Thousands of South African nurses working in the UK could be forced to return home because of new immigration rules introduced by the British Government recently.
Under the new regime, employers in the United Kingdom will only be granted a work permit for a foreign nurse if they can prove they were unable to find a suitable candidate in Britain or the European Union. Previously nursing was exempt from this requirement as one of the "shortage occupations" where there weren't enough qualified people locally to meet the demand.
However, with up to 80% of newly qualified British nurses now unable to find jobs, the Government has decided to remove the exemption for foreign nurses in a bid to safeguard jobs for locals and to create an "NHS workforce that reflects the communities it serves".
The changes, which affect all but the most senior nursing positions and those in specialist areas, will make it much more difficult for South African, and all non-EU/EEA, nurses to get jobs in the UK. Foreign-born nurses who have graduated from UK- or European Union-accredited institutions will have a strong advantage, also.
However, it appeared there was some confusion about how the rules will affect those who already have jobs in the UK. According to the UK's Royal College of Nursing, even foreign nurses who already have work permits could be forced to leave when their contracts run out.
A spokesperson said: "We have huge concerns about what will happen to those people already in the UK who are on work permits. Unless the employers can prove there was nobody else in the UK or the European Union suitable for that position, they won't be able to have their work permit extended."
But Val Detnon, an immigration expert, said employers would be able to apply for an extension to existing work permits without having to re-advertise the job. Where the new rules would hit foreign nurses, she said, was when they moved [changed jobs] or took a promotion. Then they would have to apply for a new work permit and that would only be given if the employer could show there were no suitably qualified candidates from Britain or the EU.
There were particular fears about the effect of the new rules on those foreign nurses who have gone to the UK but have not yet taken up jobs.
"There are thousands of overseas nurses who have come over, are doing their adaptation courses and are waiting to get into the job market who will be affected immediately. We're really not sure what is going to happen," said the RCN spokesperson. "Some of them will have had their air fares paid by potential employers who now will probably not be able to employ them. We're worried they're going to ask for their money back."
The Democratic Nursing Organization of South Africa also cautioned that the new rules could leave some South African nurses effectively stranded in the UK. But Siphokazi Phillip, international relations coordinator for Denosa, welcomed the change if it meant that "more of our nurses stay and those who are there come back".
Indeed, with up to 10,000 South African nurses working in the UK, according to some estimates, anything that persuades more to return could be good news for South Africa, which is struggling with a critical shortage of qualified nurses.
Six years ago there were 120 nurses for every 100,000 people. Last year there were 109. According to statistics from the South African Nursing Council, at the end of last year there was just one auxiliary nurse for every 577 people in Gauteng and experts have warned the situation is getting worse.
The problem has been exacerbated by aggressive recruiting efforts of western countries such as the UK, Canada, the United States and Australia in recent years. It is estimated that nearly 25,000 medical professionals left South Africa for the UK, Australia, Canada and New Zealand, among others.
Most have been drawn overseas by better pay, increased education opportunities and the promise of better working conditions. An experienced theatre nurse in the UK can earn up to five times the salary of a colleague in South Africa.
Four years ago the UK government introduced an "ethical" recruitment policy for the NHS, which banned it from actively recruiting nurses and other healthcare professionals in over 150 developing countries, including South Africa.
However, South African health officials accused the UK of circumventing the ban by using private recruitment agencies. In the four years since the ban has been introduced, 6,104 South African nurses have registered to practice with the UK's Nursing and Midwifery Council (NMC).
Some South African nurses working in the UK said the new rules could be the final straw for many who are already fed up with being treated like second-class citizens and given menial tasks, even though they have many years of experience.
"We don't really know how it's going to work," said Zodwa Dube, a South African nurse working at a private hospital in Surrey. "A lot of South Africans just want to go home anyway because they had certain expectations about England and those haven't been met."
Another South African nurse, who did not want to be named, said she had heard of one major London hospital at which it was now policy that any overseas nurse who committed even a minor misdemeanor would be dismissed in a bid to open up jobs for British nurses.
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