Two Australian citizen nurses, who were born overseas, are currently campaining for changes to the English Language proficiency requirements for domestic nurses seeking registration in the country.

The Australian Health Practitioner Regulation Agency (Ahpra) requires nurses to demonstrate their language skills via one of several tests such as IELTS, OET, PTE, etc. to get registration as enrolled nurse (EN) and registered nurse (RN).

Joby Kizhakehkattil and Biju Akkamparambil argue that this is unnecessary for overseas-born nurses who have studied in Australia, where they would have developed their English skills through participation in programs and placements.

Their campaign comes close on the heels of Britain’s Nursing and Midwifery Council’s recent changes that allow assistant nurses to be registered if they have worked for the same employer for two years and the employer can confirm that they possess a satisfactory level of English Language proficiency.

Kizhakehkattil and Akkamparambil are now asking the Australian government to also modify its English language competency guideline for overseas-born nurses who have studied in Australia.

“This is disappointing and unfair,” rue the campaigners, who despite working in the health industry for ten years, are still unable to work as nurses due to this requirement.

Akkamparambil, who is based in Townsville, obtained his nursing degree in Bangalore and subsequently worked in the UK before moving to Australia 13 years ago. He enrolled as an adult student and completed his diploma of nursing after fulfilling the necessary numeracy and literacy requirements. However, despite meeting these qualifications, he received a rejection letter from Ahpra stating that he still needs to take the IELTS test to obtain nurse registration.

Brisbane-based Kizhakehkattil enrolled for nursing in 2011 when there was no requirement for English test for registration as nurse on completion. But in September 2012, just before he was about to finish his course, the Ahpra registration for requirement of an English test became compulsory.

Akkamparambil and Kizhakehkattil’s main argument is that nurses who have studied in Australian universities and worked in healthcare professions in Australia for several years have a good command of the English language and have participated in programs and placements that require extensive use of English, which has developed their language skills to a high level of proficiency.

The requirement of a further test to demonstrate the English language proficiency is a waste of time they argue, given that the Australian healthcare sector is projected to face a shortage of up to 123,000 nurses by 2030.

Waiving the English language test requirement would allow more trained nurses from Australian universities to receive their nursing registration, they say. This, in turn, would help to share the burden of hardworking nurses and encourage more people to take up nursing as a profession.

“After graduation, they are many working in hospitals, nursing homes, and in the community as Assistant Nurses, Personal Cares, and Disability workers where they communicate with patients and families, and document in patient’s progress notes, sometimes even more than ENs/RNs do. Also, most of the adult learners worked in English-speaking countries like the United Kingdom, New Zealand, Ireland and Australia, in different positions in hospitals, nursing homes and disability services. Hence, we strongly believe their English standard is competitive to receive their Nursing registration,” the duo further said in a statement.

This March, Akkamparambil and Kizhakehkattil started a campaign with over 100 nurses seeking amendment to the AHPRA registration norm. They also launched an open petition this week, which at the time of writing reached nearly 300 signatures.

They have also written letters to the federal government and few Members of Parliament.

The Ministerial and Parliamentary Services, Department of Health and Aged Care, had responded to Akkamparambil’s letter, stating, “These matters fall within the Health and Aged Care portfolio and the Department of Health and Aged Care will consider the issues you have raised.”

Further, a letter from Teresa Gorondi, Director, Workforce Planning and Strategies Branch, said, “Under the National Registration and Accreditation Scheme (Scheme), the Nursing and Midwifery Board of Australia (Board) is responsible for all matters relating to the registration of nurses in Australia. The Board is supported in its role by the Australian Health Practitioner Regulation Agency (Ahpra) and both bodies operate independently of the Australian Government.”

The letter, sent on behalf of Federal Minister for Health and Aged Care Mark Butler, emphasised that the Australian health professional board is primarily responsible for protecting the public by establishing codes, guidelines, and standards to ensure safe healthcare delivery.

The letter, addressed to Akkamparambil, further said in order to practice safely in Australia, registered health practitioners are required to have effective English language skills and the ability to communicate with others. The ELS (English Language Skills) standard is one of the five core registration standards set by the National Boards, ensuring that practitioners have the necessary language skills to provide safe care and communicate effectively in English, regardless of their language background. The National Boards are committed to preventing discrimination and have designed the ELS standards to ensure fairness in their application, it stated.

There have been no assurances for any review so far.

Akkamparambil and Kizhakehkattil believe that if Ahpra revises the English language requirement, more people will be encouraged to pursue nursing as a profession.

“Even though the Government is trying to encourage students to take the nursing degree as their profession by giving subsidised tuition fees, unfortunately, there are a lot of migrant adults retained from joining the nursing profession,” says Akkamparambil.

“We have studied and completed everything here as Australian citizens. We shouldn’t be considered as overseas international students,” sums up Kizhakehkattil, adding, “Can’t understand what more Ahpra needs.”

Meanwhile, they maintain their determination to persist with the campaign.

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