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 role played by international staff in the NHS received widespread media coverage recently after current head of NHS Test and Trace Baroness Dido Harding said she wanted to make the NHS less reliant on foreign doctors and nurses if she became the next head of NHS England.

As a ‘foreign’ doctor myself, comments like this sadly echo the racist statements we are increasingly hearing from patients. These include things like: ‘I want to be seen by a white doctor’ or ‘Why don’t you go back to where you came from’.

At a time when abuse towards NHS staff is becoming the norm, and all areas of the service, especially primary care, face overwhelming demand, we need the next leader of the NHS to understand that the NHS relies on its workforce to function.

International staff

Almost 200 different nationalities are represented within the NHS in England. The majority of staff are British, but as of January 2020, 169,000 (13.8%) report a non-British nationality, with Indian, Filipino and Irish representing the highest numbers. Some 67,000 members of staff are nationals of other EU countries.

Despite being the biggest employer in the UK, the NHS doesn’t have enough staff to meet demand. According to recent data from NHS Digital, the NHS has a shortfall of 84,000 FTE staff, and this does not include primary care where we know there is a shortage of GPs, and is before absence figures for COVID-19 are factored in.

Since its inception in 1948, the NHS has been heavily dependent on overseas healthcare workers, demonstrating that ‘foreigners’ are not only important, but vital for the smooth functioning of NHS services.

COVID-19 pandemic

This is even more apparent as we emerge from the challenges of the last 18 months, where international healthcare workers have stood shoulder to shoulder with their British colleagues.

Last month, former health secretary Matt Hancock told the parliamentary inquiry into COVID-19 that 1,500 health and social care workers have died during the pandemic and we know that with those from a Black, Asian or ethnic minority background are at an increased risk.

‘Foreigner’ comments make international healthcare workers sound like a burden on the NHS and completely undermine their contributions. Not only do they offer their skills and experience as healthcare workers, but they pay the same amount of tax as any British worker without having any recourse to public funds.

After residing in the country for 5-6 years, they then have to pay over £2,000 to apply for Indefinite Leave to Remain. They are also frequently seen investing in property, shares and tourism.

In 2015, the coalition government introduced the Immigration Health Surcharge (IHS), an annual fee of £624 that migrants need to pay to use the NHS. For a family of four, this charge, along with visa fees can easily reach £10,000 a year – which for tax paying NHS staff is an extortionate amount of money to pay in order to access the very system they work within.

In October last year, after lobbying by the DAUK, the Prime Minister announced that international health and care staff and their dependents would be exempt from the IHS, in view of their efforts during the pandemic.

It is time we valued our migrant healthcare staff, which is why DAUK will be supporting the bill to grant indefinite leave to remain to overseas staff, like myself, who have given their all to the NHS during the pandemic.

The NHS relies on the goodwill of its workforce to stay afloat, and the next leader of the NHS, whoever that is, needs to take this onboard

• Dr Pushpo Hossain is junior clinical fellow, acute medicine and a committee member of the Doctors’ Association UK (DAUK)
• Read the article in full here

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.

Recent government action

In 2019 the prime minister, Boris Johnson, announced a new “NHS visa” which would make it significantly easier for doctors and nurses from around the world to work in the UK. This visa would cost around £464, half the usual price, and would be guaranteed a decision within two weeks. This was established pre-pandemic, to mitigate any negative impact which Brexit would have in attracting overseas staff to the NHS, demonstrating how important migrant workers are for  the service.

Following this, in the peak of the first wave of the pandemic in 2020, the government announced that all non-European Union migrant workers in the health sector whose work visas were due to expire before 31 March 2021 would have them extended for another year with no fee.

This scheme has now been extended, to allow healthcare workers that fit the eligible profession criteria with visas due to expire between 1 April 2021 and 30 September 2021 to apply for a free one year extension. The scheme also allows dependent family members of healthcare workers, such as spouses or children under 18, to apply for the visa extension too.

The Private Member’s Bill

In November 2020, the Immigration (Health and Social Care Staff) Bill 2019-21 was put forward, which intends to offer migrant healthcare workers indefinite leave to remain. This is similar to the actions taken in countries such as France, where full citizenship is being granted to frontline migrant workers. The bill is supported by the Royal College of Physicians, the Royal College of Nursing, the Doctors Association UK, Independent Age and Unison, and MPs are thought to have received upwards of 7,400 letters of advocacy for the bill. 

