Without migrants, we wouldn’t have the NHS

Jon Danzig |

Our NHS would collapse without migrants.

Almost 20% of the staff in NHS England are from overseas. Out of 1.5 million NHS staff in England, around 265,000 reported a non-British nationality as of June 2023. That’s 45,000 more than the previous year.

What’s more, since Brexit, data indicates that the proportion of EU citizens working for the NHS has declined and tapered off, whilst the proportion of Asian migrants working for the NHS has rapidly increased.

Data collated by the House of Commons Library shows that from 2009, the percentage of citizens known to come from EU countries working in the NHS rose strongly, until around the time of the Brexit vote, when their percentages decreased.

Then, from around 2016 onwards following the EU referendum, the percentage of NHS staff known to come from Asian countries dramatically increased.

How did this happen? Wasn’t Brexit supposed to reduce the number of migrants? Here’s my analysis.

A key reason given by voters for choosing ‘Leave’ in the referendum was their feeling that we had too many EU migrants here.

This view was bolstered by the the (then) pro-Remain Conservative government and the (then) pro-Remain Labour opposition, who pandered to the view that we had too many EU migrants, instead of robustly challenging that narrative.

For example, David Cameron, the pro-Remain Conservative Prime Minister until he resigned following the referendum result, told the EU in November 2015 that Britain must be able to reduce the “very high level” of EU migration.

In the same month, he warned that if his demands were not met, he would have to recommend a UK exit from the EU.

The Conservatives 2015 manifesto also pledged to bring down annual net migration to the “tens of thousands” [from 172,000 in 2015] and promised to “reduce the incentive for EU migrants to settle in the UK.”

That hardly represented a ringing endorsement of EU membership and how EU migrants here were needed, and mostly in gainful employment in the UK. With relatively low unemployment, high employment and record high unfilled vacancies, this meant that the numbers EU migrants here were at about the right level; maybe not enough, but not too many.

Despite that, Mr Cameron requested from the EU a ‘brake’ on EU migrants, by cutting their in-work benefits.

His request was granted, but what wasn’t widely reported is that almost 90 per cent of EU migrants here didn’t even take such benefits.

Daily Telegraph, 8 February 2016*

[*In 2015, only 12% of of EU citizens working in the UK received tax credits].

Instead of being a burden, most EU migrants here were employed and making a significant NET contribution to government coffers. Relatively few were taking benefits.

HM Revenue & Customs: Income Tax, NICs, Tax Credits and Child Benefit Statistics for EEA Nationals 2013 to 2014

UCL: ‘Positive economic impact of UK immigration from the European Union’. Graphic by Daily Mirror.

Labour’s front bench also pandered to the view that the UK had too many EU migrants.

In November 2014, Labour’s Rachel Reeves, the then Shadow Works and Pensions Secretary, told BBC News that:

“I don’t think it’s right to come to this country from another country whether from the European Union or outside the European Union and draw down on benefits from the day you arrive.”

It was nonsense; EU citizens couldn’t just arrive here and claim benefits. But such rhetoric helped to endorse the view that we had too many EU migrants.

Also speaking against EU migration in November 2014, the then Shadow Home Secretary, Yvette Cooper, said there were too many low-skilled EU migrants coming to the country. She said “low-skilled migration is too high, overall migration from the EU is too high”.

In the run-up to the 2015 general election, the then Labour leader, Ed Miliband, said that Labour had changed its approach under his leadership and would deal with people’s concerns” about the impact of immigration on wages and public services.

The 2015 Labour manifesto stated:

“Britain has seen historically high levels of immigration in recent years, including low-skilled migration, which has given rise to public anxiety about its effects on wages, on our public services, and on our shared way of life.”

Labour did refer to the “common good” provided by migrants and the “contribution” they make to the country.

However, the party also stoked the public’s fears about immigration, by not pointing out that there was no evidence to support migrants having a signficant, negative impact on wages or job prospects.

Nor did Labour challenge the unfounded claim that migrants put a strain on public services by pointing out that migrants made a positive net contribution to the cost of public services. Labour in the 2015 general election also did not counter “public anxiety” that we had too many migrants in the UK, and instead, referred to how migrants affected “our shared way of life”.

(However, it should be noted that two months before the referendum, in April 2016, Labour’s new leader, Jeremy Corbyn, rejected claims that there were ‘too many’ EU migrants in the UK. His intervention, however, was late and not prominently reported. And just three weeks before the referendum, it was reported that voters were “uniformly uncertain” about whether Labour was campaigning to stay in the EU.)

No doubt Labour, like the Tories, were worried in 2015 about the rise of the anti-immigration, pro-Brexit UKIP party. But a map of the country published a month before the general election by the Daily Telegraph showed that support for UKIP was highest in areas of least migration, and lowest in areas of high migration.

“Do those who oppose immigration actually know any immigrants?” asked the Daily Telegraph, pointing out that UKIP’s support was highest in areas where there are “no migrants”.

