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Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston asks | Immigration Matters

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Lord Winston in an article for the Telegraph says Bulgaria and Romania are ‘Mafia states’ and claims their nurses put patients at risk.

Lord Winston, a leading fertility expert, criticised the 'limited communication' of many East European health workers. (Photo: Channel 4)

I don’t know about you, but I’m extremely reassured to find out that the General Medical Council is unable to test the competency of doctors within the European Union, and that regulatory authorities in Bulgaria, Romania or whatever Balkan mafia state is next to join the EU don’t even have to pass on any concerns about medical staff. What could possibly go wrong?

Lord Winston warned yesterday that nurses with poor English were a potential danger to patients. He told peers: “Communication between the patient and the professional is of vital importance. We run the risk of losing it with this issue of nurses who can’t speak the English language and have been trained in a different way.”

It’s curious that in the debate about our need for immigration, one of the most frequently cited examples is the NHS, which, without foreigners, would collapse. During the leadership contest last year Nick Clegg pointed to a local maternity ward which, without foreign staff, would be unable to cope with the large increase in children being born. It never really occurred to anyone to point out that this baby boom is entirely driven by immigration, but thank God anyway for the overseas-born midwives without whom overseas-born women wouldn’t be able to use NHS hospitals.

Immigration is a difficult subject, sentimentalised by the Left, so when it is combined with the National Health Service, the most sentimentalised of all subjects – criticising it in front of a Labour voter is like questioning the Virgin Mary’s honour to a Pole – its sentimentality increases exponentially. After all, you’ll be told, a third of all doctors are born overseas, and over 30 per cent of NHS staff are foreign.

But do we actually need foreigners, or that many foreigners, in our health service? It’s a question almost never asked. Yet in the United States, which has a far more diverse work force, only 15 per cent of medical staff come from abroad. Why do we need, proportionally, twice as many? Because the NHS, with its virtual monopoly, is able to artificially set wages, usually below the market rate. It’s rarely commented on, but Britain started importing foreign doctors because British doctors were heading abroad, usually to the States, to earn a more reasonable salary.

Meanwhile, we congratulate ourselves on hiring staff from countries that are often desperately short of medical staff (sure, they get remittances, but they lose educated, intelligent, skilled people, usually for good).

The paradox is that we only need foreign staff because of the NHS’s monopoly, but we only have socialised medicine because of the high levels of social solidarity Britain had acquired by the 1940s, and we only gained that because Britain was a fairly homogenous country with a strong national identity, one where people felt close enough to their fellow citizens to want to pay their medical bills. Yet that solidarity has long been in steep decline, and many of the people who treat the NHS as their new religion aren’t actually too keen on the part.

And what’s more, while we’re always grateful to people who treat us, and I’m in awe of anyone who can both attain a medical degree and work in a foreign language, foreign medical staff on average aren’t actually as good as the British – foreign doctors, for example, are four times more likely to be struck off. Maybe we need to start rethinking our ideas about medicine and immigration. Source: The Telegraph.

Last week Dominic Raab MP claimed that a rise in crimes by EU citizens came about since when Romania and Bulgaria joined in 2007.

He said: “This staggering increase in the number of crimes committed by EU nationals in Britain, since Bulgaria and Romania joined the EU suggests, highlights a hidden cost of further EU enlargement that must be properly debated.”

Unlike workers from A8 accession countries such as Poland, who enjoy full ‘free movement of Labour’ rights to work in the UK, Bulgarians and Romanians do not have the same rights to work in the UK.

To work in the UK they must apply under various schemes such as Work Permit or BR1 Yellow Card registration, which can involve taking out Comprehensive Sickness Insurance and swearing an Oath that they will not be a burden to the UK.

Those who exercise their Treaty Rights (under Article 39) and apply for an accession card as self employed persons or as students taking vocational or sandwich courses (e.g. NVQ/QCF in Health and Social Care), are allowed to work full time, as stated on their Yellow Cards, but they have to apply for this and jump through several hoops.

