RCP president Professor Jane Dacre has written to the Prime Minister asking for clarification of the reason behind the veto on the relaxation of rules allowing overseas doctors to work in the NHS, and recommends excluding applications for shortage occupations from the tier 2 allocation process to help ease pressure on the NHS.
In her letter, Prof Dacre wrote: "I am writing to you on behalf of the Royal College of Physicians to express concern about a recent report in the Evening Standard stating that calls for a relaxation of visa rules to allow overseas doctors to work in the NHS were vetoed."
Prof Dacre called for clarification of the reasoning behind this decision and also outlined the current pressures the NHS is under and highlights the need for more doctors in the NHS.
The full letter is below:
Dear Prime Minister,
I am writing to you on behalf of the Royal College of Physicians to express concern about a recent report in the Evening Standard stating that calls for a relaxation of visa rules to allow overseas doctors to work in the NHS were vetoed. I would greatly welcome clarification of the reasoning behind this decision, particularly given the need for more doctors to ensure safe staffing levels for patient care.
The need for more doctors in the NHS
We are treating more patients than ever before. This increase in patient need – as people live longer, with more complex conditions – is outpacing the resources we have to care for them safely. During 2016/17, 45% of advertised consultant physician posts were not appointed to with 65% of failed appointments due to there being no suitable applicants. These posts remain vacant because of a lack of suitably trained applicants. This is having a direct impact on patient safety and the quality of patient care. A recent survey of RCP’s members and fellows found that 80% are worried about the ability of their service to deliver safe patient care in the next 12 months; 93% of respondents experienced staff shortages across the team and 85% cite rising demand for their service over the past year.
Recent announcements from the Secretary of State for Health and Social Care to increase the number of medical school places are welcome. However, given the length of time it takes to train a doctor, the NHS will need to continue to recruit doctors from overseas to meet patient need in the short-term. We therefore need to devise a system allowing the NHS to recruit enough shortage specialities, whilst also having the flexibility to bring in doctors who work in other specialities when there is a requirement.
Recommendations for action
In the short term, I am strongly urging you to make the UK more accessible and attractive to doctors from other countries. One way of doing this is keeping the current cap on restricted certificates of sponsorship for the short-term and to exclude applications for shortage occupation roles from the tier 2 allocation process. Excluding shortage occupation applications will help ease pressure in the system now, support recruitment across the health professions to meet patient need and work for employers across all sectors in the short-term whilst the UK navigates through a complex Brexit negotiation.
In the medium term, the following policy solutions offer a pragmatic approach to ethically increase the recruitment of overseas doctors whilst supporting the government’s position of managing migration into the UK. I am therefore calling on you to:
- expand the Medical Training Initiative (MTI): the MTI offers junior doctors from Department for International Development priority countries and World Bank Low Income and Lower Middle Income (LI&LMI) Countries the opportunity to come to the UK. They work and train here before returning to their home country after two years. It is a mutually beneficial scheme; supporting the development of global healthcare services and helping trusts fill rota gaps. Its success means it is constantly oversubscribed, with candidates being held on a waiting list. We would encourage consideration of a phased increase in the current cap from 1,000 to 2,000 places.
- The RCP believes that consideration should be given to the development of a scheme like the MTI for junior doctors from non-priority countries where the RCP has strong links. These countries include Australia, where there is a surplus of Junior Doctorsi and Singapore. The use of a model like the MTI would create a mutually beneficial scheme and would meet demand from overseas colleges.
- The government should also seek to establish a scheme to attract students from particular countries to study medicine on a Tier 4 student visa in the UK
I would welcome your thoughts on the proposed policy solutions and your reasoning behind the decision to veto the relaxation of visa rules to allow overseas doctors to work in the NHS.
I look forward to you seeing your response.