Workforce globalisation, language and discourse

• DOI: https://doi.org/10.13169/workorgalaboglob.16.2.0040
• Pages: 40-58
• Published date: 17 October 2022
• Date: 17 October 2022
• Author: Andrei Kuznetsov,Olga Kuznetsova,Jaime Fernández de Simón de la Cruz
• Subject Matter: Language testing,nurses,NHS,overseas workforce,international mobility,professional discourse

40 Work organisation, labour & globalisation Volume 16, Number 2, 2022

Workforce globalisation, language

and discourse

Recruitment of foreign nurses in the UK

Andrei Kuznetsov, Olga Kuznetsova and

Jaime Fernández de Simón de la Cruz

Andrei Kuznetsov is Professor of International Corporate

Social Responsibility in the Lancashire School of Business

and Enterprise at the University of Central Lancashire, UK.

Olga Kuznetsova is a Visiting Fellow in the Faculty of Business

and Law at Manchester Metropolitan University, UK

Jaime Fernández de Simón de la Cruz is a Consultant with

the Energize Group, UK.

ABSTRACT

The globalisation of the labour market creates new challenges for organisations

when hiring. This article addresses one such challenge that is rarely in the

spotlight: the implications of the choice of a language prociency test for

non-native speakers by the hiring organisation. We use the UK National Health

Service (NHS) recruitment practices as an example. With the help of a staged

experiment, this practice-based study argues that the current international

recruitment procedure to the NHS tends to underestimate some important

differences between language as a formalised system of words and grammatical

rules and discourse as ‘language in action’, causing the loss of stafng capacity.

It follows from our analysis that when setting the requirements and objectives

of a language test, the recruiting organisations need to consider more explicitly

the social and cultural context in which their employees operate and the impact

of this context on the communication demands faced by the staff.

KEY WORDS

Language testing, nurses, NHS, overseas workforce, international mobility,

professional discourse

DOI:10.13169/workorgalaboglob.16.2.0040

Work organisation, labour & globalisation Volume 16, Number 2, 2022 41

The moment one starts thinking of language as discourse, the entire landscape

changes, usually forever.

- McCarthy & Carter (2014) Language as Discourse: Perspectives for Language

Introduction

Developed countries have seen increased imbalances between the supply of and

demand for health workers. Demographic factors such as population aging and the rise

of life expectancy have created increasing job opportunities in the sector. According to

The European Centre for the Development of Vocational Training, in the EU alone,

employment in the sector grew by 14.3% between 2006 and 2018 and has been

projected to grow by a further 5% over the period 2018 to 2030, an increase of more

than 300,000 new jobs (CEDEFOP, 2019). In order to provide for the vacancies and

replace healthcare workers who will leave the occupation for one reason or another by

2030, almost 4 million job openings will need to be filled (CEDEFOP, 2019).

Abundant employment opportunities have intensified the international mobility of

doctors and nurses and instigated a continuous battle to attract health professionals by

the healthcare providers (Mara, 2020). The COVID-19 pandemic reminded everyone

with unprecedented urgency about the essentiality of the role that health workers play

in modern society and made the examination of the factors that influence their

international mobility particularly topical. This includes recruitment procedures, which

the literature argues are crucial for productive employment (Andresen, 2015; Reiche

et al., 2019). As a result of the complexity of the operational environment (Mayo et al.,

2021) and the specific tasks and responsibilities that the provision of healthcare services

requires, when hiring, healthcare organisations have to apply particularly strict

requirements to test the preparedness of the applicants to fulfil their duties. Under these

circumstances, the choice of selection criteria acquires particular importance and has

profound implications for both the hiring organisation and the career of the applicant.

In this article, we investigate the challenges that surface when language proficiency

is tested as a part of the process of hiring overseas healthcare workers. Our analytical

focus is on the challenges that the available options used to demonstrate the required

competence pose to the recruiting organisation. We consider the case of the UK

National Health Service (NHS), possibly the largest publicly funded national healthcare

system in the world. Over many years, the NHS has been experiencing staff shortages.

Consequently, its growth has been accompanied by an increase in the number of

medical professionals coming from abroad: in 2018, 144,074 of the NHS employees

(12.7% of all staff whose nationality was known) were classified as non-British nationals

(Baker, 2018). In the foreseeable future, the NHS will continue facing a shortage of

medical staff in all categories (Iacobucci, 2017), accentuating the need for research on

the bottlenecks that impede the absorption of skilled workers from abroad. In this

respect, this article offers an original contribution to the debate by addressing a facet

that is rarely in the spotlight: the effects and implications of testing foreign recruits’