PULSE: Recently qualified GPs are receiving deportation letters soon after completing their medical training, the professional development vice chair of the RCGP has told MPs today. 

New doctors are ‘literally going from celebrating the fact that they’ve become a GP to receiving letters threatening them with deportation’, Dr Margaret Ikpoh told the House of Commons Health and Social Care Committee during an evidence session on the future of general practice.

Pulse revealed in April 2022 that up to 1,000 overseas GPs could be at risk of being deported despite completing their UK training because of complex immigration rules that mean they are unable to extend their visas.

The Doctors’ Association UK (DAUK) said it is ‘utterly appalled’ that newly-qualified GPs face deportation despite having completed their GP training in the UK and are left ‘in limbo’ with this threat ‘hanging over them’.

DAUK spokesperson Dr Dolin Bhagawati said: ‘This simply defies belief and demonstrates the siloed thinking that is present in Government when it comes to NHS staffing. These doctors, who worked during the pandemic, are ideally placed to help address the problems faced by a dramatically understaffed GP service currently.

‘Yet the Government’s immigration stance runs counter to alleviating this simple immigration issue. A Parliamentary Bill to give Indefinite Leave to Remain to all NHS workers that worked during the pandemic has been repeatedly kicked into the long grass. Despite being a simple measure to implement, the Government have chosen to embrace foolish bureaucratic madness rather than take measures to address a crippling NHS shortage.’

DAUK co-chair Dr Ellen Welch added: ‘We are short of thousands of GPs in the UK and desperately need these doctors to stay and work in the NHS. 

‘If the Government is serious about bolstering the workforce then they need to take immediate action to ensure these doctors are not deported and are granted indefinite leave to remain to use their skills within our crumbling health service.’

The story was also covered in the Lancet and the Morning Star

Listen to our Five Live appearance here

Ministers are being urged to grant migrant NHS workers the indefinite right to remain as the health service braces for what could be one of the most difficult winters it has ever faced.

Cross-party MPs, along with medical bodies including the British Medical Association (BMA), have backed calls to change the law so that foreign health and social care staff are given the right to stay in the UK in honour of their commitment during the pandemic.

Liberal Democrat Christine Jardine, who is pushing the second reading of a private members’ bill that would make this happen, warned that failing to provide “certainty” to these healthcare workers would risk “fuelling the winter crisis with an exodus of staff”.

Dolin Bhagawati, interim co-chair of the Doctors’ Association UK, said it was “time the government assures [migrant NHS workers] that they will not be callously cast aside as a political inconvenience”.

“These are dedicated professionals who have performed heroic service over the last 18 months. Yet they live with the potential for deportation over their heads at any instant. The country they have sacrificed so much for should be welcoming them home,” he added.

Read the full article here

The Doctors’ Association UK are dismayed at the governments less than inflation uplift for NHS workers and call for “fair say on fair pay”.  

At a time when doctors have given their lives and livelihoods to this pandemic, with no 
clear end in sight, it is an insult that the Government sees a 3% uplift as fair remuneration. In support of member opinion, DAUK’s ‘Fair say for fair pay’ campaign demonstrated the extremes staff have been put through during the pandemic, risking their own lives, whilst the challenges to the NHS have never been greater. 

The government’s decision to exclude junior doctors, who make up more than 50% of doctors in the NHS, is callous in view of the large number of doctors in training who have worked tirelessly through the pandemic. Junior doctors, a term than encompasses all doctors from leaving university up until becoming a consultant, are at the forefront of the fight against COVID. Many have been redeployed from their area of expertise or training to work in COVID medical wards or in critical care. Not only has their training been disrupted but they have been expected to pick-up shifts and cover rota gaps due to the on-going understaffing.

The 3% offered does not come close to what staff deserve. Inflation this year is estimated at 3.7%, making the proposed rise a pay cut in real terms. 

We consulted with our members last night and the overwhelming majority of responders supported industrial action. We plan to hold an emergency meeting with members soon to formulate next steps and we request that the Government reconsider its position with immediate effect.

