What colour is your passport?

The prime minister of India, Manmohan Singh, visited the United Kingdom towards the end of 2006. One issue that he raised with his UK counterpart, Tony Blair, related to the fate of thousands of doctors trained in India, who felt cheated by the recent changes to immigration rules, which might force many of them to return home.

Doctors trained abroad have shored up the UK's NHS since its inception. From 1985, international medical graduates (IMGs) have been able to take training posts in the NHS without a work permit. Many of these doctors came from the Indian subcontinent, where training is similar and English is well spoken.

Their presence has been welcomed by a health system without enough graduates of its own. But in the past few years, as European migration and a 50% rise in UK medical school intake have started to fill this deficit, the government has reappraised its approach to IMGs.

In March 2006 it announced with one month's notice that permit-free training would be withdrawn. To employ an IMG, a hospital would have to meet work permit requirements by showing that no home or European candidate was suitable.

At about the same time, the Department of Health advised NHS employers that a different group of IMGs admitted under the separate Highly Skilled Migrant Programme should also have to pass labour market tests before getting training posts, unless they had leave to remain until the end of their training, which most did not.

“It meant that the employers were making two piles of applications. In the first were home …