The UK’s healthcare sector is facing a growing crisis as the number of applicants for health and care worker visas has plummeted following major policy changes implemented by the previous government. Between April and August 2024, there were only 13,100 applications for these visas, marking an 83% drop from the same period in 2023, when 75,900 applications were received.
In August alone, the decline was stark, with just 2,300 applications compared to 18,300 in August 2023. This sharp decrease is attributed to stricter immigration rules, including increased salary thresholds and restrictions on dependents accompanying foreign healthcare workers to the UK.
Rising Costs of Medical Recruitment
The NHS is already grappling with significant staffing challenges, with the cost of medical recruitment reaching alarming levels. The NHS currently faces a high vacancy rate, with 100,658 unfilled positions in secondary care as of March 2024, including nearly 9,000 medical vacancies. This persistent shortage of healthcare professionals has forced the NHS to rely heavily on agency and bank staff, with the annual cost of temporary staffing soaring to £10.4 billion in 2023. This figure underscores the financial strain on the NHS, which spends billions annually on filling gaps left by unfilled permanent positions.
The Impact of Immigration Policy Changes
The previous government’s decision to tighten immigration rules for healthcare workers, including raising the minimum salary requirement for skilled worker visas from £26,200 to £38,700, has exacerbated the staffing crisis. Additionally, the ban on foreign care workers bringing dependents to the UK has made these positions less attractive, further reducing the pool of potential applicants. The number of applications for dependents on the health and care route fell by 73% between April and August 2024 compared to the same period in 2023. These policy changes, aimed at reducing net migration, have had the unintended consequence of deterring essential healthcare workers from coming to the UK at a time when the NHS is in desperate need of staff.
Broader Implications for UK Healthcare
The reduction in health and care worker visa applications comes at a time when the NHS is struggling to cope with a significant shortage of healthcare professionals. England has only 2.9 doctors per 1,000 people, compared to the OECD EU average of 3.7. To match this average, England would need nearly 50,000 additional full-time equivalent doctors. The regional disparities are also concerning, with no region meeting the OECD EU average, further highlighting the strain on healthcare services across the country.
This staffing crisis not only affects the delivery of healthcare services but also places additional pressure on existing NHS staff, leading to high levels of stress, burnout, and dissatisfaction. Nearly 42% of NHS staff reported feeling unwell due to work-related stress in the past year, and only 31.2% of staff expressed satisfaction with their pay, contributing to ongoing industrial action. The challenges extend beyond financial compensation, as many NHS workers feel undervalued, overworked, and unable to provide the quality of care they believe their patients deserve.
Reforming the Reform
The new Labour government is reviewing these restrictive immigration policies, with Home Secretary Yvette Cooper tasking the Migration Advisory Committee (MAC) to investigate the impact of wage thresholds and labour shortages in key sectors. This review will consider whether visa curbs for skilled workers should be adjusted to address the critical gaps in the UK healthcare workforce.
Reforming the system is essential to ensure the sustainability of the UK healthcare sector. Potential reforms could include revising the salary thresholds to make healthcare roles more accessible to international applicants, relaxing restrictions on dependents, and streamlining the visa application process to attract the necessary talent. Additionally, the government must address the underlying issues within the NHS, such as improving working conditions, increasing staff retention, and investing in the domestic training of healthcare professionals to reduce dependency on overseas recruitment.
Without urgent action, the combined impact of stringent immigration policies and ongoing workforce challenges will continue to threaten the provision of healthcare services in the UK, jeopardising patient care and the overall effectiveness of the NHS. Addressing these issues requires a comprehensive strategy that balances the need for controlled immigration with the critical demand for healthcare workers who are essential to the UK’s health system.