Shabana Mahmood's migrant crackdown could plunge the NHS into crisis and leave Labour's promise to slash waiting times in tatters, health chiefs have warned. NHS Employers want foreign doctors, nurses, hospital staff and care workers to be given preferential treatment under the Home Secretary's settlement reforms.

Overseas nationals face a 10-year wait to apply for indefinite leave to remain, double the current five years. But NHS Employers, which helps develop the workforce, has demanded a "fast-tracked settlement route" for health service personnel, warning of spiralling costs and workforce shortages.

The intervention is a fresh headache for the Home Secretary, who is already facing opposition from dozens of Labour MPs and trade union barons.

The body told MPs: "NHS Employers supports a fast-tracked settlement route of under 10 years for those sponsored by NHS or care organisations.

"This should apply across both clinical health and care roles (such as those on a Health and Care Visa) and key support functions such as digital, finance, estates, and administration (such as those on a general Skilled Worker Visa).

"Extending settlement from 5 to 10 years would place a substantial financial burden on the NHS.

"Sponsorship periods would double and combined with increases in the Immigration Skills Charge (32%), visa fees, and Certificates of Sponsorship, costs for recruiting internationally trained staff would more than double.

"Delays in settlement may reduce the UK's attractiveness as a workplace for international recruits, leading to vacancies in both health and care sectors and creating knock-on effects for NHS service delivery, including the government's headline pledge to reduce waiting lists over the course of the Parliament."

Under Labour's plans, migrants will be told to wait at least 10 years before they can apply for settlement rights.

Foreign nationals who arrived in the so-called 'Boris Wave' face a 10 to 15-year wait to apply for indefinite leave to remain amid fears over an influx of low-skilled workers, particularly on the abused Health and Social Care Visa in the early part of this decade.

And migrants could be barred from claiming benefits unless they become British citizens.

Ms Mahmood said those relying on handouts must wait 20 to 30 years to receive indefinite leave to remain.

Arrivals applying for indefinite leave to remain after 10 years must have no criminal record, speak English to A-level standards and have no debt, under Labour's new proposals.

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But NHS Employers told an inquiry by MPs: "We can also confidently predict an increase in numbers of people leaving the UK for more favourable destinations, which are in competition for healthcare professionals.

"The GMC data published in November 2025 shows an increase in the number of internationally educated doctors leaving the UK over the last year which could be a result of current policy changes and the negative narrative."

Net migration surged to a record high of 944,000 in the year ending March 2023. It hit 764,000 in 2022, before dropping to 649,000 in June 2024.

It fell to 204,000 in the year to September 2025 as the number of people leaving the country hit the highest level for a century.

The number of arrivals dropped below a million for the first time in three years in 2025. Some 1.47 million arrived in the UK in 2023.

Home Secretary Ms Mahmood, speaking to the Home Affairs Select Committee, stressed the proposals are necessary due to an "unprecedented" number of arrivals between 2021 and 2025.

She compared the influx to "free movement".

Ms Mahmood said: "On any measure, the numbers that we have seen in the last few years are unprecedented.

"There is no other equivalent period where we have seen such a large number of people arrive and such a mismatch between what the expectation was and what has in fact happened.

"On scale and pace, and the unprecedented nature of what we are seeing, it is something akin to signing up to free movement with the European Union-that is the only other historical comparator you could possibly look at.

"Without any change, at the point of settlement all those individuals will be able to access social housing and the welfare state.

"Because of the lower-skilled nature of many of these people in terms of their salary expectations, you can expect that there will be a correlation between those numbers and those who, having achieved settled status, may require assistance from the state, if we do not change the rules."