Indefinite Leave to Remain: Healthcare Workers

Tom Hayes Excerpts

Monday 18th November 2024 Westminster Hall

[Tom Hayes (Bournemouth East) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Southampton Test (Satvir Kaur), whom I am delighted to follow. She is always a keen champion for Southampton and the NHS. I also thank my hon. Friend the Member for Folkestone and Hythe (Tony Vaughan) for introducing the debate.

In this petition, we have a proposal to bring eligibility for indefinite leave to remain for migrant carers down from five to two years. Only a few months into being an MP, I am always delighted to see solutions and proposals rather than a regurgitation of problems. For me, it comes down to identifying the problems that the proposal intends to solve.

Behind the petition lies a concern that we lose migrant carers once they are here; that we lose out on them to other English-speaking countries; and that without the migrant carers in our country and those who may come to our shores, the NHS—as we all know, it faces its worst crisis in a generation—will fall over. The NHS is perhaps in the worst situation it has ever known, partly as a consequence of the vacancies that it carries, although there are many other reasons, too. To put it on a firmer footing, we need to fill those vacancies more urgently than the timescales for recruiting and training new NHS staff allow, so migrant workers will be part of the temporary solution to our workforce problems.

In that spirit, I commend the NHS carers who support patients in my constituency of Bournemouth East, particularly at the Royal Bournemouth hospital. A full 24% of the workforce at that hospital are from the global majority—a far higher percentage than is reflected across Dorset. Some 477 are Indian, 530 are African, 273 are Filipino, 72 are Pakistani, 29 are Nepalese and 31 are Sri Lankan. As I saw when I was at the hospital recently, that really is reflected in the spirit of care given to patients. I commend everybody who contributes to our NHS, wherever they come from. It is great to see the Indian population in Bournemouth growing—I have been to some of their recent celebrations. They are so proud to serve in our NHS, and I commend their work.

On the whole, however, we should recognise that migrant working will be a temporary solution. We must urgently start the longer-term and more sustainable solution of training, recruiting and retaining a domestic workforce. The NHS is the largest recruiting employer in Dorset. However, accounting for 6% of all vacancies in 2023, the NHS and the care sector face significant skill shortages and recruitment difficulties. The long-term workforce plan predicted that the workforce would need to grow by 2.6% to 2.9% a year, with 71,000 to 76,000 allied health professionals, which is an enormous target to meet. The plan identified shortfalls in the number of allied health professionals, namely paramedics, occupational therapists, diagnostic radiographers, podiatrists and speech and language therapists. There is clearly a gap in a wide range of professions. The shortfall is due to the education and training pipeline not keeping pace with the demand that we all knew was coming, and that, my hon. Friends, is a casualty of 14 years of Conservative Government.

We need to increase the number of local people employed in health and care careers. I commend the Dorset integrated care system’s people plan, which outlines that as a priority. We must also open young people’s minds to the idea of roles in health and social care before they make their career choices, and we must make apprenticeships an attractive career pathway for a wide range of people, including those who would normally choose higher education. Indeed, the long-term workforce plan identifies that more than a third of AHPs could train through apprenticeships. I commend Health Sciences University, Bournemouth and Poole college, and Bournemouth University, which are excellent education providers. With more support from Government in the form of funding and frameworks, they could do so much more to train the carers of the future from within our communities.

We all know that a larger domestic workforce is the future, and that investing in education and training is key. Because we have not done so, we have an urgent workforce gap to fill. Migrant workers can be part of the solution to fill that gap and avoid significant vacancies in the future, but it begs the question of what policy levers need to be pulled, and whether we lose migrant carers once they are here because they choose to leave—because of the cost of living crisis, or for other reasons—or because they choose not to come here in the first place and go to other English-speaking countries.

By requiring migrant healthcare workers to qualify for indefinite leave to remain after five years rather than two, and by making no immediate changes to existing policy, the Government are taking a view about whether they need to encourage migrant carers to come to or stay in the UK. The Government had at least three other options in relation to the petition and the urgent need to fill the gaps in our workforce. First, they could have agreed with the petition in its full scope. Secondly, they could have done something about eligibility for indefinite leave to remain, but not delivered the full scope of the petition; they could have reduced eligibility from five years to something more than two years. Thirdly, they could have done nothing with eligibility, but they could have done something else to further encourage migrant carers to fill the gaps in health and social care.

Whether the Government create new policy levers over time and pull them to encourage migrant workers to serve in our NHS, we must bear in mind one key thing. We must make sure that all future planning around workforce is effective and happens at place-based level. We need our integrated care systems to map projected vacancies and understand where carers will come from, whether it is through apprenticeships and training or from overseas. We must plan the healthcare, education, housing, transport and other infrastructure necessary to support any increase in the population at a local level. I think that is particularly important, because when I was knocking on doors in the months before the general election, it was clear that behind every single door there was a feeling of hopelessness—a feeling that nothing improves, nothing gets better, the problems are too big to fix and nobody has done anything for so long.

If we do not put in place the right frameworks and funding, and if we do not fill the gaps in our healthcare workforce and put in place a longer-term, sustainable trajectory to a full workforce, we will store up yet more problems and create yet more hopelessness. I therefore encourage the Government to do all they can to support the NHS—now on life support—by filling those gaps in the workforce, and to do all they can to support colleges and universities in my area and elsewhere to make sure that we have the workers of the future.