British government restricts recruitment of non-EU doctors

By Ajay Prakash
18 April 2006

The hopes of thousands of doctors from overseas for a better job and life in Britain sank recently after the government effectively banned their recruitment from July 2006. From that date, all foreign doctors will require a work permit. In addition, hospitals will only be allowed to offer them jobs if they can prove that they cannot fill the vacancy with someone from the UK or the European Union.

Health Minister Lord Warner announced on March 7, 2006 that “International Medical Graduates who wish to work or train in the National Health Service will need a work permit. To obtain a work permit an employer must show that a genuine vacancy exists, which cannot be filled with a resident worker.” Warner added, “We will continue to need small numbers of specialist doctors, who can bring their skills and experience to the NHS. However, increasingly the NHS will be less reliant on international medical recruitment.” Warner stated that there are currently 117,036 doctors working in the NHS, an increase of 27,417 since 1997 when New Labour came to power.

The change in the work permit rules has provoked anger and frustration among doctors abroad and those who are currently training in Britain who will now be subject to the same restrictions. Already, many who have successfully passed previous restrictive requirements, such as the Professional and Linguistic Assessment Board (PLAB) test, remain unemployed and live in desperate conditions.

The British Medical Association said it was “very concerned about the immediacy of the application of the new rules and the effect it will have on international medical graduates who have been led towards unrealistic expectations of training opportunities in the UK. In particular we are anxious about the many doctors who have been providing invaluable service within the NHS, and have families that have been living in the UK for some time who now face having to return to their countries of origin at short notice.”

Dr. Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO), explained, “We are under enormous pressure from our members who are extremely anxious and worried about the serious consequences.”

He has received phone calls and email from many trainee doctors who are “in turmoil over the proposals, not knowing what will be their fate after July 2006.”

Mehta said that there are 7,000 unemployed doctors and many had been without work for two years. “Several have returned empty-handed and some have committed suicide. Those who remain here face trauma, depression and penury. The scene is dismal and it is not going to change so doctors aspiring for UK should beware,” Mehta added.

The long waiting period that doctors face has forced them to take whatever work they can in fast food outlets or petrol stations and many have ended up standing in line for free meals at religious temples. A survey carried out by BAPIO revealed that one doctor was working for two hours every night in a wine shop for £3 an hour. He said, “I have already borrowed large sums of money from my brother in India. He can’t afford to send any more.”

Another doctor reported that he was given accommodation with 11 other doctors in a three-bedroom house and that “It was filthy. There was only one toilet and one kitchen, both were very unhygienic.” He added, “to my horror I discovered that night thousands of bed bugs. This accommodation had rats running around in the house. There was no microwave in the kitchen (as promised) and the washing machine was not working.”

The BAPIO survey showed that on average each doctor had spent about £4,000—about three years of their earnings—to take the PLAB test and come to the UK. Even when doctors have passed the PLAB test there is no guarantee of employment. A General Medical Council survey shows that it is taking longer and longer for doctors to secure their first post after passing the test. Of those who passed in July 2004 only 48 percent obtained a job within six months and just 74 percent within 12 months.

The Indian media has criticized the British government for earning money from the PLAB test and the British International Doctors Association has accused it of charging doctors £500 for renewal of their visas. It has also condemned the NHS for charging doctors several hundred pounds to get work experience for a few weeks.

BAPIO hopes it can pressure the government into reconsidering the regulations and has called a demonstration on April 21 in front of the Department of Health in Central London. At the same time it has welcomed measures help to regulate immigration of overseas doctors that would put an end to the “myth” Indian doctors have about NHS job opportunities.

One young doctor on a Yahoo Health group forum explained that the expansion of the NHS in the last eight years had “lured” many doctors from overseas, mostly from the Indian subcontinent, to the UK with promises of “equal opportunities, training and a future.” Thousands of doctors who are in the middle of their training in the UK are now being asked to leave the country: “This is obviously unfair and many feel this as betrayal. These doctors have invested their critical time in their career, effort, emotions and money and served in the NHS for years, and never expected to be thrown out of the UK by a single law favouring EU citizens.”

The new work permit regulations came as reports were published of a growing financial crisis in the NHS, which faced a projected £623 million overspend in its £76 billion budget. Some 6,000 jobs cuts have been announced across the NHS in the last few months. The Reform think-tank has said there could be a 10 percent cut in staff, amounting to 100,000 job losses.