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Can Nigerians save the NHS?

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Can Nigerians save the NHS?
NHSS STAFF

As staffing gaps rise by almost 50 percent in five years, the growing contingent of Nigerian medical staff might help fill the vacancies.

At the meat counter of Afro Foods in Peckham, south-east London, 55-year-old Ronke Audu is weighing up the options. “Nigerians like meat,” she says emphatically, considering a large hoof for a cow’s-foot recipe. In the end, she plumps for mutton, to boil up in a rich stew with peppers and onions. Powdered yams will provide the carbs. “Just like powdered mash,” she laughs, hefting a large bag of it. But at a cost: “It’s not good for cholesterol. No, no.” 

She should know. Audu is a nurse at nearby King’s College Hospital, part of a large and growing contingent of Nigerian-born NHS staff, currently more than 11,000 strong. Some, like her, have been in Britain for decades, and have gone on to raise families here. But others are just arriving, part of a new wave of post-Brexit migration, which has seen numbers of non-EU workers coming to Britain soar as Eastern Europeans head back to their home countries. Say goodbye to the Polish plumber, hello to the Nigerian nurse.

The exchange is revealed by an exclusive analysis of Labour Force Survey statistics for The Telegraph conducted by the Migration Observatory at Oxford University. It reveals that 30.6 percent of Nigerians come to work in British health and social care, compared with just 9.8 percent of EU workers. And while almost a quarter of EU workers filled posts in manufacturing and construction, the equivalent for Nigerians is just 8 percent.

“The standout point is how over-represented Nigerians are in the health and social care,” says Rob McNeil, the Observatory’s deputy director. “Very much more than the UK- or EU-born populations.”

Indeed, one could argue that they’re needed now more than ever, given the latest survey of 20,000 nurses by the Royal College of Nursing, which found that eight in 10 nurses said the staffing levels on their last shift were inadequate. Staffing gaps have risen by almost 50 percent in just five years, with the loss of 25,000 workers last year.

Nigerians arriving in Britain today are part of a much broader trend of non-EU immigration. Office for National Statistics (ONS) estimates now show that, while annual EU immigration fell by 51,000 between 2016 and 2019, non-EU immigration rose by 108,000. A total of 843,538 non-EU visas were issued last year, the vast majority allowing long stays, more than a quarter of a million more than before Brexit. According to the Migration Observatory, Britain’s foreign-born labour force has grown 400,000 since 2016, to 5.9m workers – with the increase all accounted for by arrivals from beyond the EU.

Oppressed at home, Ukrainian and Hong Kongers are arriving in exceptional numbers. Among other nationalities, however, it is Nigerians whose numbers have leaped the most, with the number of work visas issued to citizens of the Commonwealth country up 700 percent in the five years since Brexit. According to Statista, the number of Nigerian nationals resident in the UK is up by 68,000 in a year, from 114,000 in 2020 to 178,000.

Among them are Damilola Adesina, Temitope Adewunmi, and Yetunde Alao, who now work on the wards at Victoria Hospital, in Deal, on the Kent coast, among a group of 19 nurses recruited from Nigeria and Ghana by Kent Community Health NHS Foundation Trust (KCHFT). In a report for KCHFT, chief nurse Dr. Mercia Spare notes that the Nigerian nurses were helping to fill a critical staffing crisis: “The NHS has struggled to recruit qualified nurses; across the whole of the UK there are around 90,000 vacancies in nursing and clinical roles.”

In the report, Matron Suzanne Vogle says that after six weeks of extra training and a practical exam, “Dami, Temi, and Yetty are very much part of the family. It’s wonderful to have them, they are very highly qualified and such lovely people. We’ve tried not to throw them in the deep end right away but, as nurses, they just want to get stuck in, of course.” 

Alao is 35, and has a two-year-old daughter, Bliss. According to the health trust, her husband, Lanre, is an engineer in Nigeria and hopes to join Yetty in the UK as soon as he can. Adesina, also 35, from Ogun state in south-western Nigeria, has two sons, Daniel, four, and Joel, two. “When I found out I had got the job I called my husband Adeniyi straight away. We were so excited,” she says. “The people in Deal have been so welcoming and kind… My family will be joining me later this month.”

Adewunmi, 38, has two daughters – Olasubomi, 10, and Mobolaji, seven – and is from Lagos, “where I was working in an acute surgical ward”. Like her two compatriots she is now in the very different field of community nursing, vital in a town in which half the 32,000-strong population is over 50, and 27.5 per cent over 65 (compared with 19 per cent nationally). “I was looking for roles in the community as I had previously worked in home-based care and in schools, which I really enjoyed,” she says. 

According to the 2011 census, just 67 residents of Deal were black, with 29,955 white. But the trio says they have been warmly welcomed. “Everyone at the hospital is lovely,” says Alao. “I have already gained so much knowledge. The patients are also lovely, we have been listened to and treated with respect by everyone.” 

The need to plug gaps in NHS rosters is one reason that Boris Johnson’s government has adopted what, perhaps counter-intuitively, is a decidedly liberal post-Brexit immigration policy. While deportations to Rwanda for illegal migrants have dominated the headlines, legal migration has dominated the reality. 