Dr Jenny Vaughan, Chair of DAUK: “Any improvement on the derisory 1% previously offered to NHS workers is welcomed, but 3% barely takes the edge off the erosion of doctors’ pay over two decades. Doctors in the NHS have suffered a 30% pay cut in real terms, and after inflation this “pay rise” will ultimately be a pay freeze. DAUK’s campaign ‘fair say for fair pay’ demonstrated the extremes staff have been put through during the pandemic – the effects of which are only starting to be realised. It is time to pay and we hope the BMA and the HCSA as well as allied health professional unions will join us in voicing our discontent – including taking industrial action.”

Dr Duranka Perera, junior doctor and DAUK Treasurer: “We are in an ongoing pandemic that has killed 128,000 people in the UK, including over a thousand colleagues. With staff shortages at critical mass and thousands more on the verge of burnout, no number of claps for the camera can change these cold, hard facts. The service and sacrifice of NHS workers over the past year is being treated with open contempt.

There is no time but now to pursue the most powerful form of resistance. This Government – one that saw fit to pay private Test and Trace consultants £7000 a day – must be held to account. Amidst the most testing era in NHS history, unions across all healthcare disciplines must come together to demand just compensation for the workers that put their lives on the line for their patients and their country. After over a decade of austerity and real terms pay cuts, a 15% pay increase is the bare minimum we at DAUK see as acceptable. If it requires industrial action to achieve this, then we wholeheartedly back that too.’

Neurosurgeon and DAUK co-vice chair Mr Dolin Bhagawati: “The figures put forward by the government show a breath taking level of wilful ignorance regarding the pressures that NHS staff have faced during the pandemic and will continue to face in the current wave of COVID-19 infections. With the NHS staring into an abyss of millions of patients on waiting lists, we need staff that are compensated appropriately for the skill sacrifice and commitment they have and continue to demonstrate. A Government that does not realise this is catastrophically out of touch. “

Nottingham GP Dr Shan Hussain: “GP Practices have delivered over 75% of Covid vaccinations whilst caring for 2 million patients with long covid, looking after rising numbers of patients on secondary care waiting lists, and continuing day to day GP work. All of us have worked incredibly hard without recognition, and for the pay rise to exclude more than half of practicing GPs shows how little the Government values Primary Care.”

GP Partner Dr Rosie Shire: “Since the start of the pandemic GP’s have been battling covid in the community and changing the way we work in response to the ever changing regulations. For the pay rise not to include all GPs shows how undervalued we are.”

The UK Government has been urged to hand indefinite leave to remain to health and social care staff amid warnings of a “psychological and financial” burden on Britain’s key workers.

Liberal Democrat MP Christine Jardine is urging ministers to act and offer “security and reassurance” to those who put their lives on the line during the pandemic.

Speaking to The Scotsman, the Edinburgh West MP claimed failing to do so could see the heroes of the pandemic face expensive visa costs or even being deported.

Ms Jardine, who has tabled a Private Members’ Bill in a bid to see the ambition realised, said: “So many of us have so much to be thankful to our NHS and care workers for in this pandemic that it seems the most appropriate way of saying thank you, to say to those who are here on visas, and want to stay and contribute, yes of course you are welcome.

“When the pandemic was at its worst and the daily death toll was frightening, many of those at most risk in the NHS and care sector did not, at any time, shrink from the threat to their own wellbeing.

“Now that many of them who have lives here, make an invaluable contribution to our society and want to stay, it is surely unreasonable to ask them to come up with the expense of visa costs or face the threat of being deported.”

Earlier this year it was announced that NHS and social care staff would have their visas extended by one year, but Ms Jardine insisted this was not enough.

She explained: “They are here legally, have worked hard, saved lives and made an astonishing contribution to getting this country through the worst pandemic and economic crisis in recent history.

“Without them the burden on our NHS and care sectors would have been so much heavier for everyone.”

The UK employs 170,000 non-British individuals from more than 200 countries in the NHS, making up 14 per cent of all NHS staff.

One of these is Dr Krizun Loganathan, who worked in a busy intensive care unit during the first wave of the Covid pandemic.

Read the full article here.

London (CNN)Few would envy Britain’s embattled National Health Service (NHS) workers over the past year. One of the world’s worst Covid-19 tolls has meant grueling shifts, danger, and workplaces full of grief and trauma. But Charles Oti would swap places with them in a heartbeat. A microbiologist by training, Nigerian by birth, Oti has spent four years working for the NHS honing a specialism in infection control.Oti’s skills are in short supply and among the UK government’s highest priorities for recruitment. But instead of taking a position on the front line of the pandemic response, he has been prevented from working and threatened with deportation.

