Examination of Witnesses (Questions 766-779)
MS LORRAINE
ROGERSON AND
MS JUDITH
MACGREGOR
18 FEBRUARY 2008
Q766 Chairman: Good afternoon. Can I
welcome you to the sixth evidence session of our inquiry into
Modernising Medical Careers. I wonder if I could ask you to give
your name and the position you hold for the record, please.
Ms Macgregor: My name is Judith
Macgregor and I am Director for Migration at the Foreign &
Commonwealth Office.
Ms Rogerson: My name is Lorraine
Rogerson and I am the Director of Policy and Head of Profession
in the Border and Immigration Agency.
Q767 Chairman: Good afternoon and
welcome. I was going to start with Liam Byrne but, given that
he has not been able to get to us this afternoon, Ms Rogerson,
the first question is for you. When did the Home Office become
aware of the Department of Health's policy of making the UK more
self-sufficient for its medical workforce?
Ms Rogerson: The Department of
Health first approached the Home Office in 2005 about using the
Immigration Rules to limit further competition for training posts
from international medical graduates.
Q768 Chairman: So it was 2005?
Ms Rogerson: That was the first
approach. Do you want me to tell you the first change to the Immigration
Rules?
Q769 Chairman: Yes.
Ms Rogerson: We first made a change
which took effect on 3 April 2006 which restricted the provisions
of the postgraduate doctors and dentists category.
Q770 Chairman: I think we will be
asking you a few questions about that as we go along. Given that
the move towards self-sufficiency began in the year 2000, why
has it taken so long to address the number of overseas doctors?
Did it not seem obvious to anybody that the increase in home-grown
doctors would need to coincide with a reduction in overseas doctors
or did you not hear any of this at all until 2005?
Ms Rogerson: As far as I know
we were not approached about this until 2005. Before that we were
still requiring quite a lot of international doctors to fill vacancies
in the Health Service.
Q771 Chairman: You will have seen
the headlines in the media over the last 12 months about whether
or not this situation we are currently in has cut short careers
for graduates here in the UK. Do you think there has been a failure
of the Home Office and the Department of Health and the Treasury
to co-ordinate this type of policy?
Ms Rogerson: We have been reviewing
the impact of the changes of 3 April 2006 and also working with
the Department of Health and other government departments to identify
the best way of addressing this. It was based on joined-up thinking
and a total government approach that we change the rules now.
Q772 Chairman: It is when the thinking
came into being that we are more interested in. It seems it was
a long time the Department of Health was setting goals that you
were not asked to respond to until much later.
Ms Rogerson: We changed the rules
on 3 April 2006. In January 2006 we were writing the command paper
about changing the Immigration Rules and creating the new points-based
system, and at that point we were looking with the Department
of Health at restrictions on the Highly Skilled Migrant Programme
and changing it to the new points-based system. It is that policy
change which we have just done now.
Q773 Chairman: You introduced that
on 6 February, preventing non-EEA doctors from applying for UK
training posts from 2009. The memo that we received states that
you were asked to make this change as early as June 2006. Why
did it take so long?
Ms Rogerson: The Department of
Health is the driver of the policy and there are a number of steps
which they are thinking of taking to address the problem. The
immigration solution is one part of that and we wanted to check
what the evidence was about the change that we made in April 2006
and we were also discussing this with other departments. We wanted
to check how this fitted. The Highly Skilled Migrant Programme,
which was the one which was the concern, is a programme which
is meant to enable non-EEA nationals who want to come here and
who meet a certain level of qualification and skills to have access
to the labour market, and as part of that the principle is that
we would not restrict what they would have access to, and we have
been looking at other ways with the Department of Health at meeting
this concern.
Q774 Chairman: Your submission acknowledges
that the rule change goes against your Home Office policy of attracting
the brightest and the best to the UK.
Ms Rogerson: Yes.
Q775 Chairman: Was this agreed by
the Home Office?
Ms Rogerson: Yes.
Q776 Chairman: Was it ever debated
in Cabinet?
Ms Rogerson: It was. It has been
debated through the Domestic Affairs Committee of the Cabinet.
I think the Department of Health will be able to tell you more
when you see them about the other steps they are taking. We have
made this change which restricts the access by highly skilled
migrants and forthcoming Tier 1 people to have employment in training
places as a short-term step. It is implementing government-wide
policy. It is not quite in step with our overarching principle
of the Highly Skilled Migrant Programme but it meets this need
and seems an appropriate thing to do for a short time while other
more sustainable policies are put in place by the Department of
Health.
Q777 Chairman: I was going to ask
you about that because the Department of Health has described
these provisions as "temporary changes". How long will
they be in force and why would you now reverse them when UK medical
school output is still increasing quite rapidly if you look at
the figures? What is behind this temporary change?
Ms Rogerson: The intention is
that the Department of Health should find and are working on other
methods of making a sustainable change to being self-sufficient
and that it would not necessarily need to be a restriction like
this on an immigration route.
Q778 Chairman: We may pursue that
a bit later this afternoon. Could I finally ask you this? If the
Department of Health's guidance is declared lawful by the House
of Lords will these rule changes become obsolete and, if so, will
they be withdrawn?
Ms Rogerson: We need to review
that at that time.
Q779 Jim Dowd: Before we go any further,
Ms Rogerson, what is a Head of Profession?
Ms Rogerson: I am the Head of
Profession for Policy in the agency.
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