Author: Jamie Grierson and Denis Campbell
The government’s decision to allow many more overseas doctors and nurses to work in the NHS was only temporary, Sajid Javid has said, in a move that has prompted concern that tough restrictions on numbers may be reimposed.
The home secretary hinted at a possible U-turn on the relaxation of strictlimits on medical staff allowed to come to Britain in a letter to the government’s advisers on immigration. Instead they could once again be included in the annual cap on the number of highly skilled migrant workers given work visas.
In his letter to the Migration Advisory Committee (MAC), Javid said his decision to remove doctors and nurses from the cap on tier 2 work visas for non-EU nationals was done on a “temporary basis”, adding that he intended to “keep this change under review”.
Before the change in June – which was warmly welcomed by NHS staff groups – applications made via the tier 2 route, which has an annual cap of 20,700, had been exceeding the allocation of visas.
Javid excluded doctors and nurses from the cap after a vociferous campaign by NHS organisations and medical groups, who argued that doctors and nurses should be exempted to tackle the deepening workforce crisis in the NHS.
Senior doctors voiced unease at Javid’s apparent U-turn, calling it “ill-judged” and saying it would exacerbate the NHS’s worsening shortage of medics.
Dr Nick Scriven, the president of the Society for Acute Medicine, said: “This is alarming and appears to backtrack on the recent change that was widely welcomed by the medical profession. With the ongoing uncertainty of Brexit and its effect on recruitment, this appears ill judged. We should be doing everything in our power to recruit and retain the people we need to look after our patients.”
In his letter, which was dated June but not released by the Home Office until Thursday, Javid wrote to the MAC to ask them to review the shortage occupation list (SOL) for the first time since 2013.
He said: “As the committee will be aware, the tier 2 (general) cap has recently been hit and has continued to be under pressure in every month since December 2017, resulting in a number of occupations being refused places.
“This has also impacted on doctors working in critical roles in the NHS – and other highly skilled professionals across other parts of the economy.
“The recent demand for tier 2 places appears to have been driven, in part, by increased recruitment for overseas health professionals.
“In view of the risks associated with doctors not being able to fill necessary posts within the NHS and in view of the current pressures, I have exceptionally agreed – on a temporary basis – to exempt all doctors and all nurses from the tier 2 cap, but a review of the full SOL will enable the committee to assess which occupations should be given priority within the cap. I intend to keep this change under review.”
Under the existing system, the SOL exempts the UK from the need to advertise certain jobs to the resident labour market and ensures that when the tier 2 cap of 20,700 has been hit, priority is given to these applications above other occupations.
Any return to the previous system, which would again limit the number of overseas doctors who can come to work in the NHS, is unlikely to be welcomed by Matt Hancock, the health and social care secretary. He has explicitly acknowledged the extent of the NHS’s problems in recruiting and retaining key staff and made tackling it one of his key priorities.
The NHS in England has almost 10,000 vacancies for doctors – the most since records began – the regulator NHS Improvement admitted last month. Its chair, Lady Harding, told a conference of health service bosses earlier this week that “the single biggest problem in the NHS at the moment is that we don’t have enough people wanting to work in it”.
The MAC recently published a report on the impact of EU migration on the labour market in the UK and recommended that the skilled migrant cap is scrapped. The home secretary said at the Conservative party conference he would consider scrapping the cap.
A Home Office spokesman said: “In June we took action to exempt doctors and nurses from the annual cap on tier-2 work visas, freeing up hundreds of places a month for other skilled professionals.
“We said then that we would be keeping this change under regular review, which is continuing. In June we also commissioned the MAC to review the Shortage Occupation List, and they are expecting to report in spring next year.”