How much should a migrant nurse have to earn before they are allowed in the country? Why does the Government pay less than this?

Brexit causes many problems – one of which is Britain having to construct its own migration policy. We know this will have a big impact on the NHS. That’s why I have spent some time going through the EEA Migration in the UK – Final Report of the Government Migration Advisory Committee. – so you don’t have to.

In the course of justifying its own bar for migrants (of having to earn more than £30,000 annual income) this report turns out to have some surprising things to say on how much more nurses need to be paid in this country.

If the Government were to accept this report it would have major implications for the sustainability of the NHS. Existing staff shortages in every part of the NHS tell us why this is so important.

Lady Harding said the other day that, “The single biggest problem in the NHS at the moment is that we don’t have enough people wanting to work in it.” This may seem to add little to the debate, but actually it is a crystal-clear statement of the problem. Training people is a good idea, but it doesn’t help the NHS if, when they are trained, they don’t want to work in the NHS. Staff shortages exist because we haven’t made it a place in which enough people want to work.

But there are a significant number of people from abroad who want to work in it.

And that is why this report has such a potentially important impact on the NHS.

The report starts out with a clear statement of the recent past experience in the Executive Summary paragraph 22,

“EEA migrants contribute much more to the health service and the provision of social care in financial resources and through work than they consume in services. EEA workers are an increasing share of the health and social care workforces though these sectors employ greater numbers of non-EEA migrants. There is no evidence that migration has reduced the quality of healthcare.”

Historically this is an important finding since it conflicts with the everyday beliefs of many people who have argued against migration. Migrants from Europe contribute more to the NHS and social care than they use the services. They are a benefit and not a cost.

But the report is not only an analysis of the past, it crucially has recommendations for the future. And those recommendations have a direct impact on the NHS and will stop some people who want to work in it from coming here.

Much of the report argues for a cut-off point that people need to be earning in the UK before they are allowed in. The bar is set at £30,000. If you earn more than that you can come in – less and you can’t.

Chapter 4 paragraph 16 states


“…averaging across all household types, the net fiscal contribution of EEA and non-EEA migrants varies with annual household income. The “break-even” point seems to be about £30,000 for EEA migrants…”

What this means is that if they earn less than £30,000 p.a. EEA migrants are more likely to consume services and be eligible for benefits – costing the country more than we get from them. (I know this is a tough way of looking at human beings and their lives – but it has its own internal logic that I want to work through).

The problem for the NHS (and a much greater one for social care) is that many of the nurses that we need to come to the country will earn less than £30,000. Many NHS leaders have pointed out that a £30,000 bar will cause it a big problem.

And if the Government accept this recommendation, it will cause severe and growing problems for the NHS as staff shortages become more and more critical.

But I also want to make another point.

If the committee says you need to earn £30,000 p.a. to avoid having to depend on benefits, how come we are paying nurses less than that in the first place? Apparently its OK to pay a British born nurse so little that they need benefits, but it’s not OK to pay a migrant nurse that much.

If the Government accepts that £30,000 is the amount you need to earn to not be dependent on benefits, then it is also saying something about how much it values nurses and its own culpability by paying them less.

Importantly this isn’t just me saying this. The report itself says, in the Executive Summary, para 42,

“There is often a claim for public-sector workers to be treated differently, most commonly on the grounds that the value of the work is not reflected in the salaries paid. The MAC does not think the public sector should be treated differently: it would be better to pay public sector workers salaries that reflect the value of the work.”

By sticking to the £30,000 recommendation they are expressing the belief that public sector staff (in our case nurses) should be paid more.

So let’s see what happens.

If the Government accepts the report’s recommendation of a £30,000 bar it will mean that we will run out of nurses.

But if it accepts the whole report we will be OK as all nurses will be paid more than this.

I would love to be in the Cabinet room when this is discussed between the Home Secretary (migration policy), the Secretary of State for Health and Social Care (chronic need for more nurses) and the Chancellor of the Exchequer (who is going to have to pay for higher salaries)

Just remember this farce is called Taking Back Control.

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