However, the second reading of the bill was delayed in January 2021 due to the Commons’ COVID-19 safety rules. The Liberal Democrat MP Christine Jardine, who sponsored the bill, has since called on the government to consider debating the bill remotely due to the urgency of its nature, stating “I make no bones about the fact that I would like the government to recognise the contribution made by the NHS workers – the foreign nationals – who have done so much for this country in this crisis”.

The rest of this article can be read 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

Migrant workers have been essential to the operations of the NHS ever since its inception in 1948. Over the decades, many programmes have been used to encourage and find overseas workers and help them migrate to the UK to be employed in the healthcare system, demonstrating how important they are.

Migrant workers have been essential to the operations of the NHS ever since its inception in 1948. Over the decades, many programmes have been used to encourage and find overseas workers and help them migrate to the UK to be employed in the healthcare system, demonstrating how important they are.

However, throughout the current COVID-19 pandemic, many have argued that migrant workers have not been given the rightful respect or recognition they truly deserve. Many of them have been putting their lives on the line every single day fighting against a deadly virus, yet still face immigration insecurity.

There are currently 170,000 overseas NHS workers from 200 countries residing within the UK, many of which have to apply every year for five years to renew their work visas. Some are required to have employers provide certificates of sponsorship for them, and if they do not, then they can be deported at any time despite their critical service to the country. As the pandemic has raged on since March 2020, support for a private member’s bill which would grant migrant NHS workers indefinite leave to remain has grown.

The Story So Far

In 2019, Boris Johnson announced a new “NHS visa” which would make it significantly easier for doctors and nurses from around the world to work in the UK. This was pre-pandemic, and is said to have been established due to fears that the NHS would not be able to attract staff after Brexit, showcasing how important migrant workers are to our health service.

In April 2020, Priti Patel announced an Immigration Health Surcharge was under review, which would essentially mean migrant NHS workers are taxed twice to use the health service themselves. However, following the outbreak of COVID the UK government decided to abolish such fees as a gesture of appreciation for the service NHS workers were providing. Although this initially seems positive, studies have found that due to differing immigration statuses, there were only 12% of migrant workers paying the surcharge. This means that although the gesture exists, it did not alleviate any widespread issues for migrant workers like it first appeared to.

Furthermore, in the peak of the first wave of the pandemic in 2020, the government announced that all non-EU migrant workers in the health sector whose work visas were due to expire would have it extended for another year with no fee. However the scheme is expected to end in March 2021, leaving many migrant doctors, nurses and paramedics in a position where they must spend hundreds of pounds and weeks applying for new visas from then on. This seems like an extreme disservice to the workers who have carried the country through the pandemic, who are then having to spend their own hard-earned money just to try and remain in the country to continue with their service.

The Private Member’s Bill

In November 2019, the Immigration (Health and Social Care Staff) Bill 2019-21 was put forward, which would offer migrant healthcare workers indefinite leave to remain. This is similar to the actions taken in countries such as France, who are granting full citizenship to frontline migrant workers. The bill is supported by the Royal College of Physicians, the Royal College of Nursing, the Doctors Association UK, Independent Age, and Unison, and MPs are thought to have received upwards of 7400 letters of advocacy for the bill.

Unfortunately, the second reading of the bill was delayed in January 2021 due to the Common’s COVID safety rules. The Liberal Democrat MP Christine Jardine, who sponsored the Bill, has since called on the government to consider debating the bill remotely, due to the urgency of its nature.

How Will This Impact EU Nationals?

As of June 2020, 67,000 of the UK healthcare workforce are nationals of EU countries – 5.5% of NHS staff in England. It is estimated that 9.1% of doctors and 6.0% of nurses in the UK are from the EU, but since 2016 this has actually fallen.

Under the terms of the Withdrawal Agreement between the EU and the UK, EU nationals now have until the 30th June 2021 to apply for settled status via the EU Settlement scheme. Those healthcare workers who are successful in their application will be able to remain in the UK and will have access to public services and healthcare. EU nationals who have the status of indefinite leave to remain do not have to apply for this. However, if they choose to do so and are successful they will gain the right to leave the UK for up to 5 years and not lose settled status rather than two years under indefinite leave to remain.

EU nationals are largely not going to be impacted by this bill. This is because they have the EU Settlement scheme in which to apply to, which non-EEC migrant healthcare workers do not have as an option. The issue is that for those healthcare workers that do apply to the scheme and are rejected, they will be facing immigration insecurity once again.

