The UK government must urgently streamline post-Brexit visa bureaucracy for overseas general practitioners seeking to work in the UK, to help address a chronic shortage of doctors, medical leaders have warned.
Since Brexit ended free movement of labour with the EU, the UK has relied on more non-EU foreign doctors. As a result 48 per cent of all current trainee GPs require visas, according to data from the British Medical Association.
Under current rules, individual GP practices must pay a fee of up to £1,500 to become a licensed sponsor of skilled migrant workers needing visas — a process that doctors’ groups said was more of a bureaucratic burden than a financial one.
Dr Kieran Sharrock, of the BMA’s England GP committee, said the country’s general medical practices had lost the equivalent of more than 1,900 full-time fully qualified GPs since 2015 and the government urgently needed to make it easier for foreign doctors to remain in the UK after they had completed their training.
“With around half of GPs in England subject to these visa restrictions, it’s potentially a huge waste — of skills, time and money — if these doctors are then forced to leave general practice or the NHS because of a problem that is so easily solvable.”
Newly qualified GPs from overseas face a unique bureaucratic hurdle because they are required to obtain a two-year “Tier 2” skilled worker visa after their three-year training visa expires, putting additional burdens on GP practices. The issue does not arise for other medical specialities, which take at least five years, after which all newly qualified doctors can apply for permanent status.
Immigration minister Robert Jenrick said in November that the government would consider whether an “umbrella organisation” could be created to simplify the visa registration process and remove the burden from individual GP practices, but no changes have been agreed.
Sharrock said a solution was urgently needed as GPs faced the backlog of patients requiring treatment after the Covid-19 pandemic.
“Back in November the immigration minister said that he was going to fix this by seriously looking at sponsorship by an umbrella body and removing the bureaucratic burden for individual practices at a time when their focus must be on treating patients.”
He added: “The government needs to make good on this and resolve it immediately, so we don’t haemorrhage more skilled GPs when patients need them most.”
The Royal College of GPs, which represents a network of 54,000 general practitioners, is also calling for the government to fix the visa problem.
In an open letter to home secretary Suella Braverman last October signed by more than 4,000 GPs, the Royal College called the system “nonsensical” and called for a “national solution” to avoid putting off more internationally qualified doctors from working in the UK.
Kamila Hawthorne, chair of the Royal College, welcomed the government’s openness to the creation of an umbrella organisation for trainee GP visas and expressed hope that steps would be taken soon to bring it to fruition.
“Addressing these bureaucratic barriers is vital so that GP trainees from overseas can join the GP workforce easily, providing much-needed care to patients, and help to alleviate intense workforce shortages in general practice,” she said.
A survey by the Royal College last year found that about 30 per cent of international trainees had considered not working as a GP in the NHS because of difficulties with the visa process.
Kim Vowden, a partner at law firm Kingsley Napley, which specialises in immigration cases, said the visa regime was complex for small entities such as a GP practice, and it was a burden for them to keep up with policy updates and processes.
“Getting a sponsor licence is usually straightforward but operating it properly and complying with the duties which come with it can be hard for businesses which are trying to do it by themselves,” he said.
Private healthcare has also been affected by the rules. Dr Shaima Villait, chair of the Independent Doctors Federation, said the cost and bureaucracy around recruitment was a particular challenge for smaller independent practices as the private sector took on more work while the NHS grappled with pandemic-induced backlogs.
She added that the difficulties had only been compounded by Brexit. “We had a lot of people from Europe who were working within the medical sector and within the private sector and a lot of people have left.”
The Department for Health and Social Care said it recognised the importance of overseas doctors in growing the GP workforce. “We are working with the Home Office to increase the number of GP practices registered as Home Office sponsors,” a spokesperson added.