Chronic staff shortages, long delays, lack of cancer treatments – An NHS in crisis?

Patients waiting too long for routine appointments, delays in cancer treatment, A&E waiting times through the roof, a serious lack of healthcare professionals across the board. The system is obviously at breaking point. So what can be done to fix our ailing NHS? Mandie Sewa, Head of Immigration at Brevis Law shares her thoughts.

The Government’s long-term solution

Ministers say the ‘Workforce Strategy for England’ will be published shortly to tackle long-term issues within the NHS. But the document has already been delayed several times and there is still no definitive date for its arrival. When it does appear, it will apparently seek to remedy staffing gaps over the next 15 years. This is a significant period of time though, so how impactful – and valuable right now, when we really need it – will any outputs be? Particularly as future changes in government will inevitably mean even more, vast policy changes.

The Government’s solution for this year

The ‘Delivery Plan for Recovering Access to Primary Care’ was recently updated. This is an ambitious plan for short term fixes that (apparently!) aims to:

  • Empower patients
  • Implement modern GP access
  • Build capacity
  • Cut bureaucracy

But, despite the bold claims, the plan doesn’t actually address the current acute shortage of medical professionals in the NHS. It does outline the need for more GPs. But the staffing crisis affecting the NHS so acutely at the moment isn’t just about the lack of GPs. It is root and branch across every service and at every level.

But while addressing the GP shortage on its own, the plan does recognise:

  • Over 50% of trainee GPs are International Medical Graduates (IMGs)
  • IMGS are critical to the NHS
  • IMGs are ‘typically not eligible for ILR (Indefinite Leave to Remain in the UK – settlement) when they qualify and must be employed by a practice with a visa sponsorship licence’ to work in the UK. A sponsorship licence is Home Office authorisation for an organisation to employ overseas workers.
  • NHS England will look to increase the number of GP surgeries with a sponsor licence.

But this approach fails to acknowledge that IMGs will have spent 4-6 years at medical school overseas. Then usually a 2-year foundation and 3 years’ GP training in the UK. This makes 5 years working in the UK, which is the same requirement for other skilled workers to get ILR.

So many IMGs may already be eligible for Indefinite Leave to Remain using as their Health & Care visa, providing any extensions are made in time?

Forcing GP surgeries to apply for sponsor licences is time consuming, bureaucratic and costly. The government could more easily make simple changes to the Immigration Rules to achieve the same ends. They could, for example, lower the amount of years needed to get ILR for healthcare workers – across the board, not just for GPs. This would be a sensible and much-needed solution at a time when the NHS is on its knees and overseas employees are so obviously fundamental to its future.

Why won’t they make these changes?

There are many reasons why this is unlikely to be adopted. But money is sadly at the top of my list of probable causes! With fees to obtain a sponsor licence and employ even one overseas worker for three years standing at almost £4,000 (at the time of writing), this could be quite the cash cow for the Government. Particularly when you consider the number of sponsor licences required to fill the gaping hole in the system.

Mandie Sewa / Head of Immigration / Brevis Law

If you are an overseas healthcare worker or an organisation facing issues employing overseas nationals into the healthcare sector please contact us to discuss if we can help. Alternatively, you can contact Mandie directly via an initial consultation.



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