Right now, if you are a head of midwifery running a short-staffed maternity service, you can recruit a midwife from anywhere in the European Union. That midwife has to be registered with the UK regulator and be able to show evidence that they have the necessary qualifications and skills (including English language skills), but once they have cleared those checks they can start work as an NHS midwife. With the health service short of around 3,500 midwives, it is a good thing that we can recruit relatively easily from right across the EU.
There are more than 1,300 EU midwives working in the NHS, and that’s just counting those in England, with hundreds coming and going each year. Any barriers to recruitment will not stop the hundreds who leave the NHS from doing so, but they will make it harder – or even prevent – the hundreds who want to join. And every single midwife willing and able to work in the NHS but prevented from doing so by the knock-on effects of an arbitrary migration target makes the national midwifery shortage worse.
It is not just midwives, of course. Around 60,000 NHS staff in England are known to be nationals of another EU member state. That includes 10,000 doctors, of whom 4,000 are highly skilled and experienced consultants, 22,000 nurses and health visitors, more than 200 ambulance staff – the list goes on and on.
And it is worth digging into those figures too. For instance, more than 200 of those doctors are cancer specialists, working alongside over 100 EU radiographers who specialise in treating cancer too. Ask someone waiting for cancer treatment, or a member of their family, whether we should have a target to stop too many of these people coming in.
We can give EU nationals already here a guarantee that they can stay, of course, but that is only half the solution. We need to keep the door open to new EU healthcare workers too. That is why it is so important that groups such as Open Britain are campaigning against the target.
And this is about much more than just the health service. With the country desperately short of homes, we need to keep the door open for EU nationals to work in the construction industry. With an ageing population, we need them in social care. If London is to continue as a world financial centre, we need them in financial services. If our universities are going to continue to be world class, we need them in the higher education sector. And on and on it goes.
But with a blunt cap on numbers, someone has got to lose out. Some sectors will have to be told they cannot recruit the people they need; not because that sector does not want to recruit and not because they aren’t exceptionally able people willing and able to come here, but because of an arbitrary, political net migration target, plucked out of thin air.
And there are consequences from having a target like this. It means that at some point that head of midwifery is told they cannot hire the midwife they want because that midwife is Polish. It means that at some point the pharmaceutical company is told it cannot recruit the leading scientist it wants for its research and development department because she is French and that would push the Home Office over its target.
I have worked in healthcare my entire life. I want to see the NHS offer the best care it can. And that comes from the NHS being open to professionals from across Europe and the world. An arbitrary net migration cap would limit our ability to do that and inevitably result in a health service with fewer of the best specialists, less able to care for the people of this country. That is surely not what anyone wants. It’s time to drop the target.
Cathy Warwick CBE is chief executive of the Royal College of Midwives
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