Sanwar Ali: additional reporting and comments
Doctors are quitting the NHS in droves and heading overseas amid an ongoing row over UK visas for elderly parents. Last month, Workpermit.com reported that top NHS officials had warned of ‘another Windrush scandal’ because of a policy that stops health professionals from bringing elderly relatives to Britain to live with them.
It is very difficult to bring in your elderly parents into the UK. Parents need to show that they are unable to obtain the required level of care that they need in their home country, even with the help of their UK sponsor. Not many people meet the requirements. Probably most applications are refused. There is also no UK retirement category as such.
Thousands of GPs and consultants have reportedly left the NHS over the last six years, heading to countries like the Australia, Canada and the United States where rules on bringing elderly relatives to live with them are far less strict.
Since 2015, more than 2,000 GPs and specialist consultants have left the UK for another country and asked to be removed from the UK register, according to General Medical Council (GMC) data. The main reason for the ‘staggering exodus’ is the row over UK visas for elderly relatives, doctors say.
Meanwhile, a further 4,000 non-specialists, such as junior doctors, have also quit the NHS to work abroad. Doctors have argued that the latest figures ‘make a mockery’ of the UK government’s economic argument for severely restricting the number of adult dependent relative (ADR) visas for elderly parents of NHS staff.
In 2012, the introduction of the coalition government’s so-called ‘hostile environment’ policy – now known as the compliant environment policy – saw an immediate slump in the number of ADR visas granted.
Medics have pointed to the £250,000 cost of training a doctor to reach consultant level and say that the government is the, therefore, spending way more on replacing lost doctors with expensive locums, while billions of pounds are then needed to train their replacements.
The GMC data, obtained under the Freedom of Information Act, shows that between 2015 and 2020, 1,695 specialists, 743 GPs and 4,315 non-specialists asked to be erased from the UK register and now work overseas.
While specific reasons for leaving are not disclosed, doctors say that the change in UK immigration rules, particularly ADR visas, has played a major part in health professionals leaving Britain.
A Home Office review of the revised policy found that in 2014, just 135 ADR visas had been granted, compared to 2,325 ADR applications being approved between April 2010 and March 2011. 98 of the 135 granted in 2014 only came after reviews and appeals. No further figures on ADR visas have been published since the 2016 review.
Meanwhile, a recent survey conducted by the Association of Pakistani Physicians of Northern Europe (APPNE) and the British Association of Physicians of Indian Origin (BAPIO) revealed that 91% of respondents who had failed in their attempt to bring relatives to live with them in the UK were left feeling ‘anxious, stressed and helpless.’
85% admitted that they had considered returning home or relocating to a country with more flexible ADR immigration rules.
APPNE and BAPIO told iNews: “We note with grave concern, the staggering figures received from GMC of the thousands of specialists and GPs who have moved overseas in the last six years.
“This huge drain of trained professionals from the NHS is tantamount to the loss of millions of pounds every year as each specialist (consultant) and GP generates hundreds and thousands of pounds every year for their respective NHS trusts or care commissioning group for primary care practitioners.”
The two organisations expressed particular concern over the loss of specialist doctors, saying: “The specialist doctors are a unique group whose services are creating a positive business model for the NHS thereby creating millions in revenue which helps the NHS to flourish and their irreparable loss keeps in view that it takes years to train a specialist.
“The rationale presented by the government is that the elderly parents would be a stress on the NHS but may we remind the authorities that our parents would not have settlement visas and would not have recourse to public funds.
“On top of that, the loss to the national exchequer by the migration of the trained personnel is running into millions if not billions who are moving as they do not have the choice to bring their parents to the UK due to visa regulations.”
British Medical Association
The British Medical Association (BMA) recently announced that it had joined forces with APPNE and BAPIO calling for an urgent review into the ‘very harsh ADR visa rules’.
BMA international committee chair, Dr Kitty Mohan, said: “The NHS has suffered a shortfall of doctors for many, many years, with hospitals in England alone currently having around 7,000 medical vacancies.
“This historic workforce shortage means the health service does not have the capacity to guarantee it can safely meet the needs of all patients – something so keenly exposed during the pandemic, when all but the most urgent non-COVID services had to be suspended to cope with demand.”
Dr Mohan added: “Therefore, with a record backlog in the number of patients waiting for care, the last thing the NHS can afford right now is to lose more doctors. The thousands who have left the UK in recent years represent a huge loss of knowledge and expertise to the health service and its patients.”
Dr Mohan urged the government and employers to ‘do more’ to retain skilled clinicians, saying: “While the reasons underpinning doctors’ decisions to move overseas are likely numerous and complex, the government and employers must step up efforts to retain these skilled clinicians.”
“This includes making it as easy as possible for appropriately qualified overseas-born staff, to whom the NHS owes so much, to work and stay in the UK, and by removing bureaucratic, illogical and heartless barriers preventing them from giving their all to the health service,” Dr Mohan added.
Meanwhile, a spokesperson for the government said: “We are hugely grateful for the vital contributions made by NHS staff during the pandemic and have brought in a range of unprecedented measures to ensure the sector is supported fully. Those who apply for an adult dependant relative visa need to demonstrate they require long-term personal care which can only be provided by their relative in the UK and without needing to access public funds.”
“It is right that these rules apply equally to all professions; relaxing the rules for family members of doctors could undermine this equality principle and discriminate against other professions,” the spokesperson added.
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