skills our country depends on. Breaking our word to people already here is wrong and un-British.”

The number of people applying for a health and care worker visa in the UK nearly halved last year, with approximately 61,000 applications (main applicants or dependants) compared to 123,300 in 2024.

This decline followed changes introduced last summer, which ended overseas recruitment for care workers and raised the minimum salary for skilled workers to £41,700.

While NHS doctors and nurses, or those paying higher taxes, might still qualify for settlement after five years under the proposals, lower-qualified workers who arrived on health and social care visas during the so-called “Boris wave” from 2022 could face a 15-year wait.

Amber Jabbal, director of policy at the Royal College of Nursing, said their analysis indicated one in 10 registered nurses would be affected.

Ms Jabbal warned that thousands could be “driven away” from health and care settings at a time of existing staff shortages.

She stated: “International nursing staff are crucial to the functioning of our health and care services. We should be thanking them for the sacrifices they make to care for us, not seeking to make their lives more difficult.”

Ms Jabbal continued: “While the Government has stated that nurses working in the NHS won’t be directly affected by the changes, extending the ILR qualifying period for the rest of the nursing profession and registered nursing staff in social and primary care would be a grave error, causing uncertainty and denying them access to vital support. It is also a disaster for patients.”

Helga Pile, head of health at Unison, commented: “To introduce these life-altering rules with so many unanswered questions is nothing short of reckless.”

She added: “Every overseas worker in the NHS will be affected if they don’t already have residence rights. That will leave key workers in limbo for 15 years under these proposals and will cause chaos for long-term planning in healthcare.”

Ms Pile concluded: “NHS staff are all part of one team but that will be split apart by the Home Office’s view about who is high or low skilled. Ministers must conduct a proper impact assessment on the health and care sector before these plans go any further.”

Dora-Olivia Vicol, chief executive of the Work Rights Centre, echoed calls for clarity, stating: “We urgently need a detailed impact assessment. Without it, this consultation is a farce.”

A Department of Health and Social Care spokesperson reiterated: “We are proud that the NHS is one of the most diverse workforces in the world and we hugely value the contribution of our overseas staff.”

However, they added: “it is important we are not over-reliant on international recruitment at the expense of giving opportunities to our own homegrown talent.”

The spokesperson confirmed their upcoming workforce plan, due this spring, would further detail staffing plans for the NHS.