Call to review rules on dependent relatives

by Tim Tonkin

MPs have called for the Government to review its policies on ADR (adult dependent relatives), warning that restrictive immigration rules are negatively affecting doctors and the NHS.

Location: International
Published: Thursday 4 November 2021

Home Office ministers should re-evaluate their policies and processes around granting visas to the older relatives of international doctors working in the UK, or else risk the possibility of hundreds of skilled overseas medical staff leaving the health service, a parliamentary debate heard yesterday.

The debate, which was brought about by Labour MP for East Ham Stephen Timms, saw MPs question the Government’s decision in 2012 to adopt a ‘hostile environment’ approach to immigration rules, a change that has made it far harder for overseas doctors working in the NHS to bring older and infirm relatives to live with them in the UK.


Citing evidence provided by the BMA, Mr Timms warned Parliamentary under secretary of state Rachel Maclean that restricting and impeding overseas doctors’ ability to obtain visas for their relatives was causing considerable stress and anxiety for many.

He added that, with the NHS already facing a crisis in staffing shortages, the Government should be ‘bending over backwards’ to support and retain highly skilled and desperately needed international staff.

He said: ‘Over the past two years, we have all been reminded just how important the national health service is. I know I speak for all of us when I say how grateful we are for the extraordinary efforts of doctors, nurses and other NHS staff to protect and care for all of us throughout the pandemic.

‘They should be rewarded for their hard work and dedication. Instead, many are being punished with these hostile immigration policies.

‘Having invested so much in their training, we need to keep those experts here, not force them to leave the country. There are more than 96,000 non-UK graduates on the GMC register. The evidence of the potential loss to the NHS if these restrictions stay in place is enormous.’


The BMA, along with other organisations such as BAPIO (the British Association of Physicians of Indian Origin), APPNE (Association of Pakistani Physicians of Northern Europe), have campaigned for rules on ADR to be relaxed.

At the association’s annual representative meeting earlier this year, the BMA endorsed calls to simplify visa procedures concerning dependent relatives, with the association and its partners having continued to lobby the Government to this end.

Meanwhile a survey of almost 1,000 doctors carried out by BAPIO and APPNE found that 91 per cent of respondents unable to obtain visas for family members said they had been left feeling ‘anxious, frustrated and helpless’ as a result, with 85 per cent warning the experience had made them consider leaving the UK.

Doctor retention

Mr Timms warned the debate that with just 70 ADR visas having been issued by the Home Office last year, an urgent review of immigration rules was needed if the Government was to avoid a potential future exodus of overseas doctors from the health service.

He said: ‘The BMA has consistently raised concerns about the potential impact on patient care and on the wider NHS if doctors have to move because of these rules.

‘Ministers do not seem to take much notice of the urgent concerns of those working on the front line of our health service, but it is time to start taking notice before serious harm is inflicted on the NHS.

‘Doctors must not be kept waiting any longer. There is no justification for forcing committed, dedicated NHS doctors to choose between their work and their home in the UK, and their deeply felt duty to their elderly parents to support and care for them in difficulty and old age.’

Responding to these warnings Ms Maclean said there was no evidence show that ‘significant numbers’ of doctors and other medical professionals had left the UK as a result of the rules on ADR.

She added the NHS had ‘made significant savings since the rules were introduced’ but conceded the policy would be kept under review.