Adult Dependent Relative Visas

Debate between Stephen Timms and Khalid Mahmood

Wednesday 3rd November 2021 Westminster Hall

[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.

[Mr Khalid Mahmood (Birmingham, Perry Barr) (Lab)]

I thank my right hon. Friend, who has done terrifically well to secure this very urgent debate. Coming from Birmingham, I know both the associations he referred to. To train a junior doctor costs about £230,000 and to train a GP or consultant costs about £500,000. Every time we lose one of those consultants or GPs, or even a junior doctor, it is a huge cost to us. Should the Government not understand when they are looking at value for money that these people are well paid and able to support the parents they bring over, and will contribute towards the health insurance that they have already agreed? This would give them peace of mind. They are hugely stressed at the moment and most are still thinking of leaving at a time when we need their expertise.

[Stephen Timms]

My hon. Friend is absolutely right. Having invested so much in their training, we need to keep those experts here, not force them to leave the country. There are more than 96,000 non-UK graduates on the General Medical Council register. The evidence of the potential loss to the NHS if these restrictions stay in place is enormous. We simply cannot afford that loss. The investment made in their training is a very important point; I am grateful to my hon. Friend for raising it.

This is a real threat, not a theoretical worry. The Association of Pakistani Physicians of Northern Europe said that

“in many cases, highly trained and competent”

members of staff are leaving the UK to return to their home country or go somewhere else where the rules are more accommodating in order to care for their elderly family members.

Of course, these rules will apply to EU citizens arriving to live in the UK post Brexit. They will deter skilled doctors from European countries from working here, as they are forced to opt instead for countries with a less hostile and more accommodating policy. I remind the House that adult dependent relative entry clearance applications to the UK are among the most expensive type of visas that there are. The cost of a visa application for an adult who requires care from their relative here is £3,250. The Government say these rules are to avoid burdening the NHS; I wonder whether the Minister can put a figure on the cost of a more accommodating policy. What is the estimate that we are talking about? What will be the cost of losing all these highly trained staff who are forced to leave to fulfil their family responsibilities?

The British Medical Association represents and negotiates on behalf of all doctors and medical students in the UK. In January, together with other leading medical bodies, it wrote to the Home Secretary asking her to remove this restrictive adult dependant rule for doctors. Soon after its letter, I wrote to the then Immigration Minister asking him to meet to discuss the issue. He declined my request to meet and simply told me,

“those most in need of care remain the most likely to qualify.”

The problem is that enormous numbers are not able to come. According to the Home Office, just 70 adult dependent relative visas were issued in 2020. The Government need, at least, to review their application process to determine just why so few applicants succeed. I am certain the Minister will have received representations from the Health Secretary about this issue, and I hope they will undertake a review.

The BMA has consistently raised concerns about the potential impact on patient care and on the wider NHS if doctors have to move because of these rules. Ministers do not seem to take much notice of the urgent concerns of those working on the frontline of our health service, but it is time to start taking notice before serious harm is inflicted on the NHS. Doctors must not be kept waiting any longer. There is no justification for forcing committed, dedicated NHS doctors to choose between their work and their home in the UK, and their deeply felt duty to their elderly parents to support and care for them in difficulty and old age.

Will the Minister commit today to review this unfair policy? Why have so few applicants been successful in the past nine years? Why are Ministers weakening the NHS in order to prevent elderly relatives from joining their key worker families here in the UK?