“I believe I have the skills to make a difference,” says Oti. “This has been so frustrating because I am being wasted.”The case represents a personal ordeal and a wider issue. At a time when Britain is heavily reliant on immigrants to staff its essential services, particularly in the NHS, many of these same workers are fighting for their right to remain in the country. 

Living in legal limbo 

Oti, 46, received a five-year residence permit when he arrived in the UK in 2013 with his partner, a European citizen.After a spell in the private sector, he took a job with the NHS in London in 2015 as a medical devices coordinator. His regular duties included contamination control and ensuring the safety of equipment such as X-ray machines and respirators.Better money was available in private enterprise but Oti says that public service suited him. He felt the job made more of a difference to the lives of patients and enjoyed the camaraderie within the NHS’s multinational workforce which was “like a family.” There, he says he formed close friendships that helped him adapt to a new country.

But Oti’s residence permit was revoked without his knowledge when his relationship ended, and after returning from a trip to Nigeria in 2017, he was detained at the border and ordered to leave Britain. Since then he has existed in a legal limbo. Several applications to remain have been denied. Oti was allowed to continue working until 2019, when the Home Office informed the NHS that his status was insecure and he was suspended without pay. “They tell you to stop working and it puts a person in a very difficult position,” says Oti. “You can’t afford to make a fresh application or to appeal if it fails. One can go destitute because of this, a lot of migrants do.”Oti has avoided this fate with help from his friends and new partner — a British citizen and NHS worker — who have supported him while he has been unable to work.

Tip of an iceberg

Oti’s case is far from unique, statistics show. An estimated 170,000 of the NHS workforce of 1.28 million are foreign nationals, many of whom have an insecure status. The Doctor’s Association UK (DAUK) group is campaigning for Indefinite Leave to Remain for all NHS workers and their families, writing an open letter to Prime Minister Boris Johnson that notes his own recent reliance on the service. “Charles Oti’s case represents precisely the reason DAUK have campaigned for NHS workers and dependents to be granted immediate Indefinite Leave to Remain,” Vice-Chair Dr. Dolin Bhagawati told CNN. “It beggars belief that the Home Office is not playing its part in the national effort to combat a pandemic that still affects the country.”Migrant rights campaigners believe the Home Office’s “Hostile Environment” policies, launched in 2012, are to blame. Those policies, aimed at deterring illegal immigration, introduced more stringent and frequent checks on immigration status that increased the difficulty of accessing services and left migrants more vulnerable. In the most notorious case of the “Windrush” generation, legal arrivals from the Commonwealth were cut off from housing, healthcare and banking services, and in some cases deported. The government has since apologized, commissioned an independent review, and established a compensation mechanism.

“The Home Office has a long history of treating migrants with disdain and cruelty,” says Minnie Rahman of the Joint Council for the Welfare of Immigrants (JCWI). “The Windrush Lessons Learned review showed how deeply the Home Office needs fundamental and meaningful reform, but the Government has so far failed to act.”The government has introduced free visa extensions for around 3,000 health and care workers, which unions have criticized as it excludes thousands more. Oti’s solicitors are now pursuing a judicial review of the case, which they say is his last hope. A crowdfunding appeal for his legal fees has raised around £2,700 ($3,700).For Oti, the pandemic has highlighted the need for people to work across boundaries as our fates are invariably connected. “When you walk into a hospital, the consultant who sees you might be a migrant, and the nurse supporting the consultant could be a migrant,” he says. “When something goes wrong (like the pandemic) it can affect everybody.”

Read the article in full here

A year ago today, we lost the first of too many healthcare workers to covid as Dr Adil El Tayar and Dr Habib Zaidi passed away. Since their tragic deaths, hundreds of NHS workers have died from covid.

The full extent of the devastation that has been wrought on the NHS workforce by covid is yet to be established. Even the figure of 883 NHS staff covid deaths only records those who died between March 2020 and December 2020 and does not include the many more who have tragically died during the second wave.

We do not yet have data on some other major effects of this pandemic on the NHS workforce, such as the impact of long covid; the toll on mental health of witnessing death on an unprecedented scale; the trauma of treating colleagues and watching them die. This trauma is multiplied in those cases when, only weeks ago, those colleagues were standing shoulder-to-shoulder with us in the pandemic response.

