Examination of Witnesses (Questions 780-799)
MS LORRAINE
ROGERSON AND
MS JUDITH
MACGREGOR
18 FEBRUARY 2008
Q780 Jim Dowd: Yes, I heard you say
that before. I do not know what a Head of Profession is.
Ms Rogerson: I take care of the
policy skills and ensuring that we are developing policy in line
with good standards.
Q781 Jim Dowd: Assuming that the
House of Lords does not uphold the department's guidance, will
the Home Office come under pressure to make further restrictions
through the Immigration Rules?
Ms Rogerson: We will have to look
at that at the time. No further suggestions have been made about
further changes we might need to make.
Q782 Jim Dowd: So you are making
no preparation for an adverse decision at all?
Ms Rogerson: The current restriction
is meant to have the same effect regardless of the House of Lords
decision. We have made a restriction so that people coming in
under the Highly Skilled Migrant Programme will no longer be allowed
to have access to these training places. That is the short-term
solution. There has been no suggestion that we need to make any
further change.
Q783 Jim Dowd: You are saying that
the House of Lords decision will not affect that one way or the
other?
Ms Rogerson: If the House of Lords
upheld the guidance then we would not need to have a restriction
in the Immigration Rules.
Q784 Jim Dowd: And if they do not
you do not need any other arrangement?
Ms Rogerson: No. At the moment
the suggestion is that this change to the Immigration Rules that
we have made would be enough in the short-term to relieve the
pressure on the places.
Q785 Jim Dowd: The Appeal Court ruled
in November that the department's guidance was unlawful as it
did not have the authority of Parliament. Why did you not just
take the opportunity when amending the Immigration Rules to enforce
the department's guidance by law?
Ms Rogerson: The Department of
Health guidance?
Q786 Jim Dowd: Yes.
Ms Rogerson: I am not sure that
we are able to do that. What we are able to do in the Immigration
Rules is give effect to the Secretary of State's decision about
the purposes for which people might be able to come here and the
conditions and restrictions that might be placed on them when
they are here, and that is what we have done in these rules.
Q787 Jim Dowd: Do you know whether
the department have asked you to do this?
Ms Rogerson: I believe that what
we are doing is in line with what the department have asked us
to do, which is to make any immigration changes a short-term contribution
to the solution but it does not affect the Department of Health
guidance.
Q788 Jim Dowd: This question again
was originally meant to be directed to the minister so if your
reply is somewhat more guarded I fully understand. Is the Home
Office frustrated by the Department of Health throwing a spanner
in the works of your attempt to introduce a fairer and simpler
immigration system?
Ms Rogerson: One of the Border
and Immigration Agency's jobs is to manage migration in the interests
of the UK and the changes we have made are about short-term immigration
restrictions to meet a government objective agreed by the whole
of government.
Q789 Jim Dowd: Is that why you only
agreed a temporary exemption for doctors?
Ms Rogerson: Because the Department
of Health has a whole range of packages of things that they can
do and they are working on a more sustainable solution, it was
intended that this would be a short-term contribution rather than
the whole answer. Immigration control can only play a part in
meeting Department of Health Workforce objectives.
Dr Taylor: I am very sorry the minister
is not here and you are having to bear our attacks.
Jim Dowd: No—inquiries, Richard,
not attacks.
Q790 Dr Taylor: This seems to me
to be about the best or the worst example of unjoined-up thinking
across four government departments that we have ever come across
because we have got the Department of Health, the Treasury, the
Foreign & Commonwealth Office and the Home Office. You have
told us that the Department of Health was the driver and that
there was a Domestic Affairs Committee. My question is really
to Judith. Was your department represented on the Domestic Affairs
Committee, because the very full and very helpful paper that you
have given us suggests that really your involvement was pretty
limited. Is that fair?
Ms Macgregor: We certainly were
involved in the DA Committee, absolutely. Yes, I suppose, if you
like, we are neither the drivers of health policy nor the drivers
of immigration policy, so our involvement in this had been primarily
to put in the foreign policy implications of any particular course
of action and help steer the discussion in that way, so limited
in that sense but very full nevertheless, I can assure you, within
that.
