Plan to recruit Nepalese nurses for NHS puts them at ‘risk of exploitation’ | Health policy

Plans to recruit Nepalese nurses to help fill shortages in the NHS will put workers at ‘unacceptable risk’ of exploitation and should be halted until safeguards are in place, labor experts have warned .

The UK has been accused of going on a hiring spree despite concerns over abusive practices by Nepalese recruitment agencies, which are notorious for charging illegal fees that leave workers in debt.

The government-to-government deal, signed last month despite Nepal’s status on the World Health Organization’s recruitment ‘red list’, will start with an initial pilot involving around 100 recruits, but could see thousands nurses and other healthcare workers relocate to the UK from Nepal over the next few years.

The Department of Health has hailed the scheme as an “ethical” initiative that will enable “managed” recruitment to fill shortages in the UK. A memorandum of understanding stipulates that workers should not pay fees and that recruitment will be overseen by an “implementation unit” run by the Nepalese government. But critics accuse ministers of turning a blind eye to abusive recruitment practices in Nepal. They say safeguards are needed to protect workers from exploitation.

In May, a study by the Nepali research institute Social Science Baha found that about 40% of Nepalese interested in overseas employment seek help from illegal agents. In the same month, the Bureau of Investigative Journalism revealed that fruit pickers in Nepal were routinely charged up to £5,000 in illegal fees for jobs working on UK farms under the government’s seasonal worker scheme. Many take informal loans that they find difficult to repay.

The testimonies collected by the Observer suggests that agencies operating in Kathmandu have started offering job search services to applicants seeking NHS positions – despite the promise that no workers will be charged.

Facebook ads targeting Nepalese workers, which were live on the platform last week, offered counseling services, including job application support and access to a ‘sponsor database’ for job seekers. of a job in the UK. A second advert offered ‘online coaching’ for nurses and claimed to offer ‘the best route to the UK’.

Other adverts suggest recruitment agencies have been targeting nurses in Nepal for months, despite its redlist status, which requires active recruitment not to take place due to the potential effect on the healthcare system. fragile of the country. Nepal has 21 nurses per 10,000 people, compared to 84 per 10,000 in the UK.

Andy Hall, an independent migrant rights specialist based in Nepal, said “systemic corruption” meant that “in reality in Nepal, illegal agents are involved at every stage of migration”. Many of these billing charges have ties to UK-based companies, he said. Hall and other critics, including the UK Nepal Friendship Society, are calling for third-party monitoring and the involvement of human rights experts to ensure recruitment does not lead to worker exploitation. “For the Ministry of Health, just saying ‘everything is fine’ is not acceptable,” he said.

In a rare intervention over the weekend, the World Health Organization voiced its support for practical safeguards, saying it was an “excellent suggestion”.

Jim Campbell, Director of Health Personnel at WHO, said: “We strongly encourage the UK and Nepal to consider some of these comments and take all mitigating measures to ensure there is protections for workers’ rights, protections against fees and protection against poor working conditions.

He said third-party monitoring or input from human rights organizations would “help the government understand the lived experiences of workers to ensure good practice is being followed.” “It would be a safeguard for the workers in this case,” he said. “You need to make sure that this behavior is not allowed to start and if it is, it is identified immediately and eliminated from the bilateral agreement.”

Siobhán Mullally, UN special rapporteur on human trafficking, said imposing recruitment fees could impose “a significant burden on workers, leading to conditions akin to debt bondage”. “It’s a concern in many sectors and it needs to be looked at in the health sector,” she said. “The problem is often that we have words on paper but safeguards are not implemented in practice.”

The Ministry of Health said it would be inappropriate for bilateral discussions to be overseen by a third party and that it would engage the appropriate stakeholders when implementing the pilot program. No British recruitment agencies would be involved in the initial phase, he said, adding that the process on the Nepalese side was “a problem for the Nepalese government”.

Nurses often take out loans to pay agents they struggle to repay. Photography: MartinPrescott/Getty Images

The deal is part of an international recruitment drive to address a shortage of 50,000 nurses and midwives in the UK. This is the first recruitment agreement signed with a country on the WHO red list.

Pat Cullen, chief executive of the Royal College of Nursing, said it was an example of the UK’s ‘overreliance’ on overseas workers and called on the government to ‘do more to invest in the national workforce”, in particular by “fairly remunerating nursing staff”. to boost recruitment and retention.

She added that the “government’s determination” to hire from Nepal despite its status on the red list was “very worrying”. “Recruitment must be managed in a sustainable way and measures taken for the benefit of both countries. The fact that we take nurses from countries with poor health infrastructure and chronic shortages is unforgivable. »

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