OPEN SPACE: Despite a crippling shortage of nurses, Maggie Oldham says the NHS is continuing to ignore a rich source of recruitment - asylum seekers

The process and ethics of recruiting nurses overseas have been well rehearsed. But the needs, and potential value, of immigrant workers have received much less attention.

There are significant numbers of asylum-seeking and refugee healthcare workers in the UK who are finding it difficult to get jobs.

They have a broad range of skills and experience that could be used to meet the needs of the British healthcare system and its patients. But at present, this resource is largely neglected.

One important consideration is that the present overseas recruitment campaign takes a short-term view: nurses are recruited from overseas on a twoyear contract.

Conversely, nurse asylum seekers and refugees are settling in the UK with thoughts of a long-term future and, as the present nurse shortage is predicted to last considerably longer than two years, a project to look into this resource surely makes sense.

But at the moment, there are numerous barriers that stop asylum seekers and refugee nurses getting jobs.

Arriving in the UK, nurses and other healthcare workers do not know how to find information on continuing their professional careers and how to get advice or guidance.

Language problems mean that some potential recruits require preparation in order to apply for places on adaptation courses.

Nurses encounter difficulties finding and understanding the workings of the UK Central Council for Nursing, Midwifery and Health Visiting. It is the role of the UKCC to ensure that any nurse placed on the professional register is fit for practice and purpose.

Obviously, the protection of patients is of paramount importance, and stringent and rigorous assessment of each individual case is necessary. This is a process that takes time.

The UKCC warns potential recruits to expect their application to take approximately 135 days to process; this is not to gain registration, but merely to receive information detailing the form of adaptation required and the length of time this will take.

There are insufficient adaptation courses, particularly in the inner cities where asylum seekers and refugees are housed.This means that nurses from this population find it extremely difficult to access adaptation.They are further disheartened as they see places on these courses occupied by international recruits, and the high profile given to international recruitment over the past 12 months.

Lack of money is also a problem.Many of these nurses have the responsibility of being part of a family. They are already short of cash and may have no option but to seek alternative employment (or state benefits) rather than incur expenses while completing the lengthy adaptation process.Many will not have the funds to register initially with the UKCC.

In June 2001, the UKCC issued a press statement recognising that the NHS was becoming increasingly reliant on international recruitment to support the nursing workforce in the UK.Many trusts feel they have no option but to continue to recruit in this way.

The hefty financial implications of this continuing recruitment policy should give rise to discussions about the potential of recruiting asylum seekers and refugees.

Encouragingly, Praxis, a London-based charity, is running a programme of preparation for asylumseeking and refugee nurses who are in the process of applying for adaptation courses.

Praxis offers a pre-adaptation course that lasts three months and includes general English, orientation to nursing in the UK, and preparation for employment in the NHS.

It is working in partnership with local trusts which provide placements and guarantee interviews for those nurses who complete the programme.

This work needs exploring and developing further; surely it is an opportune time to explore this untapped pool of resources. It should also be remembered that the government has a commitment to the United Nations Refugee Convention, which Britain signed in 1951 and obliges us to provide refugees with access to health, education, housing and employment.

A national project is needed to look at this recruitment source and co-ordinate a strategy for asylum seeker and refugee healthcare professionals, integrating them into the British system.

This would increase the number of qualified nurses and enhance the diversity of the UK nursing profession - and show a real commitment to the refugee population. l