Parliamentary report: non-British nationals an important minority of NHS staff

By Lauren Distler

A recent report by the House of Commons Library investigated the nationality makeup of the doctors, nurses and staff currently working for the NHS. The parliamentary report found that while the majority of NHS staff are British, a significant minority - 12% of all staff for whom nationality is known - report a nationality other than British.

The highest proportion of non-British staff is found among those working as doctors, where fully 26% of staff identify as having a nationality other than British. Non-British nationals also make up 16% of nurses, 9% of support staff and 7% of technical support staff.


Chart showing nationalities of NHS staff

The regional distribution of doctors with non-British nationalities working in the NHS is fairly consistent across Britain, with the highest percentage of British doctors found in the south-west (83%) and the lowest in the east of England (67%). Some categories, such as nurses, see greater variation: 96% of nurses in the north-east are British, whereas over one third of nurses in north-west London identify as a nationality other than British.

The largest group of non-British staff comes from the EU: 60,000 EU (non-British) nationals work for the NHS, making up 7.4% of nurses and 9.8% of doctors. The report notes that since the Brexit vote the government has sought to reassure NHS employees from the EU that they will still be welcome after the UK leaves the Union. However, the report warns that “even if the residency status of EU nationals working in the NHS is confirmed, it could become more difficult to retain staff and attract new recruits from EU countries, at a time when services are already under pressure”.


The parliamentary study uses self-reported nationality. The report cautions that this “may not always reflect the person’s citizenship or country of birth and can instead reflect cultural heritage”. Nationality is not known for about 7% of NHS staff. 


The future of EU migrants in the UK

EU_2013.pngSpeaking at a recent Migration Matters round table, Professor Bernard Ryan of Leicester University gave an exceptional overview of the legal issues facing EU migrants living in the UK. He also discussed the options open to the government in determining post-Brexit visa regimes.

His argument is set out in a paper published by the Immigration Law Practitioners’ Association. For more on securing the residency rights of EEA nationals, Professor Ryan also recommends this paper by Matthew Evans of the Aire Centre.

Photo: Aotearoa


EU leaders sign new declaration on irregular migration

By Lauren Distler

On 3 February, EU leaders met in Malta for a summit aimed at reducing irregular migration through the Central Mediterranean route. In 2016 there were over 181,000 attempts to enter Europe after crossing the Mediterranean from Libya. More than 4,500 people drowned on the journey last year.


The Malta Declaration, unanimously approved by EU leaders on 3 February, seeks to curb migration by stabilising Libya and strengthening the country’s ability to control its own borders.

The declaration includes plans to

  • train and equip the Libyan coastguard
  • increase efforts to disrupt the human smuggling business
  • aid economic development in Libya, particularly in coastal areas and along migration routes
  • improve the capacity and condition of Libyan migrant reception facilities
  • step up support for voluntary return programmes through the International Organization for Migration and
  • work with Libya and its neighbours to reduce pressure on Libya’s land borders.

These activities will be funded partly through existing programmes, namely Official Development Assistance for Africa and the EU Trust Fund for Africa

In the lead-up to the Malta summit, the Italian government and Libya’s UN-backed Government of National Accord signed a Memorandum of Understanding, with the objective of helping African countries “control their external borders and to stop departures", according to Italy's foreign minister Angelino Alfano. The European Commission expressed support for the agreement, and pledged to mobilise an additional €200 million (£173 million) for the North Africa window of the Trust Fund for Africa to support the projects outlined in the Memorandum and the Malta Declaration.

The Declaration has been criticised by some organisations, which accuse the EU of misrepresenting the safety and stability of Libya. The medical charity Medecins Sans Frontieres said in a statement that "Libya is not a safe place and blocking people in the country or returning them to Libya makes a mockery of the EU's so-called fundamental values of human dignity and rule of law”. There is also scepticism about how effective the EU programme will be in curbing migration, as the UN-backed government of Libya is only in control of a portion of the state’s territory.


What the public really think of immigration

Bobby Duffy, MD of the polling organisation Ipsos MORI, is well placed to explain how complex the answers to this question are.

Speaking at a recent Migration Matters Trust roundtable, Duffy noted that immigration is a long-standing concern among the British public. Nevertheless, the issue is surrounded by myths and misconceptions – and people’s attitudes are surprisingly nuanced and flexible.

Asked how many immigrants there are in Britain, respondents guessed more than double the true total – 25% of the population, as opposed to the real figure (from the 2011 census) of 13%.

Asked why they thought immigration was so high, people gave as their top reason the view that those entering the country illegally weren’t being counted. When told the census figure, 46% of respondents said they still believed that immigration was “much higher than 13%”. 56% thought that people coming into the country illegally weren’t being counted.

Those interviewed also had a skewed view of current types of immigration, exaggerating the number of asylum-seekers and consistently underestimating those entering the country for study, work and family reasons.

Beyond these misperceptions, however, the views of the public on immigration are far more nuanced than is usually reported in the press. Only one in five respondents thought that immigration had adversely affected them personally. And while there was a strong majority view that immigration from the EU was bad for the NHS (55% as against 27%), a majority also believed that immigration was good for culture and society in Britain (42-36%) and for Britain’s economy (46-30%).

