The NHS could face a bill of almost £500m a year to hire overseas staff as a result of Brexit and the government’s immigration policies, hospital doctors have said.



The Royal College of Physicians (RCP) has calculated that the costs of recruiting EU and non-EU staff could more than triple from the current £150m a year if freedom of movement ends as a result of Brexit.

The money would be spent on paying for visas to enable staff to work in the UK and also the £200-a-year immigration health surcharge, which even health professionals coming to work from abroad in the understaffed NHS have to pay for themselves and every member of their family.

Dr Andrew Goddard, the RCP’s president elect, said that under current plans the total costs of obtaining a three-year tier 2 visa, which doctors need to get to work in the UK, would rise from £4,409 to £8,609 by 2020. That sum includes the health surcharge, the £1,000-a-year immigration skills surcharge and also a certificate of sponsorship, which doctors usually get from an NHS trust or GP surgery.

“Unless the government acts now, the NHS faces a significant new cost pressure,” Goddard said.

The Conservatives’ manifesto last year pledged to increase both the health surcharge, which will double to £400 a year, and the immigration skills charge by 2020. Last year 12,303 health professionals joined the NHS in England from overseas.

Goddard said that given the higher costs, the NHS would have to find £105m a year to recruit staff that previously attracted no immigration costs because of freedom of movement. Visa charges would push the total cost of employing them to £150m, he estimated, and the NHS would also face a further potential liability of £225m for visas for their relatives.

A third extra cost, for employing health staff from outside the EU, would push the NHS’s total bill up to a potential £490m a year, Goddard calculated.

Whether NHS trusts paid all these costs directly or reimbursed staff who pay them upfront, Goddard said, “either way it’s clear that the NHS could soon be spending millions and millions more just to maintain current, already inadequate staffing numbers.”

Goddard praised ministers for relaxing tier 2 rules that previously limited the number of overseas doctors who could come to Britain, and for recognising the key role overseas staff played in the NHS. But he said Brexit “creates a major risk” for NHS budgets and staffing levels.