Sajid Javid's 1st week:
NHS crisis made worse by
immigration cap

4 May 2018

As the Home Secretary Sajid Javid completes his first working week in his new job, he will have to decide how best to tackle a set of challenges that he has inherited from his predecessors.

As well as taking over management of the Windrush scandal, there is an ongoing problem in recruitment for the NHS.

Yesterday, Javid received an unprecedented open letter from the BMA, signed by NHS Employers, 12 Royal Colleges and other healthcare professionals.

It warns him that his department’s immigration rules are continuing to have a direct and negative effect on patient care, safety and cost.

Dr Chaand Nagpaul, BMA council chair, states that although many hospitals have found suitable overseas workers who are ready to travel, they are not able to, because of the cap on non-EU workers entering the UK.

Given how long it takes to train domestic clinicians, he says ‘there is and will remain an on-going need to attract staff from outside the UK.’

The problem stems from the distinctions made on the shortage occupation list – those workers given priority to receive a Tier 2 Restricted Certificate of Sponsorship (RCoS) visa. While nurses are counted as a ‘shortage occupation,’ most medical practitioner roles are not.

One NHS  Trust claims that it was forced to pay out £100,000 to use locums, even though they had already found a suitable foreign doctor who could have employed at a lower cost.

The BMA proposes that the Home Office exclude all applications from shortage occupations from the Tier 2 RCoS allocation process.  This would then enable ‘the NHS to employ the doctors and nurses it has attempted to recruit in recent months and who are needed now to manage the patient demand in the system.’

This letter echoes last month’s warning from the NHS, and comes after Tuesday’s report that, despite direct invention from the Health Secretary and the then-Home Secretary, Theresa May ‘refused to budge‘ on the restrictions, and would not permit 100 Indian doctors to come to work in the UK.

But if the old Home Secretary failed to persuade the Prime Minister to relax the monthly immigration limit, how will the new one be able to? And should he succeed, what would be the implication for businesses? Should the rules be relaxed for them too, to allow them to employ skilled migrant labour?

We should know soon enough. Today (Friday 4 May) is the deadline for applications for a Tier 2 RCos visa. At the allocation meeting on May 11, it is likely to be announced that, for the sixth month in a row, demand for visas exceeds supply.

While there are at present 100,000 unfilled NHS posts, the number of RCos available for May is only 1,975.

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