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High Court rejects overseas doctors' challenge of UK work restrictions

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39125.369178.DB (Published 15 February 2007) Cite this as: BMJ 2007;334:333
  1. Clare Dyer, legal correspondent
  1. BMJ

    Doctors from other countries who challenged the UK government in the High Court over new rules restricting their right to work in Britain lost their case last week.

    Mr Justice Stanley Burnton ruled that the government had acted lawfully when it abolished the permit free training scheme, which allowed graduates of foreign medical schools outside the European Union to take up training posts in the United Kingdom without a work permit.

    He also upheld guidance from the Department of Health that has made it much harder for doctors on the highly skilled migrant programme to obtain appointments in the NHS.

    The British Association of Physicians of Indian Origin, which brought the challenge, was given permission to now take its case to the Court of Appeal. Ramesh Mehta, the association's president, said it was seeking contributions to an appeal fund from doctors and medical organisations.

    The association, which represents 5000 doctors from the Indian subcontinent, was joined in its challenge by Imran Yousaf, a doctor from Pakistan. The judge revealed that Dr Yousaf had committed suicide last month, after the case was heard in the High Court but before the outcome was known.

    Dr Yousaf came to England to complete his postgraduate training, running up substantial debts, but had not been able to obtain an NHS post before the rules changed in April 2006, the judge said. In his application to the court, Dr Yousaf said he would never have come to the UK or remained here had he known that permit free training was under threat.

    The changes to the rules prevent doctors from outside the EU taking up UK training posts if there are eligible candidates for the posts from the UK and EU.

    In the past, the judge said, the NHS had a shortage of British trained doctors, which had been alleviated by large numbers of foreign doctors, mainly from India, coming to the UK to train or work.

    But a big expansion in medical school intake meant that allowing overseas doctors to obtain training posts in the same numbers would have left many UK medical graduates unable to complete their training.

    The association's lawyers argued that the government had acted unlawfully in failing to consult it before the rule changes were announced without notice in March 2006, to take effect the next month. But the judge ruled that the government was under no obligation to consult the association in advance.

    He said that the Home Office had failed to carry out an assessment of the effect of the change on racial equality, as required by the 1976 Race Relations Act, but that this did not justify quashing the regulations.

    Edwin Borman, chairman of the BMA's international committee, described the government's treatment of overseas doctors as “very disappointing.” He said, “They were given the impression that they'd be able to contribute to the NHS and spend their whole careers in the UK. Then the rules changed overnight and many were forced to leave.

    “The failure of the government to consult with the medical profession meant that they had little opportunity to prepare to leave the country.”

    Andrew Rowland, vice chairman of the BMA's Junior Doctors Committee, said: “We are in the middle of the recruitment process for new junior doctor posts, and it is crucial that the Department of Health issues full and transparent guidance immediately.

    “The deadline for shortlisting job applications is two weeks away, so those involved in selection need to be absolutely clear about what this decision means. If they're not, the whole recruitment process will fall apart.

    “The government must learn lessons from this episode. It needs to undertake rigorous, long term workforce planning so we can be honest with overseas doctors about opportunities in the UK.

    “If that had happened in the past we wouldn't be in this situation now.”

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