In the long run, the proposed bill that would grant non-EEC healthcare workers the indefinite leave to remain could create some changes in employment opportunities for EU nationals. This will be because there will be a much smaller turnover in non-EEC staff who are losing immigration status and leaving the UK, therefore leaving fewer job openings for EU nationals who are wishing to settle in the UK and work in healthcare. However, this is an ongoing issue so such impacts cannot yet be determined. It is certainly a topic area that EU nationals may want to watch closely.

Read the full article here

“The NHS could not function without its foreign born workers. Around 169,000 people, or 13% of the workforce was born outside of the UK.”

Radio 4 interviewed DAUK’s Dr Pushpo Hossain on NHS Overseas Workers Day last Friday:

Would you like to continue working in the nhs?

“I really love working for the NHS and I would like to call it my home. But unfortunately it is our fate as an international health care worker, we are on temporary visas and cannot obtain permanent residency…we have to be on temporary visas for five years before we can apply for the Indefinite Leave to Remain, which also comes with an exuberant fee of around £3000 per applicant.”

Will your salary be affected by this proposed 1% pay increase? 

“To be honest, it feels very, very insulting…for some of us [the 1% pay increase does not even cover] the £3000 that is required for the Indefinite Leave to Remain application. So how are we being recognized? How is this being fair to all these international health care workers…we have put our lives on the line and is this how they want to reward us?”

Today marks the first ever Overseas NHS Workers Day, organised by Dr Pushpo Hossain, of the Doctors’ Association UK, and supported by the Unison trade union and a number of other organisations.

Almost 14 per cent of NHS staff identify as non-British, with nearly 200 different nationalities represented within our health service. Among NHS doctors, 30 per cent were born overseas. The international medical community has formed a massive and crucial part of the NHS frontline, with members risking their lives to look after patients with Covid-19.

As an overseas NHS worker myself, I have felt the impact of being alone during a pandemic, more than 5,000 miles from home and family. I’m delighted by an initiative which celebrates the contribution of the international medical community during this crisis, and raises awareness of some of the issues international staff face.

Chief among these issues is immigration status. Indefinite leave to remain (ILR) or permanent residency is currently awarded to those with Tier 2 visas who have lived in the UK for a qualifying period of five years. I’m originally from Kerala, India, where I was born into a family of doctors who inspired me to gain international experience within the NHS after completing medical school in India. I will only be eligible for ILR in 2023, which as a frontline worker, adds an extra layer of stress to be uncertain about my fate in this country.

Many of my NHS colleagues have faced delays in obtaining a Biometric Residency Permit, without which we cannot rent accommodation, apply for a training post, enrol our children in school, apply for a driving licence, or even open a bank account. It’s not unusual for DAUK to be contacted by doctors unable to travel home to see dying relatives because of delays receiving this permit.

I’m currently a trainee in psychiatry in the Oxford Deanery. Being an international doctor in training on a Tier 2 visa is not straightforward. To apply for any out of programme experience, research, or training, brings with it mountains more bureaucracy. I truly believe that international minds could devote more energy towards boosting clinical innovation within the NHS if we didn’t have to worry endlessly about our expiring visas, and research repeatedly shows the material and psychological benefits of gaining permanent residency.

The NHS has significant staffing and retention issues, with more than 88,000 vacancies in England alone; vacancy rates are approaching 10 per cent in some areas. Visa challenges and uncertainties contribute to these issues and have a drastic impact on the attractiveness of working as a doctor in the UK.

Progress of sorts has been made – for example exempting international NHS staff from the immigration health surcharge, which was a huge financial burden for doctors waiting to start work or renewing their visa. This came as a huge relief. 

The government has also introduced ILR for the dependents of staff who die during the pandemic while caring for Covid-19 patients, though not for staff who survive. I feel this is morally reprehensible and not in line with British values of fairness and respect. 

I can truthfully say that not once did I think of stepping back from the frontline. The call of duty has driven me to give the best to my patients. This is a spirit that all doctors and other NHS staff share. But we expect this to be recognised, and our hope is that us “Covid Soldiers” will be rewarded with ILR, showing that we are valued, and our sacrifices appreciated.

I would like to proudly call the UK my “home away from home”.

