Reform UK proposal to levy employers of overseas staff raises concerns for health and social care

A proposed Reform UK policy to introduce a levy on employers who recruit overseas workers has prompted warnings from health and social care leaders that it could increase costs and worsen workforce shortages across essential public services.

The proposal would introduce a higher rate of employer National Insurance alongside an annual “migrant worker surcharge” for employees who do not hold a UK passport. According to reports, the policy would apply across all sectors and would not exempt the NHS, adult social care or education.

Health policy experts have warned that the NHS could be particularly affected because around one in five NHS England staff are non-UK nationals. The King’s Fund said the proposal would add further financial pressure to a health service that is already under significant strain, with any additional employment costs likely to reduce resources available for patient care.

The Royal College of General Practitioners also raised concerns that increasing the cost of employing overseas GPs could reduce workforce capacity and affect patients’ access to primary care.

Social care leaders warned that the impact could be especially significant for care providers, which continue to rely on international recruitment to fill workforce shortages. The Homecare Association said providers would be unable to absorb additional costs, increasing the risk of reduced access to home care, delayed hospital discharges and financial pressure on care services.

Reform UK has said the policy is intended to encourage employers to recruit more British workers, but healthcare and social care organisations have argued that domestic workforce shortages mean overseas recruitment remains necessary in many parts of the sector.

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