International Doctors: Visas

Debate between Matt Warman and Pauline Latham

Wednesday 2nd November 2022 Westminster Hall

[Matt Warman]

Ultimately, this is where we need joined-up government, whereby the Home Office and the Department of Health and Social Care deliver on the same priorities, and I really do think that they can.

As I say, 40% of trainee GPs come from abroad. In the final months before they qualify as GPs, the last thing they should be doing is dealing with the stress of a potential visa application and considering whether the practice where they might want to apply for a job is registered on the programme, and whether they can reasonably jump through the Home Office hoops at that precise moment. We are increasing stress for doctors, and we are increasing the risks for patients at the same time.

The hon. Lady alluded to figures from the Royal College of General Practitioners which show that some 30% of GP trainees are considering not working as GPs when they qualify for these visa-related reasons, and some 17% think they might have to leave the UK either temporarily or, at worst, permanently. That is some 1,200 doctors who are considering not working in the health service as a result of this system. In Lincolnshire alone, a third of practices have thought about registering as a visa-sponsoring practice, but just one in 10 have actually done it. We are really limiting the options for GP trainees and for the health service.

This is a political choice, and it reveals an inequality between different sorts of doctors. It will probably take a hospital doctor five years to qualify. After those five years, they will qualify for indefinite leave to remain in a much easier way. Because GP trainees take just three years to complete their programme, they need to go through this visa process, because three years is not five years, and the Home Office has decided that five years is what is required.

There are other associated problems. When it comes to applying for a visa, the GP practice that needs to register will consider whether that process is worth while. It may, in theory, be worth while in advance, and some practices do register in advance, but many do not. They then find themselves confronted with a brilliant candidate, and they try to register, but with the best will in the world, the timescales are very tight for doctors to apply for visas when they have a job offer from a practice that is already registered. There are lots of things to line up, and it is stressful for practices and for doctors. Even if there were no backlog in the Home Office, it would be a very tight timescale.

[Mrs Pauline Latham (Mid Derbyshire) (Con)]

I thank my hon. Friend for giving way and congratulate him on securing this important debate. I have recently returned from an International Development Committee visit to Jordan, where I spoke to a number of highly educated Jordanians, as well as Syrian refugees. Some of the Jordanians were already doctors and nurses, and the Syrian refugees in the camps in Jordan cannot get an education beyond the age of 18 but wish to become doctors, engineers and so on. They speak amazing English and would love to train here in the UK.

At the moment, Germany is hoovering up a huge number of these doctors and people who would like to study to become doctors, to satisfy the demands of its health service. Does my hon. Friend agree that it would be helpful for the Minister to consider opening up more visa routes for brilliant young medical students from countries such as Jordan that have long been strong international partners of the UK, in order to ease some of the workforce pressures on our NHS? It is important that we increase the numbers, and that would be one way of doing it.

[Matt Warman]

I absolutely agree with my hon. Friend that increasing all those routes is hugely important. Of course, we would all like to see more doctors trained in this country, and the Government have gone some way towards doing that, but where people want to work abroad, Britain should be as attractive a place as we can be. That is why, on the GP point specifically, the Government should be removing every single barrier in that visa process.

The most straightforward thing we could do, which would remove the need for a practice to register as a visa-sponsoring practice, is simply to say that when a GP qualifies in this country, they get the indefinite leave to remain that other doctors get. These are people in whom the UK has already invested. They are already here; they already have a visa. The extension of that visa into another form seems simply to be a bureaucratic hoop that we are putting in their way as doctors and in the way of GP practices. We are putting extra bureaucracy into a system, while on the other hand the Government say, “We desperately need people to come to this country to work in the NHS, and we will try to do everything we can.” The health service does hugely good work to try to recruit such people and specifically encourages them to train as GPs, but then we put an additional barrier in their way.

The response from the Government in the past has been, “Actually, the visa process registration is not terribly onerous and GP practices can do it.” They point to the numbers that have and do, which is fine as far as it goes, but it does not answer the question of why we put a barrier in the way in the first place. It should not be a cost of doing business when we say that we really want to make it as easy as possible.

Equally, it should not be a reasonable thing to put different sorts of doctors on different sorts of levels. It is not reasonable to say to people that, just as they have gone through the most stressful part of qualifying with exams, they should also be thinking about their immigration status. That calls into question their probity when we have things such as the General Medical Council making sure that they are upstanding members of our communities, and many of them have tens of thousands of patients to testify to that.

I do not think it really washes when the Government say that we need to put barriers in place, and I do not think that the Department of Health, where the Minister was previously a Minister of State, would agree, in an ideal world, with the Home Office stance. We could work together across Government to try to secure a sensible outcome.

I have talked about GPs, but there are broader issues around visas for doctors, many of which come back to the Home Office backlogs that I know my right hon. Friend the Minister is working really hard to address. There is a good argument for simply scrapping visa fees altogether for people coming to work in the health service. That is an argument for another day, but when it comes to GPs I think that lowering the five-year limit for indefinite leave to remain to three years is the neatest way to address the issue.

On the broader issues, ultimately this comes back to how many doctors we are training in the UK. We all want, as I said to my hon. Friend the Member for Mid Derbyshire (Mrs Latham), to see more people trained in this country. That is what we are doing and that is what the Government continue to pursue, but until we reach that moment—the NHS has never reached entire self-sufficiency in the UK—we should make it as easy as possible for doctors, dentists, nurses, people working in social care, and all those who work in different parts of the health service, to come to the UK. It is not primarily a question about backlogs; it is a question about process. At the moment there is a degree of bureaucracy that simply does not need to exist.