UK hospitals cut jobs but still hire abroad



Hospital bosses have spent thousands of pounds on trips to recruit foreign doctors and nurses, while laying off their own staff.

 By Laura Donnelly, Health Correspondent, The Telegraph, 11 September 2011

Visits to destinations including India and Dubai took place as the NHS drew up plans to cut 20,000 jobs for front line health workers.

An investigation by The Sunday Telegraph has found that at least 11 NHS trusts and one health authority sent teams abroad to recruit doctors and nurses, despite such posts being earmarked for cuts.

The trips were organised despite pledges by David Cameron to cap immigration and protect British jobs, and concerns raised last week by Lord Winston, one of Britain's most senior doctors, that some nurses from Eastern Europe put patients in danger because of poor standards of English. The head of the Royal College of Nursing also condemned the visits as "incomprehensible and unacceptable".

Dartford and Gravesham Trust in Kent sent a team to Romania in November and hired 20 nurses, even though Barts and the London NHS Trust, less than 20 miles away, was drawing up plans to cut 635 posts including more than 250 jobs for nurses.

Barking, Havering and Redbridge University Hospitals Trust sent seven managers to Dublin in October, returning with seven nurses. Less than two months later, it disclosed plans for 100 redundancies.

More than 10,000 doctors and nurses who trained overseas registered to work in Britain in the first 12 months of the Coalition. There was a 53 per cent rise in foreign nurses who registered with British regulators, from 2,804 to 4,303, while the number of foreign doctors increased by eight per cent from 5,359 to 5,811.

The number of nurses from outside the European Union, where an immigration cap applies, went from 635 to 1,307.

Dr Peter Carter, the Royal College's general secretary said it was "absolutely crazy" that hospital trusts had gone abroad to recruit.

"It is incomprehensible and unacceptable to have these sorts of recruitment trawls abroad when so many staff are being laid off, and so many newly qualified nurses can't find work," he said.

Dr Carter accused hospitals of failing to work together and said the Government had encouraged "fragmented" policies instead of joint planning to fill vacancies with those who had been laid off or newly-qualified nurses.

A central body, NHS Employers, negotiates general terms and conditions but recruitment is left to trusts. Hiring staff abroad usually means paying commission to agencies, which charge up to £11,000 to fill each post.

The RCN has identified more than 40,000 posts which have been axed or earmarked for cuts within three years, under NHS plans to save £20 billion. More than half are estimated to be clinical posts, filled by doctors, nurses and health care assistants.

Wendy Cupid, a senior nurse from Hayes, west London, was made redundant in July when her trust, NHS Hounslow, was restructured. Despite more than 16 years' experience, she could not get a job and was left feeling "like a failure". Responses to freedom of information requests show that 12 trusts sent more than 50 staff abroad to recruit in the year after the election, bringing back 182 nurses and midwives and 24 doctors.

Each said it had failed to recruit at home. Some said filling vacancies abroad was cheaper than using locums and agency staff. Rotherham NHS Foundation Trust spent more than £7,500 sending a team of eight to Madras, India, to recruit 11 doctors in June last year. Months later it announced plans to cut 62 medical and surgical staff.

Northampton General Hospital Trust went to Italy and Portugal in December to hire 28 nurses and midwives. In May it announced plans to cut 310 posts over two years. Last week Lord Winston, professor of fertility studies at Imperial College London, told the House of Lords of his concerns about eastern European nurses. He said he was particularly worried about those from Romania and Bulgaria who had limited communication skills "even in their own language" and were not used to talking to patients or doctors.

Katherine Murphy, chief executive of the Patients Association, said: "We hear from patients that there are real issues with nurses from other countries including problems communicating with patients and a lack of understanding of processes and procedures."

Not every attempt to recruit was successful. Sylvia Gomes, neonatal matron at West Hertfordshire Trust, was given £500 towards a flight to Mumbai in January to visit her family, combined with an "opportunistic" attempt to recruit nurses. None was hired, as the Home Office would not provide work permits.

Simon Burns, the health minister, said: "NHS employers are only allowed to employ foreign doctors and nurses if there are no suitable staff available in the UK or European Economic Area."

