As the Nuffield Trust predicts staff shortages in the NHS could increase to 250,000 by 2030 unless radical action is taken, the official advisory board on migration launches a review of which professions to include on the shortage occupation list.
Amongst its recommendations, the Migrant Advisory Committee said GPs should be added to the list, amid increasing strain on the profession and a rising shortage of doctors.
This is a welcome move, and the chair of the RCGP, Professor Helen Stokes-Lampard, has said it will be ‘good for patient care’. Inclusion on the list makes it easier to employ GPs from abroad.
Those applying to GP jobs from outside the EU will see a reduction in visa fees, shorter waiting times and a lower salary threshold for a tier 2 visa.
In 2018, NHS Employers submitted evidence to the committee that suggested that the NHS’s reliance on overseas recruitment means all roles presently on the list should remain, and additional ones should be added to prevent staff shortages.
GPs being on the SOL is vital for the survival of health services, but fails to guarantee measures to reduce staff shortages, which could send the system into chaos
However, while a role being on the SOL makes the application process easier for non-EEA Work visa applicants, there are still several hoops they must jump through.
Even with the addition of the SOL listing, work visa applicants must pay (albeit reduced) fees for themselves and their accompanying partners and children (dependents).
Whilst working, they’re also restricted – they cannot take on a new role, change their contract or leave the country too often. If they want to extend their visa or settle, they must also pay further costs.
Once free movement ends – which is set to in either a no-deal or ‘hard-deal’ scenario – EEA nationals will be subject to the same work visa regulations as those from outside the EEA. This means that they will need to pay high fees for themselves and their dependents and actions will be restricted by their visa type. It’s reasonable to assume that many EEA nationals would be put off by this, especially when they can take on roles in other neighbouring EU countries for free and without restrictions.
In 2018, the BMA conducted a survey of 1,193 UK doctors from the EEA, and discovered that 42% have considered leaving the UK workplace after Brexit. A further 23% admitted to being unsure whether they will remain in the country.
So, although those from outside the EU may now be encouraged to work in the UK, the GP workforce risks losing a vast number of employees from inside the EU, which currently makes up around 10% of their workforce.
Additionally, if a no-deal Brexit (or a hard-deal Brexit) goes ahead, it will be more difficult for new EU nationals to work in the UK. They will need to pay visa fees; be sponsored by a tier 2 registered employer; and meet various other requirements if they wish to join the workforce permanently. This includes applying for British citizenship and/or Indefinite Leave to Remain. At the moment, while still part of the EU, these requirements do not apply.
With their only requirement is to undergo language tests, this could deter many from studying and working in the UK.
The addition of GPs and other medical professionals onto the SOL is vital to ensuring the survival of health services in the future. However, it fails to provide guaranteed measures to reduce staff shortages which if left to worsen, could send the system into chaos.
The Government must ensure that the immigration system does not deter specialists from working in the UK.
Otherwise, GPs, nurses and other professionals will be excluded from the system.
If the UK leaves the EU without a deal, free movement will end, and all prospective European GPs will be forced to meet strict requirements and pay astronomical fees to choose the UK as their professional base. If the UK loses access to these individuals and their skills, the health sector could plummet, and if this happens, the level of care available to the general population risks being forced into decline.
Bethany Morris is a political commentator at the Immigration Advice Service, an organisation of immigration solicitors