Dr Alex Vallakalil is a trainee psychiatrist and part of the Doctors’ Association UK

Read the original article here: https://www.independent.co.uk/voices/nhs-covid-nurses-immigration-doctors-b1812892.html

As part of Overseas NHS Workers Day, which celebrates the almost 200 nationalities represented in staff working for the NHS, doctors’ groups have highlighted the importance of the one in six doctors in NHS general practice who qualified outside the UK.

The pandemic has highlighted the dedication of these doctors and the selfless service they give to their patients and primary care, GP leaders said.

The Doctors Association UK (DAUK) – the group responsible for launching Overseas NHS Workers Day – has called for doctors who qualified abroad to be granted indefinite leave to remain in the UK in recognition of their efforts over the past year.

GPs trained overseas represent around 18% of the 35,500-plus GPs in permanent roles in England – a figure that excludes locums and GP trainees. NHS Digital figures for December 2020 show that 6,458 GPs in permanent NHS roles were trained outside the UK – 1,300 in the European Economic Area (EEA) and 5,158 elsewhere in the world.

The number of overseas-qualified GPs practising in the UK fell from 6,949 in from September 2016 to 6,071 in June 2019 before rising to the current level over the past year. GPonline reported last year that the proportion of NHS GPs trained in the EEA had stabilised after a steady decline since the start of the decade – despite uncertainty around Brexit.

GMC figures show that 55% of doctors who joined the NHS workforce between June 2018 and June 2019 qualified outside the UK. DAUK GP advisory group representative Dr Claire Ashley said these doctors had been ‘invaluable’ in allowing NHS primary care to continue to deliver services in very challenging times.

‘NHS Overseas Workers Day is a recognition of the extraordinary contribution that people who have migrated to the UK and played an integral role in the UK’s fight against COVID-19 have made, including GPs.

Dr Claire Ashley

Pandemic efforts

‘But many of our overseas GPs are on temporary visas. Currently, if an overseas healthcare worker dies due to COVID-19, their families are granted indefinite leave to remain. However, if the worker does not die they are not granted that benefit.

‘These GPs face uncertainty about their fate in this country, but despite this they continue to show up on the NHS frontlines every day, often risking their own health to do so. At DAUK we call for the contribution of all overseas workers who have worked in any capacity during the pandemic to be recognised, and to be granted indefinite leave to remain.’

A spokesperson for the British International Doctors Association (BIDA) said an appreciation of the contribution of overseas-qualified general practitioners was ‘essential to our understanding of the history of British healthcare’.

He said: ‘They made it possible for primary care practice to function and survive – forming the cornerstone of the NHS. The pandemic has been another opportunity to recognise their dedication and selfless love for the NHS highlighted by the tremendous contributions they have made.

He recognised the ‘mammoth task’ all GPs have undertaken in delivering vaccines and adapting services during the pandemic, and added: ‘The history of contributions of the overseas-trained GPs in the NHS should be considered a cause of celebration and the Overseas NHS Workers Day today is the first step to recognise their presence.’

GMC chief executive Charlie Massey argued recently that doctors who had rejoined the NHS workforce in the pandemic must be urged to stay to help the UK cope with a drop in overseas recruitment triggered by COVID-19. His comments follow an 85% drop in the assessment of overseas doctors since March – a slowdown during the pandemic that threatens to limit the flow of international doctors into the NHS.

Read the original article here https://www.gponline.com/thousands-overseas-gps-recognised-extraordinary-contribution-nhs/article/1709182

The Doctors’ Association UK are delighted to see that our lobbying for Indefinite Leave to Remain in the UK for frontline NHS staff has been recognised in Parliament. On the first Overseas NHS Workers Day, MPs Christine Jardine and Claudia Webbe tabled the motion.

That this House supports Overseas NHS Workers Day in recognition of the extraordinary contribution of all foreign nationals working tirelessly in the UK’s fight against Covid-19; applauds the efforts of the Doctors’ Association UK with support from the Royal College of Physicians (RCP), British Association of Physicians of Indian Origin (BAPIO), British International Doctors Association (BIDA), Hospital Consultants and Specialists Association (HCSA), Royal College of Surgeons and Unison for creating this awareness day to celebrate foreign nationals in all their roles within the NHS; notes the almost 200 different nationalities represented within the NHS; further notes that although the NHS is the UK’s biggest employer, there is still not enough staff to meet demand; believes that the most meaningful way to recognise the contributions of foreign nationals and secure staffing capacity is to grant indefinite leave to remain in the UK; and calls on the Government to grant indefinite leave to remain to all foreign nationals currently working in the health and social care sector, and to their families.