Bulgarians and Romanians applying for BR1 yellow card registration as students who wish to work are being forced to take out Comprehensive Sickness Insurance – a form of private medical cover. The insurance is a new requirement introduced by the UK Border Agency as part of changes to the BR1 Yellow Card form in June. The revised BR1 form does not make it clear that a student will need Comprehensive Sickness Insurance, as the actual question relates to those applying as ‘self sufficient’ EU applicants. For more information on immigration rules for Bulgarian and Romanian citizens visit the UK Border Agency website or see an OISC registered immigration adviser. 

Aplicants should also note that the newly revised UK Border Agency website has changed previously published links to specific pages of the site may no longer exist.

For instance, the link for European Workers is now:

The link for ‘Bulgarian and Romanian nationals‘ is:

The navigation section for European workers from Bulgaria and Romania also appears to have been simplified although finding specific information is still a challenge.

Confusion remains over the need for Bulgarians and Romanians applying for BR1 Yellow Cards as students to take out Comprehensive Sickness Insurance cover. 

The BR1 Form in Section 9 states:

‘If sections 4 (Students) and 5 (Self-sufficient) have been completed: evidence of ‘Comprehensive Sickness Insurance’ cover in the UK and funds to show you are economically self-sufficient, e.g. a bank statement.’

In other words, the paragraph means you need comprehensive sickness insurance only if you are applying under both ‘student’ and ‘self sufficient’ sections.

Nevertheless, student applicants are being asked to take out private medical insurance policies and are being refused if they fail to supply the correct cover.

What is the correct insurance cover?

One insurance company manager told Immigration Matters that he has been trying to get clarification on the exact requirements from the UK Border Agency for several weeks.

Active Quote offers an easy to use online quotation and application system, but also has telephone support from advisers who are on hand to answer questions.

To obtain a quotation for Comprehensive Sickness Insurance visit the Active Quote website.  

See also:

Comprehensive Sickness Insurance now required for Bulgarian and Romanian study work yellow cards

UK firms plan to recruit more EU migrants to fill job vacancies

Health care workers needed in UK now

Crimes by EU citizens treble figures reveal

BR1 Form for ‘Yellow Card’ Registration revised

Immigration Rules for Bulgarian and Romanian nationals 

If you need any immigration advice or help with Sponsorship or Work Permits, Visa, ILR/Settlement, Citizenship, dependant visa or an appeal against a refusal please email: or visit

Majestic College offer special packages for EU students. They also have a number of employers looking for staff right now and are willing to employ Bulgarians and Romanians.

For more information call Joanna on 0208 207 1020 or email 


Free presentations are being run at Bison UK Immigration Advisers for Employers, Romanians and Bulgarians – Monday to Friday, from 11am-12noon and 3-4pm. No need to book, just turn up.

Venue: 16 Shenley Road, Borehamwood, Hertfordshire WD6 1DL. Nearest Train Station: Elstree and Borehamwood Station; Buses from Edgware underground station: 107 and 292.

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10 Responses to “Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston asks”
Read them below or add one

  1. […] EU law also covers nurses, prompting Lord Winston, the IVF pioneer and broadcaster, to speak out recently about the threat posed by the ‘poor […]

  2. […] Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston … […]

  3. […] Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston … […]

  4. […] Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston …   […]

  5. […] Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston … […]

  6. […] EU law also covers nurses, prompting Lord Winston, the IVF pioneer and broadcaster, to speak out twice in the past week about the threat posed by the […]

  7. veronica doughty says :

    Ana Guerra? it is a real british name. Are you afraid that EU nationals will be better than others?

  8. Ana Guerra says :

    EU nationals (e.g. nurses and other health care professionals) should take English exams like any foreigners who wish to work in the UK. In my experience working with EU citizens, they hardly speak and comprehend the English language resulting for their patients’ and clients’ welfare being compromised. Honestly speaking, foreigner workers like Filipinos, Indians, Africans and etc speak English far better than the EU nationals. Foreigners also provide efficient, quality and competent services worth the money that any company could ever pay them.
    It is indeed true that communication among collegues at work is an essential factor needed in the health care arena.
    The government should really reconsider this matter before it is too late to intervene the possible damages that could arise in the future.

  9. […] were organised despite pledges by the government to cap immigration and protect British jobs, and concerns raised last week by Lord Winston, one of Britain’s most senior doctors, that some nurses from Eastern Europe put patients in […]

  10. […] Do we actually need foreign nurses, especially those with poor English who are a risk? Lord Winston …   […]

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