Immigration Fees for Healthcare Workers

Debate between Stephen Kinnock and Rob Roberts

Monday 30th January 2023 Westminster Hall

[Stephen Kinnock (Aberavon) (Lab)]

It is a real pleasure to serve under your chairship, Mr Sharma. I add my tribute to my hon. Friend the Member for Gower (Tonia Antoniazzi) and the rest of the Petitions Committee for initiating this important debate today. I congratulate my hon. Friend on a very eloquent and powerful speech.

I also thank my hon. Friends the Members for Lewisham East (Janet Daby) and for Streatham (Bell Ribeiro-Addy) for their eloquent contributions. They made crucial points. In particular, the points about the Windrush generation were very apposite and also prompted me to think that it was quite disgraceful that the Home Secretary made an announcement under the radar, really, about dropping so many recommendations from the Williams review, without even having the decency to bring that to Parliament. My hon. Friends made important points in that context.

I also thank the hon. Member for Delyn (Rob Roberts), who made a very eloquent and powerful case for the points that he clearly holds dear, both personally and more broadly. Of course, 34,392 members of the public signed this petition, and that is really important in terms of the engagement in our democratic process. I again congratulate the Petitions Committee for selecting this matter; and of course I congratulate Mictin, who is in the Chamber today and has done so much to organise and drive the whole process forward.

The petition before us reflects two important policy considerations within the British Government’s system of work-based migration. The first is the fact that our national health service relies heavily on the vital contribution of migrant workers—a contribution that I am sure we in this room are all very grateful for—but that reliance is of course also a reflection of the Government’s failure to recruit and train home-grown talent here in the UK. Secondly, today’s debate is about whether current policy reflects the level of respect and gratitude that we have towards migrant health workers and ultimately, therefore, whether the fees that migrant health workers are required to pay are fair and just. With your permission, Mr Sharma, I will address that first point by saying a few words about Labour’s approach to work-based migration.

The key point to make is that we support the principle of a points-based system for migrant workers. It was of course the Labour party, a Labour Government, that introduced the points-based system for non-EU citizens back in 2008. Under the incoming Labour Government—when we enter government—there will be no return to the EU’s freedom of movement. In government, Labour will build on the points-based system that is currently in place, but we will make sure that it is a fair, firm and well-managed system that balances the requirements of businesses and public services with the need to provide the right levels of training and support for home-grown talent while recognising the critical role that immigration can play and ensuring that we treat migrant workers with the dignity and respect that they deserve. Labour’s long-term ambition is to make sure that all businesses in every sector, and our public services, recruit and train more home-grown talent to fill vacancies before looking overseas as the default position.

[Rob Roberts]

I appreciate all the things the shadow Minister is saying about home-grown talent. What is his and his party’s opinion about having much more of an emphasis on non-degree-based routes into things such as nursing? Cousins of mine who have been nurses for an awfully long time say, “Thirty-odd years ago, we just learned as we went. You learned on the job. You had a mentor and could learn all the skills that you needed in role, without needing academic qualifications and book smarts to be able to complete a degree.” What is his party’s opinion of that method of training?

[Stephen Kinnock]

The hon. Member raises a very important and interesting point. Of course, on education, it prompts me to think about how mad it was for the Government to cancel the nurses’ bursary. It is very good that it is now being reinstated, but terrible damage was done by that. However, I agree with him that we need a more vocational route into healthcare, health work and, indeed, many other professions. For too long we have not had parity of esteem between academic and vocational routes, and the fact is that we have a vast number of vacancies in our NHS and care system, so we need to take a broader and more inclusive approach. I agree with the hon. Member in principle, but the devil is in the detail. We have to make sure that we have people who are qualified, given that they do such important work looking after the nation’s health. We must make sure that they have the right qualifications, but I agree with the principle behind his point.

As I was saying, Labour’s long-term ambition is to maximise opportunities for home-grown talent, but we recognise that if we simply turn off the tap to foreign labour without the appropriate workforce structures and terms and conditions, and without adequate training in place, our public services will deteriorate further and our businesses will struggle. That is why we as a party will undertake a comprehensive review of the points-based system this year, based on real dialogue with business, trade unions, the public sector, the private sector, communities and other key stakeholders, such as the Migration Advisory Committee, to ensure that we are ready to upgrade the system and make it more fit for purpose when we enter government. The current immigration system exists entirely in isolation from long-term workforce planning, but a Labour Government would seek to connect immigration to wider workforce planning, productivity strategies and training and recruitment strategies, all the way from jobcentre reform to getting people off the record-high NHS waiting list of 7.2 million and back into work.

