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Independents' Day

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!

If you would like to write to Pulse, please email

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Readers' comments (9)

  • Wholeheartedly agree with Dr Coffey's views. I spent a few months in an East Lincolnshire Hospital before getting into the GP VTS scheme. My colleagues from non- EU countries congratulated me but readily expressed their disenchantment at being discriminated against. They had trained in UK and worked as SHOs but had been trying in vain to get into VTS for 2-3 years being surpassed by EU doctors. I took up the vacancy given but have always felt for those who have toiled in this country and are treated as second class citizen. Of course, the other factor they felt compounded their misery was their BME status.

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  • Vinci Ho

    ''Arguments about justice and rights are often arguments about the purpose, or telos, of a social institution, which in turn reflect competing notions of the virtues the institution should reward and honour .''
    Michael J Sandel

    We know the telos of NHS very well but the government led by Theresa May does not. The sole purpose of the government at the moment ,is to cut overall immigration , both EU and non EU ultimately, nothing more , nothing less.

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  • Vinci Ho

    And make no mistake , we will see more stories like this from a nefarious version of Reagan-Thatcher 2.0.

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  • If some one has spent 10 years in the UK,paying tuition fee and taxes, why can not he /she get the permanent residency, continue to work and contribute to the country?
    This is not rocket science, but is common sense.Politicians should think twice before making immigration laws.

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  • Could such GPs not be employed centrally by a GP federation with HR/Visa expertise. These GPs can then be placed in GP practices and the GP practices pay the federation the cost of employing these GPs.

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  • John, you forget one thing.

    We are post-truth, "sick of experts" and prefer alternative facts.

    The barbarians are no longer at the gate, they've taken over town and are burning down the library.

    Your sensible, informed, experienced views are simply not wanted any more.

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  • Happened to me. Ended having to work for a "corporation" as they are usually the ones with resources easily do the paper work.
    As you can imagine, I quit after three months and had move to London as that is the only place I could get someone to sponsor asap without having to leave the country.
    I am not sure if politicians understood that these sort of policy is the reason most commonwealth nationals (who can vote in UK elections) voted to leave EU. Still surprised Birmingham voted leave?

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  • More importantly, why are we still poaching doctors from elsewhere? It is morally wrong.
    India has 1 doctor to 2500 patients, we have 1 to 450.
    Is it not time to train our own ? In NI, the ones we do train are leaving for OZ etc.
    So, we cannot hold on to ours but nick them from poorer countries.
    I wonder if we will improve our conditions and pay to keep our own?

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  • I am a GPST3 Registrar sadly going to be in this very situation and getting increasingly worried. If anyone knows of any practices with a vacancy for a full time salaried GP willing give 110% and are able to sponsor a tier 2 visa, come August 2018, please let me know. Your help will be highly appreciated.
    My email address is:
    Thank you in advance.

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