Overall, there are much more positive attitudes to the immigration of skilled than unskilled workers. For business, the key concern is the ease of visa-free recruitment from across the EU.

Our understanding of these issues is further deepened by a new study looking at attitudes to both immigration and Brexit. Among its startling preliminary conclusions is the fact that, in essence, the system is broken for everyone – a majority of those for and against Brexit think that the British economy is rigged in favour of the rich and powerful, and that life is getting worse. Differences arise over issues such as competition – leavers much more than remainers believe that certain groups are getting preferential treatment.

Finally, attitudes to immigration are strongly differentiated by age. The generation born since 1980 is much less concerned about the issue than older people. This finding is further backed up by an Opinium survey reported in the Guardian, showing that people aged 18 to 34 put immigration at the bottom of their list of priorities for the Brexit negotiations.


Refugee migration, the economic implications

Vaughan Jones reports on a recent study

In the UK, refugees are 18.3 per cent less likely to be in employment than native-born citizens. For EU and non-EU economic migrants, the gap is 4.3 and 8.2 per cent respectively. Refugees from North Africa, the Middle East and other African and Asian countries are less likelyto be employed than economic migrants from the same areas of origin. The level of employment of refugees from the areas where the current crisis is taking place, i.e. North Africa and the Middle East, is  32.5 per cen below that of people born in the UK.

This data is the centrepiece of a short article ‘On the economics and politics of refugee migration

by distinguished economists Christian Dustmann, Francesco Fasani, Tommaso Frattini, Luigi Minale and Uta Schӧnberg.

Acknowledging the complexity of the current crisis, they recognise that an easy solution is not entirely within the control of the EU. In contrast to the time of the Balkan Wars in the early 1990s, the EU is less engaged in the conflicts that are producing refugees, and the internal political climate is now far less conducive to generosity. 

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NFU responds to Migration Watch on seasonal workers

Commenting on Migration Watch’s report on seasonal workers, NFU Horticulture Board chairperson, Ali Capper, said:

“The NFU is urging government to introduce a substantial trial of a permit scheme to allow workers to pick the UK’s fruit and veg in 2017, a scheme to allow workers to come in and go home again. We have seen a substantial decrease in the number of workers wishing to come here as a result of Brexit - the lower value of the pound makes the UK a less attractive place to work now than for other parts of western Europe. Without seasonal workers fruit and veg will be left to go rotten in the fields.

“Agricultural workers are well paid compared to lots of other practical skilled and semi-skilled jobs. In fact, seasonal workers can earn up to £12 or £15 per hour for harvest work. Workers have good benefits which often include housing and accommodation at well subsidised rates.

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"Open for business, closed to foreigners"


Sir David Warren exposes the economic dangers to the UK of confusing foreign students with migrants

A recent “Times” article, , revealing that only 1% of students break the terms of their visa by overstaying at the end of their course is yet more evidence undermining the assumptions behind government policy in this area.

Since the Coalition Government committed themselves in 2010 to reducing net migration to “tens of thousands”, Ministers have found themselves impaled on a policy impossible to achieve without doing serious damage to the British economy in the process. This is particularly true in the area of international students.

The Government argues that higher education is still high among its priorities. Why, then is it making it harder for universities to recruit foreign students, by insisting on including them in in its target to reduce net migration?

For a time, the Government argued that the aim was simply to maintain as much leverage as possible over overall numbers of people coming into Britain. Its aim is to reduce net migration to the tens of thousands. It denied that the intention is to have fewer international students.

Amber Rudd’s speech to the Conservative Party Conference earlier this month pointed in a very different direction. In suggesting that student immigration rules should be tailored to the quality of the course and educational institution, she appeared to be arguing that a way needed to be found to reduce the number of foreign students in Britain – despite the fact that higher education is one of our most successful exports. 

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Student visa numbers

Greg Hurst, The Times' Education Editor, and Richard Ford, The Times' Home Correspondent, investigate the controversy over foreign students in the UK. (£)



The Role of the Private Sector in the Global Refugee Crisis

PwC's Julia Onslow-Cole believes business involvement could help build trust

We are living in times of great geopolitical instability. There are currently more than 65 million displaced people, 90% from poor and middle income countries placing huge burdens on hosting countries. The majority of hosting countries are developing countries and 70-80% of displaced persons are living not in camps but in communities in cities.

We must support hosting countries and countries from where people are leaving. It is laudable that the UK government recently announced millions of pounds to support African countries where high numbers of people are being displaced.

However, we cannot assume that governments will do everything; governments alone will not be able to solve the global refugee crisis - the private sector must do more.

George Soros's recent announcement of a personal donation of $ 550m for Refugee Entrepreneurs and the 50,000 plus volunteers helping in the refugee camps in Greece highlight two examples of support. However, substantial support can come from employers in the private sector.

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James Kirkup on Theresa May's speech

James Kirkup of the Daily Telegraph gives his take on Theresa May's first speech as Prime Minster to Conservative conference.