A mug sold by Labour during the 2015 general election campaign that boasted of the party’s plans to control immigration only emphasised fears that there were too many migrants in Britain and played into the hands of UKIP’s anti-EU, anti-immigrant message.

  • Contrary to popular belief, and the unfounded claims of UKIP, Britain did not have ‘uncontrolled migration from the EU’. 2-minute video.

In addition to the Conservatives and Labour stoking fears about immigration, most of the country’s newspapers also inundated the public with a daily deluge against immigrants in the UK (no matter whether they were EU-migrants, non-EU migrants, asylum-seekers or so-called ‘illegal migrants’ – to much of the press, they were all the same.)

  • My speech to journalists in October 2015 on how British newspapers promoted xenophobia. 13-minute video.

So, with anti-immigration sentiments running high and echoed by the British press and the two main parties, Brexit happened.

As a direct result, it’s more difficult for EU citizens to stay or come here; many EU citizens no longer feel welcome here; many have left their employment, in the NHS and other key organisations; many have departed the country.

Since Brexit and the pandemic, net migration of EU citizens to the UK has fallen by almost 70% compared to its 2016 peak.

Many EU citizens who decided to stay post-Brexit, who are working and paying taxes here, many of them for decades and many who have created families here, feel unsettled, despite being offered settled status.

  • What we’ve lost – free movement across most of our continent. They could come here, we could go there. 2-minute video on how free movement rules worked.

But it’s no big deal, is it, because we didn’t need those EU migrants, did we?

Actually, yes, we did. Who was going to fill those jobs, in the NHS and thousands of companies and organisations across the country, vacated by EU citizens who had made Britain their home?

British workers? Nope. We simply don’t have enough British workers to do all the jobs in Britain.

Today, Britain has around 6 million foreign-born workers in gainful employment, and record numbers  of unfilled job vacancies. We need migrants, and with a chronic shortage of workers, we actually need more.

  •  Britain has a record number of job vacancies and not enough workers. 2-minute video.

  • Britain needs millions of migrants because we have a chronic skills shortage and not enough British workers to do all the jobs in Britain. 1-minute video.

Of course, both the Tories and Labour knew and know this. The UK has a rapidly growing older population and a declining birth rate. We simply don’t have enough young, working-age people to do all the jobs.

Yes, the UK could – and should – train more British workers to do more highly skilled jobs. But that alone wouldn’t increase the size of our indigenous workforce, which would still be too small to do all the jobs in Britain.

  • Over the past 70 years, the UK birth rate has declined whilst the proportion of older people has rapidly risen. 20-second illustrative video animation.

So, the Conservative government is quietly issuing visas to hundreds of thousands of migrants from other continents to work here, to help replace those EU citizens who left, and to ease record numbers of unfilled job vacancies following Brexit and the pandemic.

And yet, at the same time, the government is loudly pretending to the British public that we don’t need migrants, that we have too many.

The reality is different. The UK economy cannot function without sufficient workers.

It’s reported by The Guardian that net migration boosted the UK population by a record 745,000 in the year to December 2022, fuelled in part by a surge in overseas professionals arriving to work in the NHS and care homes.

Yes, more migrants coming here than before Brexit!

Let me spell this out: Since Brexit, hundreds of thousands more migrants have been allowed to come to Britain, mostly from India and the Philippines, many of them coming to work in our NHS.

Yet, despite so many extra migrants coming here to work for the NHS, our health service still has a stubbornly chronic shortage of staff, with an estimated 112,000 posts currently unfilled in NHS England.

So, lo and behold, we needed all the EU citizens who chose to come here, doing jobs and offering skills that we don’t have enough Britons to do. We didn’t have too many. We probably didn’t have enough.

Those EU citizens mostly came here to work, and if there was no work, they mostly didn’t come, or didn’t stay. The UK jobs market was an ultra efficient and natural controller of inward migration from the EU. Free movement worked. It didn’t need fixing, let alone ending.

But now we’ve lost so many EU citizens staying here or coming here because of Brexit, the UK government is having to import enormous numbers of workers from other continents instead.

At huge public expense, political turmoil, a diminished economy, and reputational damage, the UK has simply swapped EU citizens working here for large numbers of citizens from other continents working here.

I have no objection to citizens from other lands coming to help our country, wherever those lands may be.

But what a palaver, what a mad merry-go-round, what an unnecessary and cruel rigmarole, to deter and discard one set of migrants working here, only to replace them with another set, at considerably more cost and complication per migrant (sponsorship fees, extensive form filling, and travel costs from countries thousands of miles away).

The bottom line is that Brexit is based on an enormous lie about there being too many immigrants, propagated by even pro-Remain politicians who should have known better.

If you voted for Leave and now feel cheated, I don’t blame you.

Data source and graphics by House of Commons Library *

*It’s not possible to precisely compare numbers of foreign staff working for the NHS since before Brexit. That’s because NHS staff nationality data have considerably improved in recent years, making comparisons with the past imprecise. What can be calculated is how the percentage of staff with a known nationality in different nationality groups in the NHS has changed in the past 14 years.

_______________________________________________________

Follow my journalism on:

_______________________________________________________