Examination of Witnesses (Questions 800-819)
MS LORRAINE
ROGERSON AND
MS JUDITH
MACGREGOR
18 FEBRUARY 2008
Q800 Mr Bone: I think you said in
your answer that the Indian government would understand. If I
were the Indian government I would not understand. I would see
all these people from the European Union being let in all of a
sudden and yet people from India, who have been doing a wonderful
job for years, we are suddenly stopping. Do you think the Indian
government really understands? I would be a bit miffed, I think.
Ms Macgregor: I cannot answer
for what the Indian government does or does not think.
Q801 Mr Bone: I think you said earlier
on in your answer that the Indian government would understand.
Ms Macgregor: I think they would
understand that each government has the right and the ability
to regulate its own labour supply. This particular restriction,
of course, does not stop Indian doctors from coming and working
in a wider range of posts inside the National Health Service,
nor other medical care people. It is very targeted at these speciality
training posts. To that extent it is not seen as closing a door
entirely and, obviously, were that the case there would be greater
unhappiness.
Q802 Dr Taylor: "A wider range
of posts"—how would they get in if they do not get
in into these training posts?
Ms Macgregor: My understanding
is that they could come to study in the United Kingdom in the
medical profession. They could presumably come in also in some
consultancy or ancillary way. It is access through this particular
competition to the speciality training posts in my understanding
that this restriction applies.
Q803 Dr Taylor: But is not the only
reason they want to come to get the speciality training?
Ms Macgregor: I am sure a number
are wanting to do that because that is why there has been a large
number of applicants, but I think it is also the case that people
are coming under other streams of activity.
Q804 Dr Naysmith: I would like to
follow up one or two of these matters with Judith. You have said
that the Immigration Rules changing should be temporary; that
is the favoured solution, and that the department's guidance is
the preferred way of restricting non-EEA doctors. Why is the use
of guidance preferable to any other system?
Ms Macgregor: There are two reasons.
One was because, as we have said in the evidence, of the introduction
of the new points-based system and Tier 1 in particular is, if
you like, fairly untrammelled. You do not need to have a contract
before you arrive. It is based on your qualifications and your
background, and the feeling was that to, as it were, stop a particular
category of people ran counter to the principle of that, which
is that you are qualified in your profession and you are free
to come and look for work in the United Kingdom. The guidance
also, as I understand it, was guidance literally to the recruiting
people that they should give preference to candidates from a UK
training background but not exclusively, therefore, when other
candidates could be found. The Immigration Rules therefore, if
you like, cut off at source people coming in whereas the guidance
gave more discretion, and I think that was our preference, therefore,
but that was something we fed into the debate at an earlier stage,
obviously.
Q805 Dr Naysmith: That is because
it is speciality training that we are talking about; is that right?
Ms Macgregor: I was talking about
speciality training.
Q806 Dr Naysmith: And that is the
thing that makes guidance more applicable than just allowing people
in to take work, no matter how qualified they are?
Ms Macgregor: That is right. In
this context it was the guidance, yes.
Q807 Dr Naysmith: What happens if
the House of Lords does not uphold the department's guidance?
Are you concerned that the changes to the Immigration Rules will
have to be made permanent?
Ms Macgregor: As my colleague
said, I think it is very hard to pre-judge exactly what would
be the Department of Health's decision in that case. It would
be for them to decide, so I think we have to take that one step
at a time. We would hope, obviously, that some solution could
be found that would give a sustainable solution without a permanent
restriction through the points-based system, but that is as yet
to be discovered and taken forward.
Q808 Dr Naysmith: But you must be
thinking about alternatives. When you introduced guidance, for
instance, you must have thought about other ways of achieving
the same result.
Ms Rogerson: At the same time
as we made the rules change the Department of Health issued a
consultation paper which is now consultation about the new guidance
and the way in which this issue might be addressed, but I am not
the person you need to talk to about that. It would need to be
them.
Q809 Dr Naysmith: Can you talk about
it?
Ms Rogerson: No. I think the Department
of Health should talk about that.
Q810 Dr Naysmith: No, no. The Foreign
& Commonwealth Office will have a view on the consultation
that is taking place, will it not?
Ms Macgregor: I think we have
not yet taken a formal view on that, to be fair, and I think we
would really want to see where the consultation lay and the different
expert views and then we would obviously take account of that
in due course. At this stage it really would be very difficult
for us to say that we had a preferred view. We do not.
Q811 Dr Naysmith: Finally, how many
doctors do you predict will come to the United Kingdom from within
the European Economic Area over the next ten years? Do you have
any idea?
Ms Macgregor: Sorry, I do not
with my background have an idea on that, I am afraid.
Q812 Dr Naysmith: And no-one has
mentioned any figures? Presumably when you introduced this policy
you had some idea of what effect it would have on the restrictions.
Ms Rogerson: In terms of the restrictions
in the current rules the Department of Health estimate is that
there will be, through this restriction to the Highly Skilled
Migrant Programme, 3,000 to 5,000 fewer people applying for places.
We do not have any immigration prediction of people coming from
within the EEA.
Q813 Dr Naysmith: But you have not
had any advice from the Foreign & Commonwealth Office? Are
these your predictions or are they in conjunction with the Foreign
& Commonwealth office?
Ms Rogerson: We do not have any
predictions.
Q814 Dr Naysmith: So where did this
figure come from?
Ms Rogerson: The Department of
Health estimate.
Q815 Dr Naysmith: That is what I
am saying. That is a prediction, is it not?
Ms Rogerson: No. Their estimate
is that in 2009, just in 2009, the impact of this rules change
would be that there would be 3,000 to 5,000 fewer.
Q816 Mr Bone: I am sorry the Minister
is not here and that you are having to bat on a sticky wicket,
but if you do not know the number coming from the European Union
how can you match the supply? Somebody must have that figure,
we hope.
Ms Rogerson: We are working on
the basis of Department of Health Workforce planning. Because
it is self-sufficiency they will know how many people they are
expecting to come through the system.
Q817 Mr Bone: Should the Home Office
not know that really, migration? Is that not the Home Office?
Ms Rogerson: EEA?
Q818 Mr Bone: Yes.
Ms Rogerson: No, we do not have
predictions on that.
Q819 Chairman: Who would look at
the movement of the workforce throughout the EEA then under these
circumstances?
Ms Rogerson: The Department of
Health Workforce planning would be looking at people who would
be coming to work in the National Health Service.
| 
