Visa rules are preventing UK-trained GPs practising in our area
From Dr John Coffey, Lincoln
This letter has been triggered by your article about local recruitment of EU doctors as part of a scheme lead by Dr Kieran Sharrock of the Lincolnshire LMC. Whilst I fully support Dr Sharrock's efforts, I do feel I should raise the problematic issue of visas for non-EU doctors which deserves further publicity and discussion.
This is a ridiculous situation
Over the last two years, we have had visa issues with several non-EU GP registrars completing the three year Lincolnshire GP Training Scheme, most were UK graduates and all were exclusively UK trained in terms of foundation and speciality training. They held Tier 2 visas but many completed their GP training without qualifying for 'indefinite leave to remain'. During training, their visas are sponsored by Health Education England but this stops as soon as they finish. To continue to work in the UK, their employer must take over sponsorship of their visa, after satisfying the 'resident labour market test' (which dictates that the post should be advertised for a minimum period of four weeks and that any suitably EU applicant should be employed in preference). Given the dire state of recruitment locally, this is rarely an issue as many advertised posts have no applicant.
Last year I had three excellent UK-trained GPs who were all involved with issues relating to visas and the associated stress and uncertainty caused.
My own registrar at my practice applied for a one year fellowship post through HEE but ended up with a four-week delay in starting his post because his new GP practice had to apply to sponsor his visa. Whilst large employers do this routinely, I believe it is unusual at practice level. The practice involved found the process difficult and confusing and were invariably told by Home Office helplines to 'look it up on the website' when they had queries. Another registrar elected to work in hospital medicine rather than risk not extending his visa. A third registrar applied for a fellowship scheme but her new GP practice pulled out of the sponsorship process at a relatively late stage causing great anxiety and worry about having to leave the UK.
My concern is that we are training non-EU doctors who desperately want to work in an area which desperately needs them. Unfortunately, the visa issue is a potential deterrent to local practices (in terms of time and money) or the registrars themselves are so worried about a break in sponsorship (which would mean they would have to leave the UK and could not re-apply to work here for another 12 months) that they decide to work back in a hospital. Beyond this, they see EU doctors coming to this area with a fanfare and understandably feel rejected and undervalued.
This is a ridiculous situation, particularly in Lincolnshire where our recruitment problems are well documented. Over the last year, with the support of Dr Kieran Sharrock and the Lincolnshire LMC, I have written to Health Education England, the RCGP and the Lincoln MP, Karl McCartney. They all agree with my sentiments but say they are powerless to help. Only the Home Office can change the visa rules and they decline to add general practice to the 'shortage occupation' list. Interest in non-EU health workers waned somewhat after Brexit when there were new and challenging questions over the future of EU workers.
The current bottom line from the Home Office is that practices are advised to apply to sponsor visas on an individual basis. Our experience locally is that this is a complex and unpredictable process, something that worries the registrars who have strict time deadlines to adhere to.
Practices are closing in Lincolnshire and others are struggling to recruit. Only 20% of undergraduates voice a preference for general practice and Theresa May’s scapegoating of GPs will do nothing to entice doctors in to the speciality. How wrong it is, therefore, that UK-trained GP registrars are struggling to work because of visa worries. We should be welcoming them with open arms in the same way as the EU doctors who have arrived locally.
My registrars all know other GP registrars in other areas with similar worries; many chose to work back in hospital which is a dreadful waste at the current time. I write to you in the hope that publicity might help exert pressure for a solution and, at the very least, give some idea of the extent of the problem. How many trained GPs are not working in general practice because of visa issues? How many practices can and do sponsor visas? Is there any way to share experience and make it easier? My research on this issue tells me that very few people understand the visa system, even those who administer it!
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