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
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I agree that consultations should be carried out with wide group of
representatives representing all international medical graduates and
ethnic minority doctors. We had made this request to the Department of
health who tell us that there are practical difficulties in directly
contacting the affected. Unfortunately the DH still insists they held a
meeting under Chatham house rules on January 18th 2006 where the BMA and
some EMD representatives were present. This indeed raises the question as
to who else was made aware of the proposals made at that meeting. Though
the court may have held this does not rise to the level of formal
consultation our question is fairly simple "Did anybody else know about
these proposed changes before March 2006 and if so to whom did the convey
this information and did they raise their voices in protests”. It is a
moot point whether the BMA can adequately protect the interests of the IMG
if such action conflicts with the interests of the local graduates. We
need an organization which believes in meritocracy, is colour blind and
supports excellence wherever it comes from
Competing interests:
None declared
Competing interests: No competing interests
I am pained to read all the saga of restrictions placed on overseas
doctors who are in UK for work and training with new work permit and
immigration regulations. UK Govenments have always played and exploited the
overseas doctors. Until 1975 there was no representatve body for ods, it is
only after the formation of the Overseas Doctors Association (ODA) that things
changed. Even BMA was not interested in the doctors. Since ODA's
inception, all Royal Colleges, BMA, even GMC established working parties
with the ODA. ODA could get its members elected to GMC. ODA was recognised as the representative body for overseas doctors by successive governments. The Association shared all the consultatve process on the matters that
concerned overseas doctors. ODA has been warning GMC Govts about the manpower situation when it realised that medical intake in UK medical schools
had been increased. The Association pleaded with GMC to put an embargo on
PLAB test. If appropriate measures were taken we could have avoided this
awful situation of surplus of overseas doctor in UK without jobs and
training. The present anguish of overseas doctors and their court battles
is a real concern. I know by experience that the government will put forward very
tangible argument to justify their case for the change of regulations. As
usual the overseas doctors will lose. I strongly urge the UK government to look
at this on compassionate and moral grounds. For overseas doctors it is a
great humiliation to return to their countries without any training after
huge financial loss. One suicide of a junior doctor is enough, this tragedy
should gingerup the Home Secretary's conscience. Do justice to the citizens of the Commonwealth. UK government has still closer ties with the Indian subcontinent.
Competing interests:
None declared
Competing interests: No competing interests
Any consultations required regarding the IMG should be from the
department of health to the BMA International Committee, that represents
all IMG from all countries of the world except the EC, not only doctors of
indian origin whether they are majority or minority among IMG.
Hence, any court reviews or actions should have been initiated and
taken by the BMA International Committee as it has a duty to care for the
all IMG.
Competing interests:
None declared
Competing interests: No competing interests
Imagine this situation: - A patient consults a surgeon and the
surgeon agrees to perform surgery on him to alleviate his problem and
gives him a date for surgery. Patient after undergoing numerous pre-
operative tests and consultations finally arrives to the hospital for
surgery only to be told “Dear Sir, we have limited resources and we can
only perform 15 operations a day and every day we will select patients in
alphabetical order and as your name starts with S we could not accommodate
you today - better luck tomorrow." Do you think patient was treated
fairly?
Now consider this situation: - I am an international medical graduate
(IMG) and I was granted a Highly Skilled Migrant Programme (HSMP) visa
which is granted for a maximum period of 3 years at a time. Prior to that
I was asked to sign a declaration stating that my intention is to make UK
my home country. Now the same country that granted me the visa is unable
to give me a 5 year training job as my HSMP visa does not cover the whole
duration of the job, unless there are no UK or EU graduate to take that
job. Do you find any similarity between the two scenarios? I totally agree
that UK graduates should be given preference over other graduates but why
the mixed messages to IMGs?
I am still not sure about the title, maybe Recurrent IMGeal Nervous
breakdown would be a better one. I will give it a good thought on my
flight back.
Competing interests:
I am an international medical graduate affected by this High Court ruling.
Competing interests: No competing interests
Though Dyer reports that doctors "challenged the UK government in the High Court over new rules", the challenge was strictly against the Government's failure to consult. Mr Justice Burnton at para.5[1] addresses this point in the following way:
"it is important to emphasise that the legal grounds of the Claimants' challenge to the changes in the Immigration Rules are procedural only: they relate to the failure of the Government to consult BAPIO before deciding to make the changes. It is of course implicit in the challenge that BAPIO objects to the substance of the changes"
In any event, even if there was a formal consultative process,there is no hard evidence that the Government would have taken a different approach. If BAPIO is successful on appeal, it is unlikely to yield anything more than a requirement for a consultative process with relevant organisations.It is also unlikely that any interim relief like holding the new rules in abeyance, would be granted until BAPIO succeeds on appeal as commencement of an appeal per se is not a usual ground to grant such relief.Perhaps, the harder question is as to why BAPIO and BMA did not request a consultative process at least in January 2006.
References
[1]http://www.bailii.org/ew/cases/EWHC/QB/2007/199.html
Competing interests:
None declared
Competing interests: No competing interests
A true lost tribe
It is undeniable that thousands of doctors have been unjustly
affected by the new regulations. It does not only have implications on
their future careers but also on their established lives in the UK. For
most cases these doctors have been training in the UK for several years,
and have served the NHS and contributed to the welfare of the system.
Nevertheless, in this turmoil a truly lost-tribe has emerged. Non-
UK/EEA (European Economic Area) doctors who qualified from UK medical
schools have also seen their careers halted. Until the new regulations
were introduced these doctors were considered as ‘home-grown’. Neither
International Medical Graduates (IMGs) nor quite ‘home grown’ doctors, a
clear definition of this group is long overdue. It is however clear that
the new regulations negate all principals of equal opportunities. Non-
UK/EEA doctors, who have qualified from UK medical schools and have been
training in the UK, hold the same professional qualifications and
attributes as doctors of British nationality. Yet these doctors will only
be allowed to complete their two-year foundation programmes on graduation.
After that posts will only be granted if suitable EEA candidates cannot be
found. Hence these UK qualified doctors are denied the very legitimate
need to pursue speciality training. For those who are forced to return to
their home countries after foundation programme, they will need to restart
postgraduate training from scratch.
Currently, about 2000 UK qualified doctors face the same impediment
and many more have started their undergraduate courses under the
impression they would be able to continue their postgraduate training in
this country. Despite the obvious and highly unethical breach of trust, we
should also acknowledge that: Mr Justice Stanley Burnton has also ruled
that the government had acted lawfully when it abolished the permit free
training scheme, which allowed graduates of British medical schools to
take posts in the United Kingdom.
Overseas students make great personal and financial sacrifices in
order to pursue education in the UK. They leave family and loved ones
behind at a very young age. To realise in the end that the society has
turned its back on them. The very same society, which has seen them, not
only turn into qualified professionals but also into adults. We cannot
also deny the potential long-term financial impact on medical schools, as
the changes will dissuade overseas students coming to the UK. These
students pay up to four times local tuition fees, an average of £13,000
for pre-clinical years and £23,000 for clinical years. Adding to this the
£300,000 of taxpayer money the government contributes to training each
doctor (British and Overseas students alike). The new regulations will
have a truly draconian financial impact.
Naturally it is reasonable that the new law protects the interests of
‘home grown’ doctors. As it is also understandable to want to control an
already oversupplied labour market. However, the definition of ‘home
grown’ doctors needs to be re-established. In this case, it only includes
doctors with either a British or European passport.
Competing interests:
None declared
Competing interests: No competing interests