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Home Office woes

Coalface tales

James Booth

Tuesday, 08 October 2019

s300_2MS_Home_Office_sign_v2.jpgI was struck, this week, by the story of our colleague, Dr Mu-Chun Chiang. For those who haven’t heard the story, she is a doctor who has lived in the UK since she was nine years old, and was training to be a GP in Liverpool when the Home Office threatened her with deportation. I can’t imagine how it must feel to be told that you have 14 days to leave a life behind, or face imprisonment, the humiliation to be peremptorily told that you cannot work, nor claim benefits, the utter stress and anxiety that this must provoke. Happily, the extensive media coverage that this awful decision has brought has led to a U-turn from the authorities, and she will be staying to complete her training in a country that – at least temporarily – made her feel so unwanted. We can feel lucky that patients in Liverpool have not been deprived of a new GP in the future as a result of this bureaucratic nonsense.

It is a disgrace, however, that this is not an isolated story. Those readers of Pulse might have seen the story of Dr Roy Melamed this week, as well. I’m going to get my conflict of interest in from the start here: Roy works with me, and I was only too happy to write on his behalf to my MP. The entire surgery team was furious at his treatment; he is so very valued by our patients, and he has given 30 years to the NHS, as a hospital doctor, a GP partner, and a sessional colleague. For this service to be met with the suggestion that he had provided insufficient evidence to register for even “pre-settled status” was shocking. Again, this was a case where the influence of our respective MPs managed to get a speedy reversal of the decision; but I also feel ashamed that my country put him through this. I felt similarly ashamed when my Romanian colleague Elena – again, despite having completed hospital and GP training in the UK – had to attend a compulsory interview to assess her English language skills as part of her application for citizenship. This isn’t done for free, and she needed time off work to travel to London for it. Needless to say, Elena speaks English perfectly.

What is especially shaming about this, to my mind, is that without our overseas colleagues, the NHS would have collapsed years ago. Indeed, as long ago as 1961, Lord Cohen of Birkenhead told the House of Lords: “The Health Service would have collapsed if it had not been for the enormous influx from junior doctors from such countries as India and Pakistan.” It’s ironic that the Health Minister who recruited 18,000 doctors from India and Pakistan in 1963 was Enoch Powell, whose own contribution to the immigration debate was so freighted with divisive, dangerous language. This trend continues – only in March, Simon Stevens announced that the number of overseas graduates joining the GMC registrar was exceeding those trained in the UK. The NHS needs this to maintain business-as-usual – as the BMJ pointed out earlier this year, our shortage of medical staff is putting NHS planning at serious risk. I do accept that there is a potential moral argument about the UK taking qualified professionals from their own countries; but we have invited these colleagues here, and they have committed to our service, and deserve our respect.

65,000 NHS staff in England are EU nationals - 5.5% of all staff. Overall, 13.1% of NHS staff say that their nationality is not British. This is something that we all see reflected in our workplaces. In my time in primary care, I have worked, or continue to work, with colleagues from Ireland, Germany, Romania, Nigeria, Poland, India, Malaysia, Burma, Denmark, Pakistan, and Spain. I’ve probably left people off that list, too. That statement from 1961 is as true today as it was nearly 60 years ago, and we can widen it to include doctors, nurses, and other health professionals from every part of the globe. It feels to me that they have given far more to the NHS, and this country, than we can easily repay. A start, however, would be the immigration authorities treating them with dignity and respect. I don’t doubt that there are currently a very large number of people in the position of those doctors mentioned above. It is right that these errors have been rectified; but the proper thing would have been for them to have never happened in the first place. 


Image courtesy of Home Office, Open Government Licence v3.0

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James Booth

James qualified from UCL in 2002 and has been a GP partner in Chelmsford since 2006. He is also the named GP for Safeguarding Children locally. All views expressed are his own.
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