Overseas nurses in UK forced to pay thousands of dollars if they want to quit their jobs | Feeding with milk

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

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

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

Designed to retain staff and recoup recruitment costs, they often cover hiring costs such as flights to the UK, visas and language and proficiency exam fees. In many cases, they also include the costs of compulsory training, which workers hired in the UK are generally not required to pay.

Nurses affected by reimbursement terms, many of whom served on the front lines during the height of the pandemic, said they had been in debt or locked into long-term payment arrangements after leaving their jobs, even in the event bullying or family emergency. Others are keeping their jobs despite illness or poor working conditions because they fear they won’t be able to repay, charities and unions have said.

Parosha Chandran, a lawyer and UN expert on human trafficking who helped shape modern UK slavery laws, likened the clauses to ‘debt bondage’ and called for them to be reviewed 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 “very concerned” about a practice which was flourishing “in a climate of chronic understaffing”. The MRC was aware that some employers were using punitive clauses that could force workers to pay thousands of pounds.

“We have also heard of cases where employers attempt to scare and intimidate staff with threats of expulsion 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 recruits coming from the Philippines and India.

Patricia Marquis, director for England at the Royal College of Nursing, said charging fees to departing nurses was thriving “in a climate of chronic understaffing”. Photograph: Victoria Jones/PA

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

In the private sector, fees may be higher. A nurse in Zimbabwe was told to pay £10,850 when she tried to quit her job at a care home, according to Unison. She said it was obvious the charge had been exaggerated, “but the manager said she wouldn’t give me a referral unless I paid the full amount.”

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

She said it was unfair for employers to pass on recruitment costs to workers, when hiring overseas can save them huge sums.

It costs between £10,000 and £12,000 to recruit a nurse from overseas, but employers can save £18,500 in agency nurse costs in the first year alone, according to one estimate. By comparison, it takes three years to train a nurse in the UK and it costs around £50,000-70,000. The government does not pay tuition fees, but provides maintenance grants of £5,000 per year.

Stuart Tuckwood, a nurse at Unison, said the union was aware of cases of nurses being ‘trapped by unethical contracts’ – including one case where a nurse had to pay £14,000 when her salary was n was only £16,000. He said: “The government must protect and support these nurses. It means having safeguards that can be properly enforced. Otherwise, the UK could break not only its obligations to individual nurses, but also the agreements signed with the nations from which they come.

The Department of Health said it was aware of reimbursement clauses used to recover upfront costs when applicants fail to meet the terms of their contract, but it would be ‘concerned if reimbursement costs were disproportionate or punitive’ .

A spokesperson said: “We are clear that overseas staff should not pay a fee for recruitment services when securing employment in the UK. We are grateful to everyone who has come from overseas to train, learn and work in our NHS and social care sector.

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