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Overseas doctors’ victory in House of Lords

Medics trained outside the EU can still apply for junior doctor posts

Lisa Hitchen

Thursday, 01 May 2008

International doctors working in the NHS can continue to compete for junior doctors' posts after the House of Lords overturned rules to restrict them.

The Home Office and Department of Health wanted to prioritise UK-trained graduates over those who trained outside the European Union.

This represents a turnaround in government planning from the late 1990s, when Labour actively recruited overseas doctors through the international medical graduates and highly-skilled migrant programmes (HSMP).

Last year the Court of Appeal ruled in favour of the case brought by the British Association of Physicians of Indian Origin (BAPIO) that guidelines issued by the Department of Health to restrict non-EU doctors already in the UK from applying for training posts in the NHS were illegal.

The High Court had already ruled that the Home Office had failed to conduct a Race Equality Impact Assessment, needed under race relations laws.

The government then directly appealed to the House of Lords and the appeal was heard in February.

Yesterday the law lords rejected the appeal, ruling four to one that the Government guidance was unlawful. Lord Mance said: "It was informal and unsatisfactory in the way in which it was given."

Lord Rodger of Earlsferry commented: "It was unfair to the international medical graduates with HSMP status in this country because the government thereby dashed the legitimate expectations which it had fostered and on which they had acted. The advice was accordingly unlawful."

Commenting on the decision, Dr Satheesh Mathew, vice chairman for operations for BAPIO said: "This will provide much needed relief to thousands of doctors who have been through unimaginable stress."

But Dr Raman Lakshman, its vice chairman on policy pointed out:  "At this moment of victory we cannot forget those whom we could not help; those who had come to the UK to avail of permit free training but had that opportunity abruptly withdrawn, thus being put into such hardship that some ended their lives."

A Department of Health spokesperson commented: "We are disappointed that the Lords have ruled that our guidance as it stood was unlawful."

The DoH is involved in consultation on the matter, he added, which ends on May 6, after which it would consider what to do next.

"It can cost up to £250,000 to train a UK medical student and, with the increase in UK medical schools, we are now pursuing a policy of self-sufficiency. Doctors from outside Europe have made and continue to make a huge contribution to the NHS. The issue is not about whether international medical graduates can continue to work as NHS doctors but whether the taxpayer should be investing in training them instead of UK medical graduates."

BAPIO will now attempt to work in partnership with the two government departments on better processes for recruitment of overseas doctors for the NHS.

The BMA backed the law lords ruling but criticised the current recruitment processes.

Dr Terry John, chairman of the BMA’s international committee said: "Junior doctors from the UK and overseas alike have been affected by the lack of proper workforce planning in the NHS. We need long-term solutions not knee-jerk reactions."

Read the views of R Lakshman and A Sajayan of BAPIO:
OnMedica Views: What ever happened to British fair play?

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