Overseas nurses in the UK have to pay thousands if they want to stop working | Nurse

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International nurses working for NHS trusts and private care homes are locked into their jobs by clauses in their contracts that require them to pay thousands of pounds if they try to leave.

In extreme cases, nurses are tied to their job for up to five years and face costs of up to £14,000 if they want to change jobs or go home early.

The Royal College of Nursing and human rights lawyers call for an urgent government review after a Observer investigation revealed evidence that the clauses are used in both the NHS and the private sector.

They are designed to retain staff and recoup recruitment costs. They often cover rental costs such as flights to the UK, visas and the cost of taking language and competency exams. In many cases, they also include the cost of mandatory training, which workers hired in the UK are not required to pay as standard.

Nurses affected by the repayment terms, many of whom served on the front lines at the height of the pandemic, said they were pushed into debt or locked into long-term payment agreements after leaving office, even in cases of bullying or emergency situations in the United States. the family. Others continue to work despite illness or poor working conditions, fearing they will not be able to repay, charities and unions said.

Parosha Chandran, a lawyer and UN expert on human trafficking who helped shape modern slavery laws in the UK, compared the clauses to “debt bondage” and called for review at the highest level. “This raises very serious concerns about exploitation,” she said. Patricia Marquis, director for England at the Royal College of Nursing, said she was “deeply concerned” about a practice that was thriving “in a climate of chronic understaffing”. The RCN was aware of some employers using punitive clauses that could result in employees having to pay thousands of pounds.

“We’ve also heard of cases where employers try to scare and intimidate employees with threats of eviction if they choose to work elsewhere,” Marquis said.

The UK is recruiting heavily from abroad in a bid to fill a shortage of 40,000 nurses in the NHS alone, with most of the recruits coming from the Philippines and India.

Patricia Marquis, director for England at the Royal College of Nursing, said the charging of fees to nurses who leave has flourished “in a climate of chronic understaffing”. Photo: Victoria Jones/PA

A contract seen by the Observerused in an NHS hospital fund in the east of England, international nurses say unspecified “costs related to [their] recruitment” if they leave within three years. Those who leave within 18 months must repay “100%” of the costs. Another, used by the University Hospital Southampton NHS Foundation Trust, includes a £5,000 refund clause for applicants from the Philippines which is halved after a year. The trust said the fees could include exam fees, flights, visas and accommodation, adding that staff retention was vital to its operations.

In the private sector, fees can be higher. A nurse from Zimbabwe was told she had to pay £10,850 when she tried to quit her job at a care home, according to Unison. She said it was clear the charges were excessive, “but the manager said she wouldn’t give me a reference unless I paid the full amount”.

Susan Cueva, a trustee of the charity Kanlungan, which supports Filipino migrants, said: “They are taking advantage of these workers who have no idea of ​​the rules in the UK,” she said. “They end up thinking, ‘I’d better sit down even if I suffer,’ because they can’t afford to pay it back.”

She said it was unfair for employers to pass recruitment costs on to employees, as hiring internationally can save them huge amounts of money.

It costs between £10,000 and £12,000 to hire a foreign nurse, but employers are estimated to save £18,500 in nursing costs in the first year alone. By comparison, it takes three years to train a nurse in the UK and costs around £50,000 to £70,000. The government does not pay tuition but provides maintenance grants of £5,000 per year.

Stuart Tuckwood, a nurse officer at Unison, said the union was aware of cases where nurses had been “trapped by unethical contracts” – including a case where a nurse had to pay £14,000 despite her salary being just £16,000. He said: “The government must protect and support these nurses. This means that there are safeguards that can be properly enforced. Otherwise, the UK may not only be breaking its obligations to the individual nurses, but also the agreements signed with the countries they come from.”

The Ministry of Health said it is aware of reimbursement clauses used to recoup upfront costs when candidates do not meet the terms of their contract, but it would be “concerned if the reimbursement costs were disproportionate or punitive”.

A spokesperson said: “It is clear that foreign staff should not charge for recruitment services when looking for a job in the UK. We are grateful to everyone who has come from abroad to train, learn and work in our NHS and social care sector.”

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