Immigration Skills Charge for the NHS

MQT on 2017-08-10
Session date: 
August 10, 2017
Question By: 
Onkar Sahota
Labour Group
Asked Of: 
The Mayor


The government has introduced a new immigration skills charge where every employer must pay £1000 per non-EU employee per year. In March, the BMA and Royal College of Nursing wrote a joint letter to Amber Rudd, copied to Jeremy Hunt, asking for the NHS to be exempt from the charge.  Do you think this is an extra cost the London NHS and social care system can afford?


Answer for Immigration Skills Charge for the NHS

Answer for Immigration Skills Charge for the NHS

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  Thank you for your question.  This is an important question.  You may be aware that I have spoken about this issue before.  At the start, it is important to say this is not a choice - and I know you are not suggesting this - between investing in the skills of Londoners or recruiting from outside the United Kingdom (UK).  Migration benefits London and it is part of the capital’s success.  It helps make London the world’s leading city for business, research and innovation.  It leads to an economy that creates jobs, many of which will be high‑skilled, and opportunities for Londoners too. 


Frankly speaking, I do not think that London’s National Health Service (NHS) and social care system can afford this change.  I am told that the overall purpose of the Immigration Skills Charge is to address skills gaps.  I understand the logic.  Of course, I am also keen to see Londoners have the skills that London’s employers need.  However, I believe introducing this measure now will just put further pressure on health and care services that are simultaneously being told they need to absorb significant cost increases to help manage an already extremely challenging financial position.  Moreover, this measure would make more sense if there was a surplus of people in this country to work in these roles.  However, there are not.  It takes years to train doctors and nurses, and workforce planning and the health system has not been robust in recent years. 


It is also important not to lose sight of the wider context, the value of migration to London.  Last month I hosted a migration summit that brought together business and public-sector representatives, including the NHS, along with policy experts.  There was a clear consensus that London needs to remain open to skills and talent.  This drives innovation, jobs and growth which creates more opportunities for Londoners.  My position is that this should be based around the UK’s continued membership of the single market and a reformed visa system for non‑European Union (EU) nationals.


Dr Onkar Sahota AM:  Thank you, Mr Mayor, for that answer.  Of course, you know that the British Medical Association (BMA) and the Royal College of Nursing have asked for the health service to be exempt from this.  However, of course, there is a triple whammy operating here.  One is that we do not enough UK-trained citizens working within the health and social care sector.  Secondly, Brexit is causing a huge exodus of personnel from the health service.  In the Evening Standard this week there was headline saying the exodus of staff caused by Brexit could cripple the NHS.  The Head of the Royal College of Nursing warned about this.  We have a triple whammy operating.  We are not training enough people to work in this country.  It is costing us more to employ people from non-European Community (EC) countries.  People from EC countries are leaving the UK because of the threat of Brexit.  This does not make sense at all.  What can we do or what are you doing to bring pressure to bear on the Government in this respect?


Sadiq Khan (Mayor of London):  You have referred to three big issues.  The fourth issue is at a time when money is tight to expect the public-sector hospital trust to pay £1,000 a pop does not make sense.  It is a disincentive and they cannot afford to do so.  It is a big issue.  The Secretary of State for Health has to get a grip.  There is a skills shortage.  If you are a young Londoner thinking about a career in health and social care and you look at the way professionals are being treated in the recent past you may ask the question, “Do I really want to do that?”  I am not detracting from the need for us to train up our youngsters to do these jobs in the future and you are not questioning it either.  What I am saying is when there is a staff shortage and when there is a situation where people are choosing to leave this country because of Brexit and other reasons, it does not make sense for there to be this fear around the tier‑2 visa applications.  That is why your question is so important.  It is important for the Government to recognise that.  Of course we want to train up our youngsters, but this is not the way to address the current problems in the health and social care system.


Dr Onkar Sahota AM:  I agree entirely that the problem is not just about training enough people in this country, it is also about retaining them.


Sadiq Khan (Mayor of London):  Absolutely right.


Dr Onkar Sahota AM:  We need to encourage UK citizens to go into the health care system but, of course, it should be effective for them to do so and to remain in the health service.


Sadiq Khan (Mayor of London):  The context is I am told in London the nursing vacancy rate is 15%.  It is not as though there is a big surplus of skilled people.  There is a vacancy rate that is very, very high and that is why it is important for the Government to recognise that this policy is not going to do London’s NHS any good.


Dr Onkar Sahota AM:  Good.  Thank you, Mr Mayor, for that.