Reform UK's overseas worker levy would harm NHS, schools and universities, experts warn

Reform UK has proposed a policy that would fundamentally reshape how British employers hire overseas workers, and the early warnings from experts across health, education, and social care suggest the consequences could be severe. The party, led by Nigel Farage, is pledging what it calls a "migrant worker surcharge"—a combination of higher employer national insurance contributions and a separate annual charge applied to any worker without a UK passport. The only exception would be Irish nationals. The policy would apply across the entire country, with no carve-outs for sectors that are already struggling to fill vacancies.

The architects of the plan argue it will incentivize employers to hire British workers instead. But that logic collides with a stubborn reality: in many fields, British workers simply aren't available in the numbers needed. The NHS, for instance, employs roughly one in five staff members who are not UK nationals. Schools are similarly dependent on overseas teachers, particularly in subjects where shortages are acute—languages, physics, mathematics. Universities, already running on thin margins, employ international researchers and academics at rates that can reach nearly half their workforce in some institutions. Care homes and home care providers have turned to overseas workers not out of preference but out of necessity, as demand has outpaced the domestic labor supply, especially since the pandemic.

The King's Fund, a respected health policy organization, has calculated that the policy would add significant costs to an NHS that is already stretched. Suzie Bailey, a researcher there, put it plainly: the money would have to come from somewhere, which means other services would be cut. She struggled to articulate how the policy could work without damaging patient care. Victoria Tzortziou Brown, president of the Royal College of General Practitioners, noted that many overseas GPs received their specialist training in the UK at public expense—penalizing their employment would be economically perverse. General practices, most of which operate as small independent businesses contracted to the NHS, would be hit particularly hard by rising staffing costs.

The care sector faces perhaps the sharpest blow. Jane Townson, chief executive of the Homecare Association, explained that employing overseas care workers is already more expensive and administratively complex than hiring domestically. A levy structured to hit lower-paid workers hardest—which is how Reform has described it—would fall most heavily on care providers, who operate on narrow margins. Townson laid out the cascade of consequences: reduced access to home care, people remaining in hospitals longer than necessary, greater vulnerability to worker exploitation, and ultimately provider failures that would push costs back onto the public system.

In schools, the picture is mixed but still troubling. Nearly six percent of English teachers are non-UK nationals, but they're concentrated in secondary schools and in shortage subjects. James Zuccollo, head of school workforce at the Education Policy Institute, pointed out that many of these teachers have been in the UK for years and hold settled status. A levy would function as both a brake on future hiring and a tax on staff already in place. For universities, the threat is existential. Nick Hillman, chief executive of the Higher Education Policy Institute, noted that many institutions spend up to 60 percent of their budgets on salaries. With nearly half of UK universities already running deficits, higher wage bills would force cuts elsewhere—and in extreme cases, could push an institution toward insolvency. No British university has ever gone bankrupt, but some are close enough that this policy could tip the balance.

The research and development sector would suffer collateral damage as well. Dr. Alicia Greated from the Campaign for Science and Engineering warned that visa costs and complex immigration policies already drain resources that could be invested in research itself. A new levy would compound that burden. Reform UK declined to comment when approached by journalists. The policy remains in place, and so does the question: what happens when you make it expensive to employ the workers that essential services depend on?