The British Medical Association (BMA) and the Royal College of Nursing (RCN) are urging the government to exempt health and social care professionals from the incoming immigration charge to prevent the NHS budget from taking a hit of millions of pounds.

The new immigration skills charge will, from April 6, apply a £1,000 charge per year of visa to overseas staff coming to the UK on a Tier 2 visa, which the BMA and RCN argue will result in bodies such as NHS employing trusts and Health Education England (HEE) incurring “substantial costs”.

In a letter to home secretary Amber Rudd, BMA council chair Mark Porter and RCN chief executive and general secretary Janet Davies stress that failing to remove overseas health staff from the new rules would take vital funds away from frontline services.

“It cannot be appropriate to divert funding away from the budget for frontline health services and the training of health professionals in this way,” the unions say, noting: “While the Government has suggested that funds raised from the charge would be reinvested back into the UK workforce and health system, we have been given no guarantees to that effect.”

Healthcare cannot be treated as a business, they stress, and point out that if the charge been applied during 2014-15, NHS budgets would have incurred costs of £3.5 million, while HEE (which trains doctors) would have faced a bill of £1.6 million in 2015/16 with £2.1 million applied to nursing in the same period.

Similar charges apply in each subsequent year, as new staff are taken on, so these costs to the NHS would keep growing, the organisations stress, and note that, given the ongoing workforce shortages in both health and social care, the UK will continue to depend on overseas staff “for the foreseeable future”.

“It is simply not possible to up-skill resident workers or put apprenticeships in place for doctors because of the long and rigorous training process involved and additional regulatory requirements,” the unions argue.

“Checks and balances are already in place to ensure posts are first offered to UK and EU nationals through the resident labour market test.

“It is unfair therefore, to penalise health and social care employers for recruiting a doctor or a nurse on a Tier 2 visa to fill workforce gaps because a UK or EU national cannot be found to fill the post.”

The government has said the charge will help to encourage investment in training, according to the BBC.