The NHS would be placed in the “very strange” position of having to pay for its foreign workers’ private health insurance, under government immigration plans.

The proposal is contained in a Home Office consultation on capping the number of visas available for non-EU migrants.

The consultation states: “The government believes that sponsors should do more to ensure that migrants and their dependents do not place undue burden on local public services.”

The government is therefore interested in views on whether “employers should be asked to hold health insurance for their employees.”

Contacted by HSJ, the Home Office confirmed this would apply to the NHS, even where workers were already paying national insurance.

NHS Confederation acting chief executive Nigel Edwards said: “It would be very strange for the NHS to be paying top-up health insurance for people providing a service to the NHS.”

The overly “bureaucratic” system would result in higher costs for trusts employing foreign workers, he said.

He added: “All this does is transfer NHS money to workers and from workers to insurance companies.”

The consultation proposes making work visas available on a “first come first served” basis to employers to reduce immigration to levels seen in the 1990s.

Another approach outlined in the document is making trusts bid against other employers in an auction of visas, which would go to “those willing to pay the highest fee”.

Mr Edwards said it was likely most workforce gaps could be filled by UK based workers.

The plans say employers must provide training to British workers and exhaust “every reasonable avenue” to recruit residents before looking beyond the EU for staff.

The number of NHS apprenticeships rose by a third last year to 3,096, largely thanks to joint investment from the Department of Health and the Learning and Skills Council.

But Skills for Health executive director Sam Gallaher told HSJ it was unclear whether the schemes would continue in the financial squeeze.

He said: “The question for the NHS is whether [it would] pay if the funding isn’t there.”

The immigration plans, launched last week, are under consultation for 12 weeks.