BMA raises concerns over proposed changes to the Tier 2 work visa route

Changes to the UK visa rules could lead to a loss of hundreds of UK-trained doctors and affect general practice, the BMA has warned.
BMA Council Chairman, Dr Mark Porter has asked that the NHS be given specific exemptions within the Tier 2 visa route. This is the visa system for people from outside the European Economic Area or Switzerland who have been offered a skilled job in the UK, with a requirement that they are sponsored.
In January, the Migration Advisory Committee recommended that the Government should use higher salary thresholds to prioritise higher value, skilled migrants within the Tier 2 visa route. It proposed raising the overall minimum salary threshold from the current £20,800 to £30,000 although a lower threshold, set at £23,000, should be offered to graduates.
In a letter to the Minister for Immigration, Dr Porter points out that international doctors, who have been trained in the UK will be subject to the Resident Labour Market Test (RLMT) when moving from foundation year 2 to specialty training.
“Currently, international students and foundation doctors who have studied at a UK medical school will be on a Tier 4 visa. When they enter specialty training, they move on to a Tier 2 visa and can apply for specialty training posts at the same time as UK residents,” said Dr Porter.
“The new recommendations advise that these doctors become subject to the RLMT, which means they can only apply for specialty posts after UK and EEA doctors have applied – when most vacancies have already been filled. This could lead to a situation where UK-trained doctors will be unlikely to get specialty training in the UK, and may have to leave the country to work elsewhere.
“This change would not only have a devastating impact on the 500 overseas medical graduates of UK medical schools each year, but also on patient care because of the insufficient time to plan ahead for the number of doctors coming through training. Restricting the supply of UK trained doctors progressing through the system could also severely disrupt the government’s goal of delivering more seven-day services and 5,000 extra GPs.”
Dr Porter was also concerned that the introduction of a £1,000 immigration skills charge, proposed by the MAC “to act as a skills levy on firms using migrant labour.” This could cost the NHS more than £3.5 million if it were to be applied to the 3,602 doctors who were granted Tier 2 visas from August 2014 to August 2015, he said.
The increase in salary threshold requirement could also have a negative impact, added Dr Porter. “This increase would prevent doctors in training and many specialty doctors from being able to work less than full-time, which could lead to UK trained doctors being forced to leave the NHS, if they need flexible working arrangements due to caring or other responsibilities.”
He warned that the MAC Tier 2 recommendations would result in newly trained doctors leaving the UK to continue their training elsewhere.
Commenting for doctors in Scotland, Dr Peter Bennie, Chair of BMA Scotland, added: “UK medical graduates from overseas, and international medical graduates are essential members of our medical workforce and the NHS is dependent on them to provide high-quality, reliable and safe services to patients. These changes ignore that key fact, and if they are implemented by the Westminster Government they could have a series of unintended and harmful consequences for patient care in Scotland and across the UK.”
The loss of doctors “would be a completely obstructive move at a time when the NHS is facing real problems in recruiting and retaining staff and too many training posts are going unfilled,” he said. “The Westminster Government must consider specific exemptions for the health service in order to ensure we have the necessary workforce to provide patients with the care they need.”

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