The Guardian: David Cameron's immigration promises were desperate and self-defeating

By Richard Seymour, published in The Guardian (a British daily newspaper) on 6 September 2011

Torn between his business allies' enthusiasm for immigration and the Tory bedrock, Cameron has been left looking foolish



David Cameron delivering a speech on immigration in Woking in April. Photograph: Steve Parsons/PA



David Cameron's pledge to cap non-EU immigration was followed this year by a promise to Tory activists to reduce net migration to the UK to tens of thousands. This now looks as foolish as it does desperate. Some of the greatest flows of immigration in recent years have come from the EU, especially the A8 countries, to which no cap could be applied. And the government has no control over outward migration. Unsurprisingly, then, a combination of continued migration from Poland and other EU countries, and a sharp decline in Britons moving overseas, has led to a 21% increase in net migration last year.

The pressing question is whether this is anything to be worried about. For the Telegraph, it is. Its recent editorial acknowledged the factors driving the net increase, and gave Cameron a partial pardon. But still, it thundered: "The annual addition to the country's foreign-born population is about 250,000 – by far the largest influx of overseas citizens in our history." In fact, net migration to the UK adds far less to the population than it does in other OECD countries.

But the assumption that an increase in the "foreign-born population" is a problem in itself depends on a couple of associated claims. The first is typically that migrants are a burden on public resources, while the second is that they fail to "integrate" to core "British values". Both come with a freight of resentful chauvinism. In reality, migration to the UK fuelled economic growth over the past decade. Without it, tax receipts would have been depressed, with fewer resources for all. As the Financial Times reported last year, immigration subsidises the public purse. In an era of reduced tax revenues, which the government claims justifies spending cuts, it is absurd to attack one of the major sources of income. As for the chimera of "British values", it is only fair to say that even the descendants of yeomen sometimes have difficulty internalising the vindictive, property-obsessed, and smugly insular weltanschauung that passes for Britishness in the reactionary press.

Cameron, being no fool, is aware of Britain's dependency on immigration, and of his inability to do much about it. His attempt to wax "tough" on immigration also poses a difficulty for the coalition he leads. The promise to reduce net migration to "tens of thousands" aroused the ire of Vince Cable, who deemed it a Tory policy not fit for the coalition. And the further Cameron travels down this route, the more he risks alienating centrist voters whose support he spent five years courting with an appeal to social liberalism. Much of his time in opposition was spent attacking New Labour over its "irresponsible" language on immigration, and promising a more humane approach to refugees. This was an essential aspect of decontaminating the Tory brand of its "nasty" associations. Above all, business needs immigration, especially EU migration. There are some areas where Tory EU "scepticism" can suit business. Tory attempts to water down an EU directive giving temporary workers the same rights as full-time workers follow business pressure over the likely effect on profitability. Yet the EU represents an irreversible trend in the global economy toward regionalisation, and offers a vast "free market" in goods and labour that business needs.

So why did Cameron make a futile promise that he knew would cost him politically? Partly, he is torn between his business allies, who favour a relaxed approach to immigration, and the lower-middle-class Tory bedrock, who would ideally like to inhabit the sort of all-white chronotope of modern Britain purveyed by Midsomer Murders. Cameron has attempted to manage this by triangulating. Thus, his cap on non-EU migration partially made up for his reneging on the "cast iron" guarantee to hold a referendum on the EU treaty. Similarly, he has made concessions to alarmism about immigration threatening "our way of life". Yet, under pressure from big business, he has relented, even promising last year to relax the cap on non-EU migration. Thus, while tending to give business what it wants, Cameron engages in strategic rhetorical tilts to one or other element in an unstable Tory coalition, in an attempt to prevent the whole from collapsing into fragments as it did over Europe in the 1990s.

Since being almost-elected, the emphasis in Cameron's presentation has fallen increasingly on immigrant-baiting rhetoric, from the attack on "state multiculturalism" to the "way of life" speech. Notably, his self-defeating promise to reduce net migration to a trickle followed a year of coalition. This reflects the electoral weakening of the Liberal component of the coalition, and the polarisation of British politics under austerity. The centre-ground is contracting, and Cameron knows he must fortify his rightist credentials if he is to avoid being this decade's John Major. This is why he makes promises he shouldn't make, and can't keep, to people who will never be content with him anyway.

UK economy at risk from immigration cap

The UK Government's own advisory committee, the Migration Advisory Committee, has stated that the British economy could suffer permanent damage if the Government continues to restrict non-EU skilled immigration.

