20.06.18
A hostile environment
Source: NHE May/June 2018
Dr Terry John, chair of the BMA’s international committee, gives his thoughts on the government’s visa and immigration policy and its effect on the recruitment of foreign healthcare professionals.
Aspects of the government’s immigration policy are encouraging a culture of hostility towards much needed overseas health workers and are threatening patient safety.
In the wake of Brexit, there has been little clarity from the government on exactly what the future holds for EU citizens and their families living in the UK, with many already making plans to leave because they no longer feel welcome.
The medical profession was taken aback last month when a doctor who has spent the last ten years of his life studying, training and serving in the NHS faced deportation over what appeared to be an honest oversight.
And early in May, it was reported that the Prime Minister had ignored requests from Cabinet colleagues to relax tier 2 visa rules to allow hundreds of skilled doctors from overseas to work in NHS hospitals.
The tier 2 cap for highly skilled workers has now been reached for an unprecedented fifth month in a row. For the NHS, this has meant that hundreds of highly skilled international doctors have not been able to take up posts within the health service.
The simple fact is that, at a time when the NHS is under enormous strain and struggling to fill positions, the current visa restrictions and arbitrary caps for non-EU workers entering the UK are inexplicable and are threatening patient care and safety.
We not only need to find a solution to the persistent problems being caused by additional demand for tier 2 visas, but we need to hammer home the fact that international doctors bring great skill and expertise to the NHS and, without them, our health service would not be able to cope.
The demand for professionals to work in all types of healthcare settings across the UK is continuing to rise. Refusing those hardworking people from abroad who want to come and work here has a huge impact on the NHS in many ways; it means that there aren’t enough doctors, meaning patients will continue to face lengthy delays for their care. It means that trusts must spend more money recruiting temporary staff to make sure they have the right numbers of staff to provide safe care. It also affects the reputation of the NHS both domestically and overseas within the global medical professional community.
Recent announcements from the health and social care secretary to boost UK medical school places are of course welcome. However, given the length of time taken to train a doctor, the NHS will need to continue to recruit doctors from overseas to deliver safe patient care. Creating an NHS that is completely self-sufficient, one that only trains home grown doctors and doesn't take people from overseas and vice versa, is bad for medicine and bad for patient care.
Medicine is an international community of learning and it thrives on British doctors being able to volunteer to go abroad and serve communities and it thrives on overseas doctors being able to bring their learning from abroad over here.
The BMA, and 13 other health organisations, recently wrote to the new home secretary to suggest a solution - to retain the current cap on restricted certificates of sponsorship for the short term but to exclude applications for shortage occupation roles from the allocation process. This would prevent a crisis in the recruitment of NHS nurses and work for both employers and Government in the short term whilst the UK navigates through complex Brexit negotiations.
This is a practical suggestion which allows Government to focus on managing migration, but one that also means that the NHS can employ the doctors and nurses it so desperately needs to help with the pressures facing the health and social care system.
Ultimately though, the Home Office must move away from this hostile culture and any approach to immigration rules for doctors needs to be flexible, practical and must not threaten patient safety.
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