Adult Dependent Relative Visas

Debate between Ben Lake and Stephen Timms

Wednesday 3rd November 2021 Westminster Hall

[Stephen Timms (East Ham) (Lab)]

I beg to move,

That this House has considered adult dependent relative visas.

It is a pleasure to serve under your chairmanship, Ms Bardell. I want to talk about an important topic that deserves more attention than it has had, and I want to urge the Minister to change the current hostile environment policy on adult dependent relative visas, which is undermining the national health service. The immigration system should treat overseas nationals working in the UK and their families abroad more fairly than it does at the moment. I want to focus particularly on the impact on people working in the NHS.

Nine years ago, in 2012, the Government changed the immigration rules to establish their hostile environment policy. Under one of the changes, elderly parents or grandparents of British citizens are permitted to join them in the UK only if they can demonstrate that they require a level of long-term personal care that their home country cannot provide. Before 2012, a dependent relative needed to show only that they were living alone

“in the most exceptional compassionate circumstances”.

Now, the rules state that doctors are prohibited from bringing their elderly relatives to the UK from overseas unless they meet a very strict set of conditions. The problematic rules are set out in paragraphs E-ECDR.2.4 and 2.5, and I will read them. Paragraph E-ECDR.2.4 states:

“The applicant or, if the applicant and their partner are the sponsor’s parents or grandparents, the applicant’s partner, must as a result of age, illness or disability require long-term personal care to perform everyday tasks.”

Paragraph E-ECDR.2.5 states:

“The applicant or, if the applicant and their partner are the sponsor’s parents or grandparents, the applicant’s partner, must be unable, even with the practical and financial help of the sponsor, to obtain the required level of care in the country where they are living, because (a) it is not available and there is no person in that country who can reasonably provide it; or (b) it is not affordable.”

In practice, those conditions are extremely hard to meet. Home Office data shows that in the four years from 2017 to 2020 inclusive, 908 visa applications were made under the adult dependant rule. Only 35 were approved at the first attempt. Over 96% of them were refused. Some were subsequently granted after the difficulty and expense of an appeal. In 2017, I understand the Home Office did not issue a single adult dependent relative visa. Before the rule changes, thousands were approved.

What is the justification for the change? Ministers have argued that the rules are to stop adult dependent relatives from entering the UK and burdening taxpayers. Other ways to avoid any burden on the NHS and local authorities do not appear to have been considered. The existing immigration health surcharge could be incorporated into adult dependent relative applications—Canada, Australia and New Zealand have that sort of model in their schemes for elderly migration—or applicants could be required to have private medical insurance. Instead, we have made it virtually impossible for elderly relatives to come.

Over the past two years, we have all been reminded just how important the national health service is. I know I speak for all of us when I say how grateful we are for the extraordinary efforts of doctors, nurses and other NHS staff to protect and care for all of us throughout the pandemic. They should be rewarded for their hard work and dedication. Instead, many are being punished with these hostile immigration policies.

One doctor, a British national based in Birmingham, told me about the impact on him. He came from India to train as a GP in 2004. The UK is now his home. He studied here, he is working here, he is bringing up his children here. Sadly, he lost his father to covid in India earlier this year. Now, his 70-year-old mother wants to join her son and his family in the UK, but she is not allowed to do so, because of these rules. He tells me that

“no matter how much I earn and pay in taxes, my inability to look after my mother makes me feel incomplete and unfulfilled.”

He also feels his children are being denied a proper relationship with their grandmother. He says that

“my children should not be penalised for a decision I took 17 years back to move to the UK.”

[Ben Lake (Ceredigion) (PC)]

I thank the right hon. Gentleman for raising such an important issue. His account from the doctor echoes that of a constituent of mine, a British national of Indian birth. She faces the same very difficult personal dilemma of having to consider, on the one hand, her patients and her service to the local NHS and, on the other hand, her parents in India. Does the right hon. Gentleman agree that when we discuss this difficult issue, we should bear in mind not only the potential impact on the NHS, but also the tragic personal stories and the trauma that it inflicts?

[Stephen Timms]

The hon. Gentleman is absolutely right. We are putting these dedicated public servants in an impossible position. I received an email yesterday referring to

“yet another consultant who has left the NHS (to live in Oman so that his mother could be with the family again).”

Six thousand doctors left the NHS to go overseas in the five years from 2015 to 2020. We do not know the reasons why they all went, but a significant number went for this reason.

The Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt)—a former Secretary of State, of course—pointed out to the Prime Minister at Prime Minister’s questions today that

“there are now severe shortages in nearly every specialty.”

The policy we are debating this afternoon is part of the problem. We should be bending over backwards to keep doctors here. Instead, we are forcing them to leave the country. Many doctors feel very strongly, as the hon. Member for Ceredigion (Ben Lake) has just reminded the House, that they are being denied a family life. The emotional toll increases the risk of burnout.

In August this year, the British Association of Physicians of Indian Origin and the Association of Pakistani Physicians of Northern Europe carried out a survey of nearly 1,000 doctors in the UK, and 90% reported feelings of anxiety, stress and helplessness because of this issue. Is that really how the UK should treat doctors who have risked their lives to care for us throughout the pandemic?

The rules also have a severe impact on children in the families affected, not least through making it very difficult for them to have a relationship with grandparents. Equally, the Joint Council for the Welfare of Immigrants sampled a group of professionals in the UK. Of the 121 children affected, 20% came from families living in lower-income households, more likely single-earner households. It points out that having a grandparent who can help with childcare will enable parents to work in cases where childcare costs would rule that out.

The Government have said that the rules on adult dependent relatives are in place to protect the NHS. They are actually undermining it. Medical professionals have busy, stressful lives, even more so in the pandemic. Those with vulnerable relatives abroad often have to take leave, sometimes extended leave, and travel overseas often to arrange care for their elderly parents, at a time when the NHS needs them here, and we need them here more than ever. Some doctors have been forced to leave the UK altogether. In the survey I referenced a moment ago, eight in 10 respondents were looking at leaving due to these rules.