The hidden cost of immigration barriers for IMGs will be patient care, warns BMA

by BMA media team

Press release from the BMA

Location: UK
Last reviewed: 25 February 2022

The BMA has written to the Home Secretary1 calling for the government to recognise the significant contribution that international doctors (IMGs) have and continue to make within the NHS, by granting them and their dependents automatic indefinite leave to remain (ILR) without charge.

To ensure the widely acknowledged NHS workforce crisis and ever-growing NHS backlogs are not further exacerbated, the BMA is calling for the government to remove financial and bureaucratic barriers experienced by IMG doctors currently in the UK who continue to contribute their expertise and skills to the UK’s health service. The Covid-19 pandemic has further highlighted how crucial the NHS’ international medical workforce is in the delivery of patient care. As such, the UK government has made some immigration concessions for IMGs - such as granting the dependents of IMGs who died due to Covid-19 automatic ILR - but the Association believes that these concessions do not go far enough.

The BMA wrote to the Prime Minister in July 20202 and has raised these concerns with government on numerous occasions over the past two years, but no action has yet been taken to address the issue.

Dr Chaand Nagpaul, BMA chair of council, said: “If the Covid-19 pandemic has taught us anything it is just how vital the NHS and its workforce is. Official vacancy data – which we know is an underestimate – shows that there are over 8,000 medical vacancies in England’s hospitals alone3, and BMA estimates show that England is around 50,000 doctors short in comparison with our most comparable EU neighbours4. International doctors (IMGs) make up around 29% of the NHS workforce2, so charging experienced IMGs £2,389 – as well as £2,389 for each of their dependents – for the application process on top of expensive visa fees leading up to that point is a punitive penalty for a workforce that the NHS simply cannot function without. If the government fail to act to reward experienced international doctors, then we risk worsening the current workforce pressures and backlog of care facing the NHS. In turn, the hidden cost of immigration barriers will inevitably be patient care.

“Granting IMGs, and their dependents, currently in the UK indefinite leave without charge would not only recognise their invaluable and selfless commitment to fighting Covid-19 in the UK but would also ensure that these doctors are able to continue to contribute their invaluable expertise to the NHS without the added concern of immigration status. We know from our members that the financial and mental burden of the immigration process is constant and huge. This is not something that doctors should have to worry about while caring for patients on the frontline.

“Other countries have taken steps to recognise and support their international workers’ contributions during the pandemic. Removing the financial and bureaucratic barriers in place for IMGs isn’t a huge ask or a difficult decision for the government to make but rather a vital one that must be taken to protect the health service and the lives of millions across the UK.”

Dr Lisa Rampersad, clinical fellow in surgery from Trinidad and Tobago, said: “Getting indefinite leave to remain (IRL) in the UK took nearly seven years, five of which were spent working in the NHS as a junior doctor in training and in 2020, I worked in intensive care. While waiting for my Unmarried Partner Visa, I was unable to contribute my medical skills to the health service and was treated like a criminal every time I came into the UK to sit exams or spend time with my partner. By the time I was granted IRL I had caught Covid-19 twice from work and the first time, in 2020, I genuinely feared for my life and worried I’d never see my parents who, live in Trinidad, again.

“To say ‘the immigration process is mentally and physically taxing’ is an understatement. My partner and I spent years filled with anguish and despair and I got to the point where I was having panic attacks almost daily and could not stop crying. I found myself having to put these feelings aside the best I could because I was caring for patients. The whole ordeal was cripplingly expensive – eye watering visa, application and legal fees form an intended disincentive for anyone wishing to work in the UK.

“Despite my experience, sadly, I know I’m one of the lucky ones as many other colleagues across the health service are still wading through immigration barriers in anguish – dealing with unaffordable costs – all while devoting themselves to the NHS. This is no way to attract or retain a workforce that ultimately the UK needs for its health service to function and to keep patients safe."

Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

  1. BMA letter to Home Office on ‘Granting international doctors currently in the UK automatic ILR’ – February 2022
  2. BMA letter to Prime Minister on ‘Granting international doctors currently in the UK automatic Indefinite Leave to Remain’ – July 2020
  3. NHS medical staffing data analysis
  4. NHS short of 50,000 doctors heading into winter, BMA research finds