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”.

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“As opposed to [the first wave] where we were described as heroes, now we receive messages that say we are lying… it’s really painful. There are no words to explain what we see on a daily basis… When you hear these conspiracy theories, it just breaks your heart.”

“Right now, we are all on autopilot. We don’t have enough time to express grief. Maybe when the storm has passed, that’s when we’ll find out how much it is has affected all of us.”

“30% of NHS doctors were born overseas. A good proportion of these people have their families living in different continents. Not being able to visit their family, yet working day in, day out for the NHS… there is no better portrayal of loyalty than this.”

Dr Pushpo Babul Hossain, DAUK

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Unison has called on the government to stop forcing out key workers in the health and care sectors and to stop barring potential new ones from coming to work here.

Along with key workers forced to return to their home countries, many who are still in the UK are struggling to renew their visas due to delays and prohibitive costs and have become overstayers as a result, something which can further hamper their ability to renew their visas.

Unison says that the policy is having a serious impact during the second wave of the pandemic and at a time when there are 122,000 vacancies in the health and care sectors in England.

Doctors Association UK has called for indefinite leave to remain for migrant healthcare workers and raised concerns about visa processing delays.

It has drafted a letter, signed by 1,660 doctors and other healthcare workers protesting about the treatment of the Egyptian consultant cardiologist Dr Basem Enany, who became critically ill from Covid complications. Before he fell sick he had treated many patients at York hospital but he and his family fear for their future in the UK because the Home Office has not yet confirmed what will happen to them after Enany’s visa expires next month.

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“We have trained doctors in this country who are ready and willing to help combat the pandemic but unable to work due to the Home Office not doing its job and supplying appropriate documentation,” he continued.

“Meanwhile promises made by the prime minister and the cabinet regarding refunding the immigration health surcharge to NHS staff continue to remain unfulfilled. How can the NHS attract the best and brightest to the UK if the world sees a government unable to fulfil straightforward promises?

“Unfortunately, the immigration rhetoric and policies of the recent past has led to many of our valued colleagues feeling crestfallen, unappreciated, and exploited. This country must reward those that come to its aid in its time of greatest need.”

Qualified doctors in the UK are being blocked from working due to Home Office delays, at a time when the NHS is under increasing pressure due to surging numbers of coronavirus cases.

Home secretary Priti Patel has been urged to act after it emerged delays in issuing Biometric Residence Permits (BRP), which prove a visa holder’s right to work in the UK, are preventing frontline doctors from working in hospitals to combat the pandemic.

In one case, a respiratory specialist doctor with an approved visa who is currently in Leicester, a city hit particularly hard by Covid-19, is unable to start work due to an ongoing delay providing him with a BRP.

Despite multiple contacts by email and telephone as well as intervention by his MP, Dr Ahmad Ussaid is unable to start work, depriving him of an income and the NHS of a skilled doctor when the health service is being increasingly stretched.  

Boris Johnson removed the NHS migrant surcharge – a £624-a-year fee which is levied on most UK via applications – for health and care workers in May after he came under intense pressure over the “immorality” of the policy. Staff were told they could apply for reimbursements of the charge backdated to March 2020.

However, seven months later, many doctors are still waiting for their refunds and have been given no clear reason for the delay, while others have been refused as they have paid from bank accounts from their country of origin which have been closed on arrival to the UK, according to DAUK. 

A letter to Ms Patel from Doctors’ Association UK (DAUK) on Wednesday stated that delays in providing BRPs were preventing frontline doctors from working in NHS hospitals to combat the pandemic due to a “bureaucratic hindrance”, depriving the health service of skilled doctors “when the country needs them most”.

It called for a fast-track system to be introduced to ensure BRPs are issued without delay for all approved visas for international medical graduates, to make sure the NHS has the “highest number of trained personnel on the frontline during the escalating pandemic”. 

The letter also raises concern about delays in refunding the immigration health surcharge, which DAUK said “smacked of reluctance” to implement the government pledge.

“It is known that Bame NHS staff are at increased risk of dying from Covid-19 yet they are still stepping up to treat the sick during this time of emergency,” states the letter.

“If these staff members are willing to step forward and help the nation, the nation must respond in kind. Failure to do so is simply not in keeping with accepted British values.”

Dr Dolin Bhagawati, a neurosurgeon working in London and editorial lead for DAUK, said the “prolonged” and ongoing bureaucratic delays were “simply unconscionable”.

“We have trained doctors in this country who are ready and willing to help combat the pandemic but unable to work due to the Home Office not doing its job and supplying appropriate documentation,” he continued.

“Meanwhile promises made by the prime minister and the cabinet regarding refunding the immigration health surcharge to NHS staff continue to remain unfulfilled. How can the NHS attract the best and brightest to the UK if the world sees a government unable to fulfil straightforward promises?

“Unfortunately, the immigration rhetoric and policies of the recent past has led to many of our valued colleagues feeling crestfallen, unappreciated, and exploited. This country must reward those that come to its aid in its time of greatest need.”

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