Nurses in the firing line

By Gene Alcantara/ABS-CBN Europe News Bureau – After six years in the UK, if a nurse does not earn £35,000 per annum, she will be kicked out by the British Government. This is one of the continuous series of new announcements by the Home Office on migration which came out in the newspapers.

What effect does this threatened immigration change have on nurses in the United Kingdom, as well as on their employers?

Let us look at the lives of a few nurses who were recruited to the UK, their reactions to the announcement, and its possible effect on their lives.


Dyll Armamento, a Cebuana, graduated Magna Cum Laude from the University of San Carlos where she did her BSc and Masters. She obtained a high score of 9.0 in IELTS. After trying and failing to work as a nurse in Singapore, Armamento tried the UK. She arrived in January 2014 with a Tier 2 Migrant visa. Because she went through a legitimate agency, she did not even have to pay a placement fee, nor did she pay for her airfare.

“It took me a year and 3 months to wait for my registration, because of the influx of nurses, and I think NMC has a hard time. NMC has a small office, when we came, another batch came, we are in the queue, plus the coming of the EU, plus their own graduates, na sila ang priority, that’s why it took that long,” Armamento said.

At first, she had expectations about having a huge salary, and the promise of becoming a citizen of the UK, but now she does not know if it will become a reality.

For Armamento, it is a huge advantage for a nurse to come to the UK and she recommends it to others. She said, “Definitely, coming here in the UK is my ticket to see the world. I’ve travelled na a few countries, especially in EU which I never imagine I could have done if I were in the Philippines. We, in the NHS, we are given at least seven weeks, paid leave, so that’s two months, so I was really enjoying it.”

For her, the new requirement on income level and the threat of removal is like saying that the UK government no longer welcomes migrant nurses, although they are needed.

This made her feel insecure about her future here, although on the other hand, this made her think of other options such as going to another country where they treat nurses better.
Armamento believes the Home Office policy could still change. That is because they have not seen yet what effect the loss of migrant nurses will have on the NHS. She wants to know what they will do when they no longer have people to look after their patients here.

Lyra del Rosario, from Manila, was 21 years old when she finished her nursing course at the University of Sto Tomas. She came to the UK as a student in 2007 to do a Master of Science in Public Health course at Anglia Ruskin University. She now works as a Clinical Trial Coordinator at the Royal Marsden Hospital.

Del Rosario is not worried about the new requirement on salary and number of years of work. This is because she has two options to rely on. The first is that she has a European fiancé who could get her as a family member. Secondly, she is nearing her 10th year in the UK always with a visa, and this will allow her to apply for Indefinite Leave to Remain.

She follows the immigration rules closely, knowing that it is very dependent on who is in power. But although she is not affected personally, she realizes that many nurses will be affected by the salary threshold of £35k. She is a member of the UST Nursing Alumni Association in the UK and Ireland, and they have undertaken a survey of their 100 members on the issue. They will release an official statement in due course but Del Rosario said they will include possible effects on the members and the need to consider a back-up plan.

If nurses encounter problems, most likely their employers or their union will assist them. They have UNISON branches in their hospital, and she knows that “they will have a say and they will fight for the Filipino workers or other workers within the hospital.”

Northwick Hospital Nurses

At Northwick Park Hospital, London Northwest NHS Trust, they have already 350 Filipino nurses and they continue to recruit from the Philippines.

Two of the new nurses we spoke to, Juvy Ramos from Kidapawan City, and Ruby Belleza from Camarines Sur, both potentially will be affected by the new immigration rules as they have only arrived recently.

Both believe that the support they get from the Trust is crucial. Ramos said, “I could say that it is really very helpful to have a very supportive family, the A & E family, especially our matron, she’s really supportive in every field of learning that we have and most especially during the first time I came here.”

Belleza thought the Overseas Nursing Program (ONP) had been really helpful for them to adjust from practice in the Philippines to UK practice, especially, for example, being introduced to different technologies, different procedures.

Both Ramos and Belleza also value the fact that they have co-Filipino nurses which allow them to gain knowledge of the way the hospital is run in the UK. Ramos particularly was happy about this, “I worked with my co-Filipino nurses who speak the same language, because sometimes it takes sometime to work with other staff, because we Filipinos are used to American language back home, so its a little bit hard for me to hear words or phrases from other languages, like Scottish and Irish. Now I’m ready, because we were given a chance to slowly adapt in everything.”

