Kathryn Breitner: Migrants are the solution not the problem

He says this shift didn’t happen overnight. Instead, little by little, he has seen attitudes towards migrants change. Tensions had been building slowly, but Brexit was like the cork being pulled from a Champagne bottle. He began to experience behaviour he had not encountered here before. People told him to ‘go back to your country’ and accused him and others of ‘taking ‘our’ jobs’, patients refusing to be treated by foreign medics.

‘We don’t feel valued and don’t feel welcome,’ he says. ‘I feel betrayed when they say ‘go home’. I feel I have to justify my existence. It’s the first time in 17 years that I am uncomfortably aware of my accent.’

Also, for the first time, Joan is seriously considering leaving the UK. And that should be a worry for all of us. Because Joan, and other nurses like him, are the backbone of our NHS. His story is representative of others and his possible departure has profound implications for the health service.

Joan was born in the shadow of Barcelona’s Sagrada Familia. He trained in Spain as a nurse but struggled to find stable work there, enduring unpredictable hours, low pay and lack of job security. Then one day, he saw an advert in the paper. The UK needed nurses. The country had a shortfall and needed help from its European neighbours. Joan could have a secure job, train in his chosen specialty, spend his time helping patients without worrying about whether he could afford his rent and he could help address a problem for the UK. So he moved to England.

He found the language barrier tricky to begin with, but luckily there was a fellow nurse who could speak some Spanish. With her help he improved his English and was finally able to decipher the Yorkshire accent. He’d go on to marry her and the couple have three children, who were born and raised in the UK.

In his time here, he has helped countless patients and this year won the ‘Nurse of the Year’ award from the British Journal of Nursing. Indeed, his career is a helpful corrective to the false narrative that nurses are simply doctor’s assistants. While a doctor will make the diagnosis, your nurse will be the one doing everything from taking your bloods, to setting your broken leg, to helping you walk again.

Nurses make up the largest employment force of the largest employer in the UK. And EU nurses, who comprise approximately 5%, play a vital role. So it’s clear, we should most definitely care about these nurses, because they are, very literally, the ones caring for us.

However, as the figures make clear, something has happened since the referendum, EU nurses leaving the NHS have outnumbered those joining. An exodus is under way. And the health service will suffer. Joan explains that there will be both an immediate and a longer-term loss of EU medical professionals.

The first wave who are leaving are the doctors and nurses who haven’t resided in the UK that long: they can up sticks and move on to greener pastures easily.

Those who have been here longer, and are more established, are not leaving yet. But, like Joan, they are drawing up exit plans for when their children are older. ‘The immediate 30,000 nursing vacancies that are causing problems now are just the beginning. The future of the NHS is under threat,’ he says.

The problem is not caused by Brexit alone. The Conservative government’s austerity measures mean that British candidates don’t want to fill the vacancies either. Nursing is a tough gig and not for the faint of heart; people go into it because they genuinely care, but when your salary is frozen for seven years (not even keeping up with inflation) and you struggle to provide a good quality of life for your family, even the most altruistic individual might consider a career change.

A big part of the problem, as Joan sees it, is the subterfuge and misinformation put out by the government. He says that the nurses who voted for Brexit did so because they care greatly about the NHS and believed the false promise of the extra £350 million per week. They wanted to improve things for themselves and their patients.

Joan says the same games are still being played long after the referendum: ‘Jeremy Hunt has been destroying the NHS and yet now people are calling him its saviour. That would be like me as a nurse, giving you the wrong medication, and then saving you when you go into cardiac arrest!’

For EU nurses, the current situation is particularly trying. Salaries that used to be attractive now aren’t competitive because of the fall of the pound and increase in the cost of living. But more importantly, says Joan, the mood of the nation has changed. The anti-migrant feelings that he has, personally, experienced, have transformed life for migrant workers. Since Brexit, he’s weathered xenophobic insults on social media and seen his fellow European colleagues face discrimination from patients, some of whom now turn down treatment from EU practitioners, and insist on being seen by a British doctor or nurse. These experiences have made him politically active and he has got involved in anti-Brexit movements.

‘After the referendum one day, my daughter came back from school crying. One of her schoolmates had told her that because I’m Spanish, I was going to be kicked out of the country,’ he says. ‘She asked me if this was true and I just didn’t have an answer. I couldn’t reassure my daughter that her father was going to be able to stay with her. This is what made me finally get up off the sofa. I had never spoken in public and the next thing I know I’m speaking in front of 80,000 people in Parliament Square.’

Since that moment, Joan has been encouraging others to get involved. But he admits that he’s paddling against the current: the nursing community has historically been less vocal and politically-engaged than doctors. ‘Nurses are the biggest workforce in the NHS, yet we get the crumbs of everything,’ he says. ‘At debates, there are always doctors, but where are the nurses? To be honest, a lot of nurses believe the government will sort things out. They have been waiting for a miracle that isn’t going to come.

‘Also, because nursing is not a politically-active community, people are afraid to stand out or to be seen to be going against the government. You can become vulnerable if you are exposed politically. Mangers can see you as a troublemaker. But I am starting to see a shift. This May the Royal College of Nursing became the first union to publicly back calls for a second referendum. We are finding our voice. My advice to nurses is to demonstrate, and join in like I did as a member of a union. We can and should be heard.’

As his career shows, EU migrants are part of the solution for the health service – not part of the problem. That is the message he is desperate to put across.

‘EU migrants have been accused of bringing doctors’ and nurses’ wages down, accused of stealing jobs, and yet there are currently 40,000 vacancies,’ he says. ‘If you have problems with the NHS, it’s not because of migrants, it’s because of austerity. The NHS has been the best healthcare system in the world for 70 years because we have the best workers from every corner of the globe.

This is the first time in its history that it is in danger of falling apart. If we want to change this, we need to welcome migrants and fund the NHS properly. That’s why I want to encourage the nursing community and everyone to demand a People’s Vote. The government needs to produce something, and I don’t think anyone, including the Brexiteers, will like what is on offer. The so-called ‘Project Fear’ is becoming a reality. We should have the right to say that this is not what we were promised, and have the choice to reject it.