Presently, healthcare is one of the professions where migrant labour plays an absolutely critical role in filling vacancies, which is why our shadow Health and Social Care Secretary, my hon. Friend the Member for Ilford North (Wes Streeting), has already committed to delivering a long-term workforce plan for the NHS. It will be paid for by scrapping non-domiciled status, which will enable us to double the number of medical school places to 15,000 per year, and to create 10,000 more nursing and midwifery clinical placements each year, as part of setting a long-term NHS workforce plan for the next five, 10 and 15 years to ensure that we always have the NHS staff we need, so that patients can get the treatment they need on time. Not only will that provide good jobs for British workers and fill shortages in our NHS, it will also prevent us from having us to do the morally dubious deals that are going on with some of the poorest countries in the world, which involve recruiting medical professionals from impoverished communities that desperately need that medical knowledge to stay in-country, as is the case in countries such as Nepal, Kenya and, to some extent, the Philippines, where lifesaving talent plays a very important role. There are some morally dubious deals taking place with some of the so-called red list countries, as defined by the World Health Organisation.

Migrant workers’ contribution to and importance in our healthcare system is even more reason to treat them with the highest level of respect and dignity. It is important that their contribution is reflected within the specific policy that we are debating today: the fees charged to healthcare workers who apply for indefinite leave to remain.

As has been said, under the current Government arrangements, introduced in August 2020, healthcare visa applicants pay a fee of either £247 or £479 depending on whether they intend to stay in the UK for up to three or five years, and they are exempt from paying the immigration health surcharge, which is right and fair. However, the petition points out that despite the contribution that our international healthcare workers make, to apply for indefinite leave to remain they still face the eye-wateringly high fee of around £2,404.

Let us not forget that an individual on a skilled worker or tier 2 visa, such as a healthcare worker, who is applying for indefinite leave to remain must already demonstrate that they have lived and worked in the UK for five years, that they meet certain salary requirements and that there is a continued need for them to continue in that role. In effect, the Government are saying, “We still need you, we want you to stay in Britain and your job is critically important to us, but your time is up and you need to pay us £2,404 if you want to stay.”

UK Visas and Immigration transparency data shows the estimated unit cost to the Government for each indefinite leave to remain application is £491 as of November 2022. The data published in February 2022 estimated that cost to be £243, which is the figure referenced in the petition. I am sure the Minister will recognise that even the more recent figures show a huge mark-up in difference between the cost and the charge. That cost has to be shouldered by the hard-working international health and care workers who do so much to support our NHS and our care system. The Government claim the Home Office does not make a profit from those applications and that the money funds part of the wider border and migration system, but the mark-up on the fees is enormous by any benchmark.

We recognise the budgeting implications of any change to the current policy, and therefore Labour will need to look at it closely when we enter government. As a party that believes in the sound management of public finances, we have no choice but to take a cautious approach given the extent of the financial and fiscal mess that we will inherit.

To help us develop our thinking, I am keen to hear from the Minister on the following points. First, does he think that the current system and the fees associated with it are fair, given the extent of the mark-up? Does he have any plans to review that?

Secondly, have the Government undertaken an impact assessment on reducing the fees, not just as regards the border and immigration budget but looking at the wider benefits that a reduced turnover of migrant workers would bring to the healthcare system and community integration more broadly? That would also allow migrant workers more money in their pockets that they would spend in the local economy.

Thirdly, does the Minister feel that some of the language used in recent months by the Home Secretary about certain types of migrant—the use of the word “invasion” springs to mind—will be a help or a hindrance in persuading much-valued, hard-working migrant workers to spend £2,400 to continue supporting our country’s creaking health and social care system?

Fourthly, when will the Government publish their response to the Migration Advisory Committee’s April 2022 report into adult social care and immigration?

Finally, when will the Minister and this Government follow the Labour party’s lead in bringing forward a long-term NHS workforce plan that will encourage nurses to train up and stay in post, ease the burden on staffing, significantly reduce our record high NHS waiting times, reduce our dependence on recruitment from overseas and bring the quality of health and care that the British public truly deserve?