Nepali nurses will be permitted to work in Britain under a bilateral labour agreement the two governments are slated to sign next week.

A cabinet meeting held on June 14 gave the green signal to the government to conclude the deal allowing Nepal to send nurses to the United Kingdom.

“It is one of the finest proposals that Nepal has received in the labour sector,” said Thaneshwar Bhusal, under-secretary at the Foreign Employment Management Section of the Ministry of Labour, Employment and Social Security. “The agreement will most likely be signed next week.”

The details, including the qualifications for Nepali nurses to be eligible to work in the UK, is yet to be disclosed. But officials say that nurses under the age of 45 years with at least two years of professional experience meet the basic requirement.

“Also, candidates will need to score 7 in the International English Language Testing System (IELTS) or B plus in Occupational English Test (OET),” said Bhusal.

Hopeful Nepali nurses will have to appear in the UK’s Nursing and Midwifery Council examination within three months after being selected to obtain the status of a nurse.

“Those who fail to clear the examination three times will not be eligible to become a nurse in the UK,” said Bhusal. Before acquiring the status of a nurse, they will serve as an assistant nurse.

"After clearing the council’s examination, Nepali nurses will receive the same salary as their British counterparts," Bhusal said.

The Royal College of Nursing has estimated that the average annual salary of a registered nurse in the UK is £33,384, or Rs5.07 million as per Friday’s exchange rate, according to nurses.co.uk.

The National Health Service pay for nurses is structured around different bandings.

Newly qualified, registered nurses start at Band 5, and the most qualified and experienced nursing consultants and specialists can climb all the way to the uppermost pay band, which is Band 9, according to nurses.co.uk.

The starting salary for a Band 5 Nurse was £25,655 or Rs3.89 million as of February-end.

“While it is a good opportunity for Nepali nurses to work in the UK, we have to consider its impact on Nepal’s health sector too,” said Prof Mana Kumari Rai, president of the Nursing Association of Nepal, the national governing body of nurses.

“We have been saying that the decision to send nurses abroad should be made after conducting rigorous discussions and understanding its impact,” said Rai. “We might be able to send nurses to foreign countries for some years, but we need to seriously consider if we are in a position to export competent nurses to more foreign countries in the coming days.”

Undersecretary Bhusal seconded Rai. “Given the possibilities of Nepali nurses finding jobs in more foreign countries in the coming days, we need to increase the scope of nursing education in Nepal,” said Bhusal. “It is a challenge for us. While sending them abroad, we cannot create a shortage of nurses in our own country.”

But Nepali nurses have been complaining about their pay structure in Nepal, which they say is labour exploitation. In Nepal, hospitals hardly pay Rs15,000 monthly, they say.

According to the Nepal Nursing Council, 68,316 nurses, 36,446 auxiliary nurse midwives, 845 foreign nurses, 598 specialists and 28 midwives were registered in Nepal as of March 27. “But there is no data on the number of unemployed nurses,” said Rai.

"Working abroad has both challenges and opportunities," said Maya Adhikari, a senior nurse at Civil Hospital in Kathmandu with 21 years of experience. “There is, of course, a learning opportunity. If these nurses return to Nepal after working in the UK, it will boost the efficiency of the health sector.”

Many nurses in Nepal are unemployed, and those with a job too do not earn enough to sustain themselves and their families, Adhikari adds. “If they get a chance to work in the UK, they will definitely earn more.”

Adhikari believes nurses should be sent in such a way that it will not affect the health sector in Nepal. “The government should consider the long-term impacts.”

Detailed information about the requirements for nurses to be eligible to apply to work in the UK will be known when the Foreign Employment Board publishes a notice calling for applications after receiving a request for nurses from the UK government, according to Bhusal.

“The information regarding the number and types of nurses the UK will demand is also yet to be known.”

The nurses will be sent only after holding discussions with the concerned stakeholders such as the Health Ministry, Education Ministry and Nursing Council among others.

The government wants the nurses to return to Nepal after completing their tenure in the UK. In order to prevent them from permanently settling there, the government of Nepal will only grant labour permission for five years.

“The labour permit will be given for five years, and the nurses will have to return to Nepal after completing their tenure,” Bhusal said.

It is a zero-cost job since the employer will bear all the costs. “Even the cost of the IELTS or OET is refundable,” Bhusal said.

Currently the ministry is developing a web portal for the online application process. According to Bhusal, the government of Nepal will have no hand in the selection process.

"Apart from sending nurses to foreign countries, the government needs to work on improving the condition of the nursing sector in the country," said nurse Adhikari.

“The nurses, especially in rural areas, are working in poor conditions. The government should improve the working conditions there,” Adhikari said. “And more vacancies need to be opened in different sectors where nurses are needed.”

If the accord is signed, the UK will be the 11th country with which Nepal has signed labour agreements.

"The government of the Maldives too has shown interest in hiring Nepali nurses," Bhusal said. “We are trying to sign a bilateral agreement with the Maldives.”

Israel’s care giving sector, mainly hospitals, nursing homes and day-care centres, opened for Nepali caregivers after a labour agreement was signed between Nepal and Israel on September 20, 2020.

In January last year, the implementation protocol agreement was signed following which the selection and recruitment process of Nepali nationals for jobs in Israel formally began.

An examination was held and 1,132 individuals were selected to work in Israel, 297 of whom have already departed, Bhusal told the Post in a recent interview.

Similarly, Japan opened up its labour market to Nepalis as specified skilled workers in March 2019 after the two countries signed a memorandum of cooperation to send Nepali workers with the status of residence.

Japan will recruit Nepalis in 14 sectors as per the memorandum of cooperation. Key sectors include nursing care, agriculture, food and beverage manufacturing, and the food service industry. Since last month, Nepalis have started to be hired in nursing care jobs.

"Besides the nursing sector, the prospects of Nepalis going to work in the UK in other sectors in the coming days depend on Nepal’s diplomatic negotiation ability," said Bhusal.