In April of 2011, the current Government implemented a permanent cap on Tier 1 and Tier 2 skilled immigration. This followed on from the temporary immigration cap of the previous year. The popular Tier 1 (General) category no longer exists. There is a new Tier 1 (Exceptional Talent) category; However, hardly anyone meets the requirements for this visa category. Moreover, Tier 2 skilled immigration for applicants with a job offer from a UK employer was capped at approximately 21,000 visas per year and, for many people, made a lot more difficult.

The measures were put in place to appease popular anti-immigration sentiment in Britain. Immigration Minister Damian Green has stated that his government intends to reduce immigration to the "tens of thousands".

However, a report from the Government's Migration Advisory Council, Limits on Tier 1 and Tier 2 for 2011/2012, has stated that whenever the number of skilled non-EU migrants coming to the UK is reduced by 10,000, over half a billion pounds is lost from the UK GDP. This could have disastrous consequences for the British economy at a time when it has still not fully recovered from the global financial crisis of 2008.
The report suggested that "non-EU Tier 1 and Tier 2 migrants, at present levels have a small positive impact on GDP per head" and contribute positively to net public finances and play an important part in the provision of education, health and social services.

The report stated that cutbacks to immigration would not be evenly spread and could have a severe impact on certain sectors.

"It would be remiss not to point out that there is widespread concern among employers regarding the impact that limits on migration could have," the report stated.

UK Businesses and industry groups are concerned about the recent immigration restrictions.

Neil Carberry, employment affairs director at the Confederation of British Industry (CBI), told The Independent that the "ability to base highly skilled foreign staff in the UK helps to attract investment that also supports British jobs."

"With numbers in the employer-sponsored work permit system already relatively low, there is little evidence that this part of the system should be the government's key priority on controlling migration," he added. "We should want to attract these people to come and retaining a route to settlement is a key part of that, although businesses don't object to having a more formal points test for the right to settle."

Canada seeks public opinion on immigration

It has long been a destination for people from all over the world, but now Canada is looking to find out what its citizens think of its approach to immigration.

Welcome to Canada: around a quarter of a million immigrants arrive in Canada every year


An online questionnaire has been launched by the Canadian government to try and gauge the public’s opinion on its immigration policies.

Nearly 2000 people have already signed up to answer the survey, which is part of an ongoing consultation into immigration carried out by the Department of Citizenship and Immigration (CIC).

“The online consultation provides an important opportunity to gather input from stakeholders and the public on key questions facing CIC," said Jason Kenney, minister for citizenship, immigration and multiculturalism. "This is also a chance to highlight some of the considerations and difficult choices involved in managing a global immigration system."

Canada has one of the highest per capita rates of immigration in the world, accepting around 200,000 to 280,000 new migrants every year. It is predicted that by 2031, between 25 and 28 per cent of the population will be foreign-born.

While this "open arms" policy may help to combat the country’s ageing population, low birthrate and skills shortage, how to manage the constant influx has come under increasing debate in recent years.

Cambridge English test recognized by UK and Australia

The Cambridge University's Certificate of Advanced English is now recognized by the UK Border Agency (UKBA) and Australia's Department of Immigration and Citizenship (DIAC); You can now take this test to confirm your English language ability when applying for a student or immigration visa.

Cambridge said that the decision by UK immigration and Australia immigration was made in a bid to attract more students to higher education establishments both in Australia and the UK. Both countries have recently come under fire for bringing in stricter student immigration rules.

The UK recently brought in more restrictions on foreign students working in the UK. The UK also intends to axe the popular Tier 1 Post Study Work visa scheme. Australia had made English language requirements somewhat tougher for foreign students. More recently, following concerns from the country's education sector, Australia immigration eased some of the requirements for those applying for student visas.

UKBA now recognizes Cambridge's Key English Test, Preliminary English Test, Business English Certificate, Certificated Version of Business Language Testing Service, Certificate of Advanced English, Certificate of Proficiency in English, International Legal English Certificate and International Certificate of Financial English as suitable tests to confirm English language ability.

In the past, the International English Language Testing System (IELTS) was the main test used for assessing English language ability. However, it is not always easy for students to find places on IELTS courses due to the high demand for these tests.