Consensus demands changes to the healthcare industry’s “repayment clause.”


According to a trade union, overseas healthcare professionals in Northern Ireland are being required to pay thousands of pounds in order to resign their positions before the conclusion of their contracts.


According to Unison’s statement, “repayment provisions” in employment contracts ought to be subject to more stringent regulations.


According to BBC News Northern Ireland, the Department of Health is cooperating closely with the Unison on the matter.


The employment legislation in the UK does not prohibit the use of repayment provisions.


The condition is intended to assist in retaining employees and recouping costs related to foreign recruitment, such as visa sponsorship. Additionally, the clause will aid with the retention of personnel.


According to Unison, the “unethical execution of the conditions” was leaving international health workers open to exploitation.


“I felt like a slave,” she said.

One healthcare worker named Julian, whose identity has been concealed and whose name has been altered to protect it, travelled all the way from Africa to Northern Ireland in order to begin working as a healthcare assistant at a private nursing home.


He said that he comprehended and accepted the fact that the payback provision required him to stay with the firm for a length of three years, but he afterwards expressed worry about the working circumstances.


He remarked, “I felt like a dehumanized animal.”


“The employer treated me as if I were their property, and the fact that they sponsored my visa gave me the impression that I was part of their organization,”


It was expected that I would get enough instruction, but that did not occur. I was unable to call in ill to work. When I did that, you informed me that I needed to put the needs of the firm before my own.


“Even if I were to bring a complaint forward via the appropriate channels, no one would listen to me,” she said. I had no defences and felt utterly powerless. I had the feeling of being a slave.


Julian said that when he sought to turn in his notice to his employer, he was informed that he would be required to pay them a flat payment of over $4,000 before he could do so.


The BBC is aware of the existence of this request and has seen evidence of it.



Julian said that he made many attempts to bargain with his company, saying, “I was hoping that they would allow me to stretch out the repayments.”


They rejected my request and deducted my pay for the last month of my employment. After they removed it, I was still required to make an additional payment of 1,800.”


Any payback provision that is included in an employment contract has to adhere to the principles of transparency, proportional expenses, timeliness, and flexibility in order to be in compliance with the code of practice on the international recruitment of health professionals that has been established by the Department of Health.


According to the code of practice, some situations in which a payback provision needs to be waived include those in which a recruit’s health and welfare are being negatively affected, as well as those in which the recruit quits as a result of being bullied or discriminated against or because working circumstances are unsatisfactory.


“Many others had the same desire to go,”

A recruiting firm successfully placed another employee, this one given the name Marie by the BBC, in a position to work for a private care facility.


“I never believed I would be in a situation where I would want to quit the work,” Marie said after relocating her family from Africa to Northern Ireland. “It’s been a wonderful experience.”


“There were occasions when I was responsible for the care of more than 25 individuals on my own. She shared her story with BBC News Northern Ireland, saying, “Whenever I attempted to convey to the boss that I required training, I couldn’t obtain it.”


Marie submitted her resume for a new position, but she said that her current employer informed her that in order to quit, she would be required to pay a one-time fee of more than ten thousand pounds.


Marie said that after she gave her notice to the firm she was working for, the business was able to reclaim part of the money via her income.


She said, “I went to work for two months and did not earn a single cent; the company held my complete income.”




Marie said that she ultimately paid back around 6,000 pounds and was thereafter allowed to leave the nursing home and begin a new career.


“Other coworkers wanted to quit, but they were terrified because of what happened to me, and they simply had to remain in horrible working circumstances,” she added. “I had to stay in poor working conditions because of what happened to me.”


“There is no accountability; I am making my voice heard because something has to be different.”


The highest possible moral requirements

According to Nathalie Donnelly, who works as a local organizer for Unison’s black and migrant workers programme, the problem has been around for quite some time.


Having said that, the union also said that there has been a spike in the number of instances that are comparable to the Covid-19 epidemic.


“However, due to these payback restrictions, individuals are required to pay a significant amount of money, and this is a phenomenon that emerged more recently,” she said.


“Those that have been brought to my notice are in a very precarious situation. They report an overwhelming sense of confinement.”



Nathalie Donnelly of Unison has reportedly advocated for “stricter enforcement. “Employers need to be aware of the Department of Health code of practice, and there needs to be better enforcement of it.


“Because there seems to be tighter examination, it does not appear to be a problem inside the Health Trusts.”


The department said that it would investigate what possibilities, if any, there are for increasing the code’s level of enforcement and added that it would be “glad to engage further with the independent sector providers.”


“A delicate balancing act”

In response to the charges, Pauline Shepherd, chief executive officer of Independent Health and Care Providers, which is the trade association for the care home industry, said that she was “worried and alarmed.”


She said, “It’s completely unacceptable if worker complaints are not handled effectively, and then they find themselves in this situation,” and I agree with her sentiments.


Ms Shepherd said that there was a need to find a happy medium with regard to the fees that are paid by businesses.


It may cost around £11,000 to hire a nurse from another country, while it may cost up to $6,000 to hire a care worker.


“That is an amount of money that the company is paying before anybody even begins working, so there has to be some form of security in place to recover that repayment for the business.”


If that were to happen, international recruiting would come to a complete halt.


However, if we were able to resolve the issues raised by the employees and address their worries over their job, then the workers would not be in a position where they needed to pay back the money.



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