A new immigration charge could cost the NHS millions of pounds and make staff shortages worse, leading healthcare professionals have warned.
The health service should be exempt from paying the Immigration Skills Charge (ISC) when recruiting doctors and nurses from overseas, the British Medical Association (BMA) and Royal College of Nursing (RCN) said.
Enforcing the levy - £1,000 per employee per year - would effectively penalise the NHS for recruiting workers from outside the EU to fill gaps in an already-stretched workforce, the organisations said in a letter to Home Secretary Amber Rudd.
The charge, due to be introduced next month, is designed to encourage businesses to train British staff to take on skilled roles, and reduce the number of migrant workers being hired by firms in the UK.
Based on figures for recruitment in recent years the NHS could end up forking out £3.5 million, while Health Education England would have to pay more than £1.6 million to sponsor its trainees, the groups said.
The Government has argued the charge will cut down on Britain's reliance on migrant workers.
But BMA chairman Dr Mark Porter blamed the Government's "poor workforce planning" on leaving the NHS "struggling to cope with huge and predictable staff shortages" and therefore dependant on overseas recruitment.
Janet Davies, general secretary of the RCN said the charge could risk "turning off the supply of qualified nurses from around the world at the very moment the health service is in a staffing crisis like never before".
Both organisations said there are already checks in place to ensure UK and EU nationals are offered roles first, and said people are recruited from overseas when posts cannot be filled.
Dr Porter said: "The introduction of this charge could take desperately needed money from an already under-funded health service, worsen the current staffing issues, and impact the level of care that hospitals are able to provide to patients.
"Overseas staff can only be employed in the NHS if recruitment from the UK and EU has been unsuccessful. It is unthinkable that trusts should be penalised for trying to fill staff shortages from overseas, in order to maintain safe staffing levels and safe patient care.
"With the NHS already at breaking point, vital funding should not be diverted from frontline services in this way.
"In order to ensure stability for our health service, the Government must exempt the NHS and the wider health and social care system from these charges, as it has already agreed to do for other sectors."
Ms Davies said: "Forcing this charge on NHS and other services will worsen the funding crisis and harm the standard of patient care.
"Until the Government begins to train enough nurses here, it should exempt the international workforce that UK healthcare heavily relies on."