Both nurses have back-up plans in case the new rule is implemented to reduce foreign workers in the UK. However they know that the hospital which recruited them will not just let them go and will continue to give them training.

According to Jonathan Davies, Deputy Director of Nursing at the London Northwest NHS Trust, they truly value Filipino nurses.

“The quality of nurses we recruited in the Philippines has been excellent, highly skilled, maintains the quality and development by a lot of trainings here in the organization, like about mentorship and support,” he said.

According to Edwin Balarao, a Senior Nurse at Northwick Park Hospital, their NHS Trust has a lot of confidence in Filipino nurses, of which they have about 350. He said, “I think, with the good result that we had since last year and this year, I think, we will still be recruiting in the Philippines in the future, to at least support the nursing professionals in this country and this Trust.”

They have been to the Philippines twice to recruit and they have in fact just come back from a recruitment drive there, and hope to bring in 200 more nurses to work in the hospital. “The London Northwick Hospital is very famous back home,” Balarao said. “We have so many applicants. They don’t apply for another Trust. They just waited for us. We have around 200-300 applicants but we have to be careful in choosing applicants.”


Not even over with the controversy surrounding nurses as a result of the recent imprisonment of Victorino Chua, the convicted murderer nurse, many were disappointed that their profession is facing another major blow.

But the reality is the “new” rule regarding the minimum income of £35,000 after six years was published by the Home Office a few years ago already. It is only recently that UK newspapers noticed it and hurriedly bandied it in their headlines together with the negative impact on the NHS.

Nurses and their employers should have been preparing already for the implementation of the new rule. The worrying thing about all this is why the government seems unaware of the negative impact of their rule on the NHS as an employer, on patients as end users, and on nursing staff.

At the same time, they appear not to care about the costs incurred by the NHS Trust of about £6,000 to recruit an overseas nurse. Recruitment and training and development costs will be wasted if foreign nurses will be driven out of the country after 6 years of service.

From April 2016, the government will introduce minimum salaries as follows:
Gross annual salary required for Indefinite Leave to Remain (source: Home Office)
From 6 — April 2016 — £35,000
From 6 — April 2018 — £35,500
From 6 — April 2019 — £35,800
From 6 — April 2020 — £36,200

However if a nurse was given work permit or sponsored employment back in 2012, it is possible that they entered a category given six years of visa and will need to leave the country to apply to work here again.

In previous immigration rules, there were no income threshold and no time limit to apply for ILR. Therefore if you arrived here before they changed the rule regarding salaries, once you have completed five years on work permit or sponsored employment, you should apply for ILR as quickly as possible. Of course, you will still need to pass the two tests required: English and Life in the UK.

For new arrivals, their salary will depend on their Band when they enter the UK. Normally when recruited at Band 5, a nurse starts with a salary of £21,692. To reach the highest pay in the band (£28,180) would take eight years which means they will never reach the minimum £35,000. In Band 6, the minimum salary is £26,041 and the highest £34,876, which could be reached in 9 years. Even senior nurses in Band 7 might worry about reaching the set salary level because the minimum rate is £31,072, and the highest £35,891 after 5 years.

If this is the case, is the UK government not giving false information to migrant nurses to entice them to come and serve in the NHS? Then after many years of service, they will then be discarded on the pretext of not reaching a certain salary level?

Will the UK end up like Middle Eastern countries where workers come in only to work and can never hope to obtain residence?

Let us hope this is not going to happen. But if it does happen, nurses yet to come to the UK need to be prepare for the day of limitation.

Before going to the UK, you need to have a contingency plan. And if really unable to reach the set salary, you should think already of your next move.

Some of the things they could do are as follows:

– Transfer to another job category, particularly one in the shortage occupation list, because this would be exempted from the salary requirement and time limit;

– If they have family here, for example a spouse/partner or a British child, they could change their visa category to family member;

– If they have a European relative working in the UK, with whom they reside, and who supported them even while back in the Philippines, they could try to apply as a European family member;

– If they have already spent 10 years in the UK always with a valid visa, they could apply for Indefinite Leave to Remain based on long residence;

And if there are no other options, then look at the possibility of transferring to a country more welcoming of migrant nurses such as Canada, USA, Australia and others.

Find more like this: Europe

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