The families of those who have died need to have answers regarding the circumstances, both ethically and legally. An inquiry is needed as soon as possible. However, the need for honesty and openness appears incompatible with recent public pronouncements, such as denials of problems with PPE. These responses seem more concerned with disingenuous denials and spinning of facts rather than a true desire to learn and not repeat mistakes in the future.

Early in the pandemic it was clear that, in the UK, those from BAME communities were at greater risk of dying from covid. Yet a report by Public Health England, published in early June 2020, on the disproportionate effects of covid on black, Asian and minority ethnic people, was criticised for leaving out submissions from third party organisations, which included claims of “structural racism”. The third party submissions were later published, in mid-June 2020, but only after an outcry from opposition parties, the Royal College of Physicians Edinburgh, the Doctors’ Association UK and the Muslim Council of Britain, among others.

One section of the report stated that “…the pandemic exposed and exacerbated longstanding inequalities affecting BAME communities. Action is needed to change the structural and societal environments. There is a legal duty and moral responsibility to reduce inequalities.” The implication of the initial attempts to withhold this information was to summarily dismiss or to attempt to spin potential systemic and structural influences that may predispose mortality.

These actions deeply affected ethnic minority families in mourningas well as the memory of the NHS co-workers who are no longer with us. The government had discarded their sacrifice, despite pressure from groups like the The Doctors’ Association UK making efforts to point out the harm of these actions .

While the government repeated the phrase “follow the science” with a religious zeal, it was striking that they ignored years of evidence with regard to health inequality in the UK. Part of the PHE report showed that the pandemic exposed and exacerbated longstanding inequalities affecting BAME communities. Some of these inequalities arise from the “hostile environment policy” that has been in place over the last decade. Research has shown the deleterious effects of this policy on health, which will have been exacerbated during the pandemic.

Sections of the BAME report stated: “Lack of trust of NHS services and healthcare treatment resulted in their reluctance to seek care in a timely basis and late presentation with disease.” Even before the coronavirus crisis, this was evident and something I had seen personally. It has now been dramatically exacerbated in the era of covid and failure to acknowledge the harmful health impacts and disenfranchisement of the hostile environment is killing people. However, to acknowledge this requires introspection and a willingness to accept responsibility for actions past. Such willingness appears distant at best.

The institutional failure to safeguard the lives of BAME NHS workers has been duplicated in both political and medical sectors. When it became clear that so many of the early healthcare worker deaths were from a BAME background, the response from NHS England was to institute mandatory risk assessments in June 2020. However, the feeling of frontline staff is that these have largely been a paper exercise with no follow through and many BAME workers feeling exploited and at risk.

More recently the strategy has evolved to include heavy spin employed to deny the problems that frontline NHS staff have faced, as demonstrated by health secretary Matt Hancock. An egregious example was his claim that “there was no national shortage of PPE”, which in a demonstration of Nixonian doublespeak seemed to hinge on the definition of “national.”

While undoubtedly a media team congratulated themselves on this insulting view of the past, we remembered cherished colleagues like Dr Peter Tun, who treated covid patients at the Royal Berkshire Hospital in Reading. He pleaded for vital PPE supplies three weeks before dying from the disease last April. Andrew Ekene Nwankwo, a nurse at Broomfield Hospital in Chelmsford, also died of covid after desperately trying to buy his own PPE online.

We are not imagining the mourning of colleagues who had treated covid patients with inadequate PPE. They are not only numbers, but people we miss deeply. This disregard for the experience of shell-shocked NHS staff to save political face is beneath contempt. March 2020 was a month of chaos, with frontline NHS staff screaming at the government that they felt like “cannon fodder” while having to work without PPE.

Politicians and their support structures do not normally have to face fatal consequences of the decisions they have made. However, in this pandemic they have been laid bare as every decision that has been made had a fatal consequence. Every £1billion spent on unusable PPE is money not spent protecting frontline staff. Every £1billion that did not result in a workable Test and Trace programme was money not spent on ensuring lower patient numbers in our overloaded hospitals over the last year. These are very real consequences that must be faced up to. Blame must not be the aim but all those who have been involved must bear responsibility for decisions that led to avoidable deaths. Running from that responsibility disrespects the memory of our colleagues that passed away and the thousands that continue to mourn for their loved ones who have died over the last year.

