Features
Foreign nurses face a trial of exploitation and deportation, despite the fact the NHS is crying out for highly-trained healthcare workers. Helen Taylor reports
Overseas aid
When UNISON member Edina Mukwaira was detained at Gatwick airport recently, she was the latest in a long line of overseas nurses to receive unacceptable treatment in the UK.
Mukwaira, a staff nurse at the Royal Free Hospital, was threatened with deportation after returning from a visit to her home country Zimbabwe.
She was detained in isolation at Gatwick for 12 hours, where immigration officers accused her of having a forged visa.
Luckily, as a UNISON member Mukwaira was able to access legal services through the union and has since had her passport returned, along with an apology from the immigration services. But she is not alone in being bitterly disappointed at her experience here.
Mukwaira is one of 30,000 overseas nurses who have been registered to work in the UK since March 2000, with 8,400 arriving last year alone.
Zimbabwean nurses make up a significant number of these workers, with Filipino nurses by far the largest group, and Nigeria, Ghana, Zambia, Pakistan, South Africa and India also large providers.
These nurses have been recruited as a result of the severe shortage of public sector workers in the UK, especially in the fields of healthcare and education.
An extra 35,000 nurses are needed to fill the gap in the NHS by 2008, with additional overseas workers required by private sector nursing homes.
However, rather than receiving the warm welcome they may reasonably expect from a service desperate for their expertise, many nurses have experienced discrimination and exploitation.
The worst reports have come from those working in private care homes. Highly qualified and experienced staff have found themselves expected to undertake menial tasks such as cleaning and domestic work.
They have been forced to work up to 80 hours a week for much lower wages than originally promised, with money deducted from their pay for "training".
Many have been living in squalid and overcrowded accommodation and have not been granted sick pay. Their employment contracts are often believed to be in breach of labour law.
In the worst cases, nurses recruited by private agencies have been threatened with deportation for complaining about their treatment and have had their passports and visas confiscated.
More than 200 Filipino nurses have been "rescued" by UNISON from private care homes and found jobs in the NHS over the past year. But those working in the NHS are by no means guaranteed an easy ride.
Recent research found that a third of nurses are paying commission to home country agencies to secure employment here and once working in the NHS are being paid less than their British colleagues with the same qualifications.
There have also been allegations of racism over the HIV and hepatitis tests that overseas nurses are being forced to take. The introduction of compulsory English tests for nurses has also had a mixed response.
The need for health service workers to be able to communicate effectively with their patients is seen as crucial, but there is concern over potential discrimination against nurses from countries where English is not a common language.
The recruitment of overseas nurses may also have a potentially damaging effect on their home countries. Last year, when outlining the need to attract nurses from outside the UK, Health Secretary Alan Milburn banned the poaching of workers from developing countries, but said that individual nurses would be free to pursue a career in the UK.
The fact that the number of nurses coming from South Africa has doubled in the last year proves that the ban has not been effective.
There is, however, an untapped resource of highly trained health service workers already in the UK who are currently unable to make use of their skills. It is estimated that there are 2,000 refugee doctors alone who, with a minimal amount of retraining, could practise in the UK.
For most of them the cost of retraining is prohibitive, but with the NHS paying £200,000 to train a doctor from scratch, their integration into the NHS could benefit all concerned.
For the immediate future, however, if the NHS and private sector homes are relying on overseas health workers they need to make sure they are treated with respect.
Nurses are continuing to make their way to the UK in large numbers, but whether this has more to do with the lack of opportunity in their countries of origin than the beneficial conditions of employment in the UK remains to be seen.
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