“These are deliberate choices,” says Sunder Katwala, director of the think-tank British Future. “What Boris Johnson did, which Theresa May was not going to do, was in 2019 he made those rules softer than they were going to be.”

One key effect is that quotas for visas for non-EU countries have been scrapped. “You just ended up in a queue. You could be a lawyer earning 60 grand, but you just ended up in a lottery at the end of every month when the quota was full. Now if you’ve got the points, you get the visa.”

The 70 required points to get a work visa have been made significantly easier to obtain thanks to the widening list of professions, from chef to bricklayer, meeting its skill requirement. As Deal’s three Nigerian nurses know, health and care is another key qualifying sector. 

Under the post-Brexit policy, non-EU student visas also provide a “really quite easy” route to work in Britain, says Katwala. Before, students could stay on if they secured a job. But they had to do so while studying. Now, says Katwala, “you can stay for two years while you look”. 

As a result, non-EU student visas have risen 41 percent from 294,000 in 2016 to 416,250 last year. “One of the reasons that there’s been this upsurge in Nigerian student visas, I would guess, is that they find the graduate visa quite attractive because they like the idea of staying on here,” says Jonathan Portes, professor of economics and public policy at King’s College London. 

“Lots of people have come to study,” says George Mwagu, a senior officer at the National Association of Nigerian Communities. So while the traditional heart of the Nigerian community in Britain has been south London, notably in Peckham, he says many new arrivals are heading to university towns further afield – “places like Sheffield and Nottingham”.

The influx is an echo of 40 years ago, when the Nigerian economy was badly hit by a downturn in oil production and prices, prompting a first Nigerian exodus to south London. Coincidentally, then too, Nigerians in Peckham succeeded Polish immigrants, who had arrived during the war. 

Today, the Nigerian economy is again a key reason to leave. A decade ago, 100 Nigerian naira was worth about 40p; today it’s worth 19p. “I still go back every year,” says Audu, “and five years ago I would have said I would eventually go back for good. Not now. Things have deteriorated so fast. There are such high levels of poverty. People can’t pay for anything. And the government is doing nothing to help. The cost of everything is so high and there’s no NHS if you fall sick.”

The economic malaise has led to rising crime, she adds. “Corruption is at its highest level ever. Insecurity is systemic. Kidnappings, even. And people who come back from Britain are special targets because they are seen as rich. Before she died last year, my mother said: ‘No, don’t come back. Life is not good here’.”

Such crises mean that, according to a survey by the African Polling Institute last year, 70 percent of Nigerians would leave their country if they could, up from 32 percent only two years earlier. Yet if Nigerians see the UK as an escape from the pressures of home, some here have warnings that not everything will be easy. 

“They think that the West is best,” says Lagos-born Linda Joseph, 53,

 browsing the aisles at FAS, a beauty products supplier for the Afro

-Caribbean community in

 Peckham. “But then they come here and find the harsh reality about the economy,

 immigration, prices, food, jobs. It’s not easy.” She mentions the Windrush scandal,

 in which the Home Office wrongly detained and deported Commonwealth citizens, 

some of whom had worked in Britain for decades. “Now that the going is getting

 tough, the [UK government] is giving out visas. But is it to come now then

 get deported? There’s not much trust.”

But there is a significant cultural impact, not least in matters of faith. “We love God,” says Alysia, whose wares at the Kingdom Gift Centre include church supplies and Amazing Grace perfume. “Coming from Africa, we have seen our parents pray and God answer. My mother went to her knees. When there was no food, the Lord provided. You hear that and give thanks to God.”

Such fervent belief has borne fruit in the appearance of pentecostal churches – Christ Apostolic Church (Vineyard of Comfort); Redeemed Church; the Mountain of Fire and Miracles Ministry – which were founded in Nigeria but now have outposts in Britain. And Nigeria’s sizeable – and conservative – Anglican community has an effect on the Church of England. Last November, on a trip to Britain, primate of the Church of Nigeria Henry Ndukuba demanded believers be “absolutely loyal to the authority of the scriptures and to the historic Christian faith, as the Church received it from the apostles who were eye-witnesses and servants of the word”. In January, he described homosexuality as a “deadly virus” that should be “radically expunged and excised”, drawing condemnation from Justin Welby, the Archbishop of Canterbury. 

Nigerians are different from the local workforce in other ways too. While data is not country-specific, some 34 percent of sub-Saharan immigrants work in jobs considered by the ONS to be “high skilled” compared with 30 percent for EU and native workers. At £29,000, the median salary is just higher than that of Britons, which stands at £28,400. Such wages explain why so many visas are now issued, as they easily qualify for the points-based visa’s minimum of £20,480, as well as the £25,600 threshold – which brings a maximum of 20 points. 

Naturally, some of that money and talent ends up back in Nigeria. But much enriches the regional economy and culture, or at least that part of the regional economy and culture that has not been snapped up by Nigerians themselves. “You see this,” says one woman tapping a crate of Guinness in Stella’s Grocery (Fresh Veg from Africa Daily) on Rye Lane, Peckham. “It’s not Irish, it’s Nigerian, she says. Any party in Nigeria is not complete without it.” 

Author: Linda .R. Jones

London, UK

lindarj83@gmail.com