Q791 Dr Taylor: So with the new immigration
restrictions have they taken your advice into account?
Ms Macgregor: I think that our
concern, as Lorraine has said, was that an immigration restriction
can be only one part of a broader policy, so to the extent that
we have a situation where an immediate challenge has been assuaged
by recourse to the immigration system while other more sustainable
policies are sought, I think we would say that this was something
which was in the national interest to do. I think also the way
in which the restrictions have been brought in, which is essentially
to be prospective so that people coming to apply for the scheme
know the score before they apply, is very important. I think governments
do understand that other governments have to regulate their workforce
supply but clearly the aim of the immigration system is to be
as clear as possible about what that is going to be and how it
will affect individuals at the time when they apply, and so in
that respect, yes, I think our arguments were taken into the discussion
and were respected.
Q792 Dr Taylor: You say in your paper
that you recognise the tension between the desire for self-sufficiency
and the supply of doctors and an open-door policy. Is there a
compromise? Do you think this is an acceptable compromise?
Ms Macgregor: Compromise is never
a finite thing; I think it is dynamic, and I think compromise
is perhaps necessarily imperfect, but if we can achieve through
this a better understanding of longer term, more sustainable solutions,
and this will in the immediate term obviously prevent a very serious
displacement of UK-trained doctors, then I think it has the merits
of that. Obviously, we will look to see how the situation develops.
The points based system which is being introduced is an innovative
system. We will see how that also goes through and how that works
out. Our concern was that it should be as clear as possible at
the time of its introduction, which I think in this way now we
have perhaps achieved: it is clear what it will cover and what
it will not cover.
Q793 Dr Taylor: I think you suggested
that it makes doctors an exception and sets an unwelcome precedent.
Ms Macgregor: We were concerned
that, if you like, a permanent restriction at the time of something
beginning would in itself not be a very good signal. I think something
which is inherently stated not to be a permanent solution and
is something which can be looked at again meets those conflicting
requirements.
Q794 Dr Taylor: It is well known
that we owe an awful lot over many years to lots of doctors from
India. Do you think the new regulations will damage the relationship
with India?
Ms Macgregor: It will be something
that we will continue to handle very carefully and very sensitively.
Again, I think that governments, including governments like the
government of India, will understand and respect that we have
to regulate our workforce and our labour supply. The important
thing is to be clear and to be timely and not to affect and disadvantage
people who have come in in good faith under another system.
Q795 Dr Taylor: So those who are
already here, halfway through their training, are going to be
saved, are they?
Ms Macgregor: Our understanding
is that they are not prevented, that is right, from applying for
these speciality training courses.
Q796 Chairman: Have the Foreign Office
had discussions, to your knowledge, with the Indian government
about these changes?
Ms Macgregor: About these specific
changes?
Q797 Chairman: Yes.
Ms Macgregor: When Liam Byrne
was in India two weeks ago he did mention that this was likely
to happen, yes.
Q798 Chairman: And the outcome of
it is not known at this stage, presumably?
Ms Macgregor: To be fair, he also
mentioned it publicly because he was in India at the time of the
changes being announced, so he also, of course, made that public
at the time.
Q799 Chairman: Do you feel, when
we have recruited from the Indian sub-continent in particular
something like 25%-30% of doctors coming into the National Health
system over many years, that these types of changes are acceptable
or unacceptable?
Ms Macgregor: I think it is incumbent
upon everybody to take it very seriously and to look very closely
at what can be done, as I say, to be both in good faith but also
nevertheless over a period of time make clear what the policy
of the Government is. As you have said, the policy of self-sufficiency
has been one which has been coming through and I think in discussions
we have made that clear. If you like, our role has been to interpret
to both sides that there is this policy of self-sufficiency and
that it will obviously have knock-on effects, but at the same
to bring into the domestic debate precisely the fact that we have
had very good service over many years from Indian doctors and
nurses and it is only fair to ensure that the greatest clarity
is given to them and the situation has to change.
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