To ask Her Majesty’s Government what plans they have to review the Tier 2 visa system to ensure that overseas doctors recruited by the National Health Service are able to take up their positions.

I beg leave to ask the Question standing in my name on the Order Paper, and remind the House of my interest as a member of the General Medical Council.

My Lords, the Government are committed to keeping the operation of the immigration system under review to ensure that it operates in the national interest. As my Right Honourable Friend the Home Secretary has indicated, we are looking urgently at this issue.

I thank the Minister for that reply, but I have to say that I am disappointed. Although the word “urgency” was used, we have not seen a great deal of urgency in action. Does he not agree that it is ludicrous and, frankly, shameful that patient care in this country is being compromised every day by the shortage of doctors and yet, every day, doctors from overseas recruited to positions in the NHS are being turned away and refused visas by the Home Office?

Yesterday, we learned that 2,360 such doctors have been refused visas. We learned that through a Freedom of Information request, not in response to my Question four weeks ago, when the Minister at the Dispatch Box did not give me the numbers. That is in the past six months. Is it not time that the Government took urgent action and ended this damaging and dogmatic policy?

My Lords, the noble Baroness is quite right: this issue needs to be looked at seriously. That is why my Right Honourable friends the Home Secretary and the Prime Minister have been discussing it. As I said, progress will be made in the very near future.

My Lords, given that we are tens of thousands of doctors short, will the Minister explain to the House and, through this House to the British people, why the Government are prepared to put the British people’s health at risk by refusing thousands upon thousands of doctors who have been recruited the right to come into this country?

My Lords, as the noble Lord will be aware, we have made it a priority to increase doctor numbers in this country. A record number of undergraduates will begin medical training by 2020, with 1,500 new funded places and five new medical schools—

Oh!

Noble Lords may jest, but this is a very serious matter. The fact is that where the Migration Advisory Committee has recognised that there has been a shortage in the UK, visas are given priority on the SOL, and no one in these specialisms has been refused a visa.

My Lords, while adding child and adolescent psychiatrists to the shortage occupation list, as the Government have done with the other health specialties, does my noble friend agree that any removal of the tier 2 visa cap should apply to all health professionals in both physical and mental health specialisms, in accordance with the principle of parity of esteem?

My Lords, my noble friend mentions mental health issues, and as she will be aware, Her Majesty’s Government have published a green paper setting out proposals to transform mental health provision for children. As for shortages, these factors are taken into account when different specialist areas are put on the shortage occupation list.

My Lords, is it not true that the current situation is quite deliberate? The Conservative Party manifesto last year promised to double the cost of employing someone from outside the EEA. The head of business immigration at law firm Kingsley Napley believes that the cost of employing much-needed staff from other parts of the world will be £14,174 a year more than employing EU staff. So, as EU staff leave the NHS in the face of Brexit, how will the Government’s proposals help NHS budgets, even if it can get visas for the staff it desperately needs?

My Lords, I do not recognise the noble Baroness’s figures but as she and the House will be aware, the quotas have been exceeded and a large increase in the number of doctors from outside the EEA have been applying to come to this country. These are highly qualified doctors who do an excellent job.

My Lords, why will the Government not urgently announce that where there are job shortages, such applicants will be exempt from this rule? To stall repeatedly on this issue is a serious error of judgment and directly damages patient care. How does the noble Earl reconcile that position with working in the national interest, as he said in his first response to the Question?

My Lords, the noble Lord accuses Her Majesty’s Government of stalling on this issue; we are not stalling. It is being taken extremely seriously, as I said, by my Right Honourable friends the Home Secretary and the Prime Minister, and we will hear news on it shortly.

My Lords, can we first agree that the doctors coming out of the new medical schools that are planned will not be available for service for at least eight to 10 years? Having accepted that, can we find a solution to the visa cap that has been put on doctors? One solution might be to include them in the same category as those who do not qualify for the cap—those earning more than £159,600. That would not in any way jeopardise the Conservative manifesto or other plans. It would just shift a category and therefore remove them from the cap.

My Lords, we are looking at all issues relating to this at the moment. The noble Lord says that the qualifying period is seven to eight years before new doctors are fully qualified. However, I should add that graduate entry medical students—I declare an interest as my daughter has just qualified—qualify in four years. The daughter of a noble Lord opposite is on the same course, but as he is not in his place I shall not mention his name.

My Lords, does my noble friend agree that a proper procedure should be in place to ensure that such doctors have the same qualifications as those EU doctors? They should be properly qualified, have a full knowledge of and proficiency in English and be registered to practise medicine in the country from which they come.

My Lords, the doctors applying, particularly those from the Indian continent, are some of the best qualified who operate in this country. There is an exceedingly high bar for employment, and all have to meet standards on the English language.

My Lords, there is an aspect to this issue that has not been properly debated and discussed. There is no difficulty in hiring medical professionals from other EU countries, but will the Government be very cautious and careful in trying to recruit medical professionals from third-world countries—poor countries that often have very few doctors and nurses per thousand, or per million, of population? It is the most appalling act of selfishness to deprive those countries of their scarce medical resources.

The noble Lord is quite right. It is appropriate to take doctors only from countries that have their own very effective medical systems. To take them from third-world and developing countries is not acceptable.