NURSES from the Republic are being asked to sit a £150 English language test - that is sparking controversy across the NHS over its high failure rate - to work in the north.
A tightening of regulations by the UK's professional nursing body, the Nursing and Midwifery Council (NMC), means that all European and overseas nurses must prove their competence in reading, writing, listening and speaking English if they wish to register to practice.
There has been scathing criticism of the new International English Language Testing System test (IELTS) after it emerged that some highly-skilled Australian nurses with English as their first language were repeatedly failing the written part of the exam.
Some nurses have spent up to £1,000 over the course of a year retaking the test, with the essay component proving the most difficult.
A NMC spokesman confirmed that nurses from the Republic would have to prove their "English language competence" and that "one of the ways to do this is the IELTS".
He added that other routes may be possible.
However, sources have told The Irish News that southern nurses have already taken the IELTS because they were unable to get registered through other NMC 'options'.
It comes at at time of massive NHS nursing shortages, with more than 1,200 unfilled jobs in Northern Ireland alone.
Earlier this week, hospital bosses at a West Midlands health trust in England called for IELTS marking to be relaxed after it emerged that just three of its 118 Filipino applicants had passed.
Introduced by the British government in January last year, the test was brought in to restrict inmigration by requiring all foreign nationals in "customer-facing" public sector roles to speak a high standard of English.
The NMC say the system is in line with nursing bodies in other countries and has been introduced to safeguard patient safety.
But Janice Smyth, director of the Royal College of Nursing (RCN) in the north, said while she agreed patient safety was paramount, a "balance needed to struck" at a time of chronic shortages in the sector.
Ms Smyth she she believed the exam was a 'major contributory factor' in a dramatic 96 per cent decrease in the number of EU nurses registering to work in the UK over the past year.
It had previously been solely linked to Brexit.
Irish News cartoonist Ian Knox's take on the story:
"The RCN in London has raised this issue with the regulator and we are aware the NMC are currently taking stock of their English language requirements," she said.
"Good communication is essential in nursing care but when you have a situation where highly qualified nurses, some of whom are from Canada, New Zealand and Australia, are repeatedly failing the written component, then we have a concern.
"Following a law change in the past year this has been extended to all European nurses so it obviously takes in nurses from the Republic of Ireland.
"Morally and ethically there also are issues around this exam in the case of Filipino nurses for example, where the cost of the exam is the equivalent of one month's salary."
When asked by The Irish News if the NMC intended to relax marking, its chief executive Jackie Smith said she didn't believe it is "in the interests of public safety" to lower the standard of English competence required "without clear evidence".
"While we are aware of some concerns about our English language policy, we do not currently have any hard evidence on which to base a change.
"We are committed to working with organisations to better understand their concerns, but at this stage it is important to state that this decision does not indicate that we feel the current standard we require... is wrong or that we are committing to a change."