The time for empty talk and rhetoric is over. The tactic of hiding from the truth is not an option. After the shocking revelations of poor care at Mid Staffordshire Hospital in 2009, Robert Francis QC concluded his inquiry with the words that “there lurks within the system an institutional instinct which, under pressure, will prefer concealment, formulaic responses and avoidance of public criticism” and “an institutional culture which ascribed more weight to positive information about the service than to information capable of implying cause for concern”. Several years later he appears, sadly, to have perfectly described the attitude of the political establishment with regards to deaths from coronavirus, especially those of healthcare workers; once heroes to be applauded, yet now treated as a mere inconvenience.

Their memory deserves more.

Read the original article here

Matt Hancock has been criticised for a “disgustingly disrespectful” claim that there was never a national shortage of personal protective equipment during the pandemic.

Doctors and MPs condemned the UK health secretary as “deeply insulting” on Tuesday after he insisted that his team had delivered protective equipment for frontline NHS staff in the “teeth of a pandemic”.

Doctors groups said they had helped deliver 45,000 masks to hospitals that lacked adequate supply at the start of the crisis and that the families of healthcare workers who lost their lives to Covid had raised concerns about the protection they received.

Amid the first wave of coronavirus, NHS staff were photographed with poorly fitting PPE, with some having to make gowns themselves from bin bags.

Hancock said that while there were “individual challenges in access to PPE”, they “never had a national shortage, because of my team”.

He was addressing a high court ruling over failings in publishing details of coronavirus-related contracts. He told BBC Radio 4’s Today programme: “This has all been looked into in great detail. It’s only because of the transparency that I support that we can ask questions about these contracts.

“And what’s more, it’s easy to ask these questions, but what is hard is to deliver PPE in the teeth of a pandemic.”

Dolin Bhagawati, from the medical campaign group Doctors’ Association UK (DAUK), said Hancock’s comment that the NHS did not face a national shortage of PPE during the first wave of the pandemic “is disgustingly disrespectful to the memory of frontline colleagues who died from Covid-19 while raising concerns about inadequate PPE”.

He said frontline staff did not imagine having to provide their own makeshift protective equipment, “raising our concerns for weeks only for them to be ignored”.

DAUK delivered 45,000 masks to hospitals that lacked adequate supply. “We are not imagining mourning the colleagues that treated Covid-19 patients with inadequate PPE,” Bhagawati said.

He added: “This callous disregard for the experience of shell-shocked NHS staff in order to save political face is beneath contemptible.”

Read the full article here: https://www.theguardian.com/world/2021/feb/23/hancock-criticised-for-claim-there-was-no-national-covid-ppe-shortage

“None of this is normal in the NHS. At our trust, we have three times the level of ICU patients that we had at the same time last year. We have converted several floors of our hospital to intensive care. We have redeployed multiple members of staff consultants…people from all specialties have been redeployed in the roles that they don’t normally fulfil”

“There is an immediate, short, medium and long term consequence that needs to be looked at. The immediate term consequence is our ridiculously high numbers of coronavirus cases that’s going on at the moment. Our short term goal is vaccination to try and drive that down…and our long term is to deal with our ballooning waiting lists and our mental health crisis”.

He also went on to respond to comments made by a senior MP earlier this week:

“This is basically a crisis situation…I would hope that an elected member of parliament who has people dying in his constituency would help to acknowledge that””It is not an admission of defeat to accept that one was wrong in making comments in the past…that is something which is difficult to do in politics, but unfortunately it is necessary to do in health. Otherwise we don’t learn from our mistakes. And if we do not learn from our mistakes in a pandemic situation, people die.”

In December, The Doctors’ Association UK wrote to the Home Secretary outlining concerns that delays in providing biometric residence permits are preventing frontline doctors from working in our NHS.

DAUK made the following urgent recommendations: 

1.Institution of a fast-track system to ensure BRPs are issued without delay for all approved visas for International Medical Graduates to ensure the NHS has the highest number of trained personnel on the frontline during the escalating pandemic

2. The refund of the IHS to all eligible NHS staff to be issued without delay as promised by the government.

Priti Patel MP responded to our letter and her reply can be seen below.