NHS England and the Home Office are looking into whether ‘umbrella bodies’ such as ICBs could sponsor international medical graduate (IMG) GPs to remain in the UK.
Overseas doctors or IMGs must work under the skilled worker visa scheme for at least five years before they can apply for indefinite leave to remain (ILR). This timeframe covers most specialist medical training.
However, GPs usually gain their certificate of completion of training (CCT) after three years, leaving a two-year gap during which they must secure sponsorship if they want to stay in the country when their visas run out.
NHS England had expected to be allowed to sponsor doctors during the two-year period but could not reach an agreement with the Home Office.
Speaking in a parliamentary debate last week, Home Office minister for immigration Robert Jenrick stressed that the Government believes that ‘the best way to increase the number of international GPs taking up places in the UK is for GP practices to register as Home Office-approved sponsors’.
He said: ‘Sponsorship is not supposed to be onerous and the Home Office believes that it is not as onerous as some people clearly perceive it to be.
‘Over 48,000 organisations are licensed sponsors of skilled workers, and many are high-pressure, small organisations, such as GP practices.’
However, he admitted that ‘there is clearly an issue – whether in reality or in perception’ – and added that he is ‘prepared to consider other sponsorship arrangements suggested by the sector’.
He said: ‘In principle, the sponsor could be an appropriate national body, such as Health Education England. It has not approached us to ask to be such a body, but I would be open to considering that.
‘The sponsor could be an integrated care board in England or an appropriate body in Scotland, Wales or Northern Ireland, or it could be a royal college.’
He added: ‘I will therefore ask my officials to work with the sector to see whether there is a way forward to create umbrella bodies, if there is mutual support on both sides, with the caveat that any umbrella body would need to discharge the required duties in law to ensure the robustness of the system.
‘If that can be delivered by appropriate umbrella bodies, we would be pleased to see whether it can be taken forward.’
Speaking in a House of Commons health and social care committee hearing this morning, NHS England chief strategy officer Chris Hopson confirmed that NHS England is looking into the solution of ICSs becoming ‘umbrella’ sponsors for visas.
He said that ICSs provide the opportunity to do ‘at scale’ what practices were previously doing ‘on an individual basis’, such as sponsoring visas.
He told the committee: ‘You can now do that in a supported way with appropriate resource at the ICS level, so that is something I know we are looking at’.
Meanwhile, Mr Jenrick also said last week that ‘in the interim’ he has instructed officials to run ‘engagement events with the sector to talk them through how straightforward they believe it is to be a sponsor’.
He added: ‘We will take account of any feedback that we receive at these events, and if it is true that the system is simply too complex and burdensome, I have asked them to report back to me with that feedback and we will take it into consideration.’
The minister added that the Government is ‘keen to recruit and train’ more GPs in the UK and that ‘persuasive arguments have been made for raising the cap on medical school places’.
He said: ‘That is an important debate to have, and one that I am sure will find favour with the new Chancellor, who has raised the matter many times in the past.’
The Government should be ‘considering measures such as raising the cap on medical school places, if we are able to do so’, he added.
It follows a Government minister recently indicating that there is ‘no room for flexibility this year’ to increase medical school places, while Labour has pledged to double the number of places.
But Mr Jenrick ruled out shortening the length of time after which IMG GPs can apply for indefinite leave to remain, which is currently five years, saying he feels it is ‘about the right length of time’.
He said: ‘Although I am sympathetic to the arguments around granting GPs settlement on completion of their training, my view today is that it is better to stick to five years because that has been, by the long-standing convention of this Government and their predecessors, considered the right length of time for an individual to demonstrate sufficient commitment to the United Kingdom to obtain indefinite leave to remain.
‘At the moment we do not have plans to reduce the length of time that skilled workers would need to complete in the UK in order to apply for settlement.’
The row over IMG visas
Last month, an RCGP letter to the home secretary signed by more than 4,000 GPs and GP trainees demanded an urgent solution to the ‘nonsensical’ visa rules.
The College previously wrote to the Home Office in May but the response at the time put the onus on GP practices to become Tier 2 sponsors, which the RCGP said had ‘significant financial and bureaucratic implications for practices’.
Over 40% of all trainees are IMGs and a recent RCGP survey found that around 30% of respondents said they found the visa system so difficult they were considering giving up on their plans to work as a GP in the UK.
Pulse first revealed in April that up to 1,000 newly-qualified GPs could face removal from the country when their visa expires next year.
And in June, the RCGP told MPs that recently qualified GPs were receiving ‘deportation’ letters soon after completing their medical training.
In July, the House of Commons Health and Social Care Committee called for a default visa extension for six months after IMGs’ expected GP training completion date, to give them time to find an appropriate employer.
But the Government has said that highlighting GP visa concerns amounted to ‘needless scaremongering’.
Pulse also revealed in June that only 124 GPs recruited via NHS England’s international GP recruitment programme were still practising in England, out of a target of 2,000, while around one in six GP positions was vacant.
Why do I get the feeling a PCSE and pensions style re-run will ensue. May be I’ve been a GP long enough to have seen a few of these. It sounds like something out of ‘Yes, Minister/Prime Minister’.