One of Bruno Ramos’ favourite patients is a guy who used to be a teacher and who always tells him the same thing. That “the world is crooked”, says Ramos.

Ramos works as a healthcare assistant in a Dublin nursing home, as he has throughout the pandemic, even as one floor closed after someone tested positive for Covid-19.

He’s been able to do that because he could work on his English language student visa, he says. But not for long.

His student visa runs out in April, and while his employer has agreed to try to get a work permit for him, in general, healthcare assistants cannot get work permits.

“It’s ineligible for a work permit,” says Ramos, of the job.

Ramos, who is from Rio de Janeiro, says he hoped the government would grant work permits to healthcare workers on student visas. He doesn’t want to leave his patients behind, he says.

Below the Bar

Ramos’s job as a healthcare assistant is on what’s known as the ineligible list of occupations for employment permits. This means people from outside of the European Economic Area (EEA) cannot stay in the country on the basis of employment if their job ends up on that list.

More than 800 healthcare assistant roles in nursing homes were vacant at the end of 2019, estimated Nursing Homes Ireland, which represents the sector, at the time.

A spokesperson for the Department of Enterprise, Trade and Employment said that a fresh review of the occupations list is underway, jointly with the Department of Health.

Ramos says that even if the new review makes the job eligible for general work permit before April, he still won’t qualify.

He’s paid €12.50 an hour, he says, which comes out somewhere between €24,000 to €26,000 a year. “But my break hours are not paid.”

To get a general work permit for a job, the job must pay at least €30,000 per year, with a few exceptions for jobs with certain languages and for meat boners.

They set that salary bar for two reasons, says the spokesperson for the Department of Enterprise.

“To minimise displacement of Irish and EEA workers,” they said, and to ensure that non-EEA permit holders “do not require recourse to the State’s social security benefits”.

The goal, they said, is to make “economic migration” work in favour of the economy while preventing it from “depressing or inflating wage levels in the wider labour market”.

Labour Senator Ivana Bacik says her party is seeking to “lift the overly restrictive provisions” that strip some like non-EEA healthcare workers of the right to work, during the Covid-19 pandemic.

Bacik has received several emails in the last couple of months from people in a similar situation as Ramos, she says.

Bacik said that the government needs to make sure contributions made by people like Ramos and others “are recognised in our immigration and citizenship laws and policies”.

Sought Out

Camila Mauro, Ramos’s flatmate who helped him express himself accurately in English during this interview, is a healthcare assistant, too.

Mauro, who is also from Brazil, used to be a journalist there but the job became too bureaucratic, she says.

“When I came here, I had no English, nothing,” she says, laughing.

She studied English here, then marketing. She hoped to extend her stay and boost her job prospects by enrolling in a third-level course, she says.

Enrolling in a course is a solution that Ramos says he can’t afford.

Home care agencies or nursing homes often look for non-EEA students with precarious immigration status to hire, says Mauro. “Because they know we’re desperate for a job.”

Mauro and Ramos say that the sector often ignores the 20-hour working limit for non-EEA students during term time.

“I did 70 hours per week in the past, and I paid loads of taxes,” Mauro says.

Demand for Carers

Ramos hopes to work as a nurse eventually, a job that is eligible for a permit, if he scores high enough on an English exam. He used to be a nurse in an intensive care unit in Brazil. Nurses who don’t speak English as a first language must prove their proficiency to practice here.

That exam was cancelled though because of the pandemic, he says.

Mauro says she’s seen first-hand how much demand there is for healthcare assistants.

Patients needing care at home have suffered during the pandemic, she says, as most agencies focused on covering staff shortage at nursing homes.

“They have cut hours for homecare, so we really need carers,” she says.

A spokesperson for the Department of Enterprise said that nurses’ applications are being prioritised by the employment permits section. Almost 2,000 permits have been issued since March 2020, they said.

Ramos is cautiously optimistic, he says. He set up an online petition, collecting signatures for non-EEA healthcare assistants whose visas are about to expire.

“I love taking care of old people,” he says.

Shamim Malekmian covers the immigration beat for Dublin Inquirer. Reach her at

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