Examination of Witnesses (Questions 820-840)
MS LORRAINE
ROGERSON AND
MS JUDITH
MACGREGOR
18 FEBRUARY 2008
Q820 Chairman: And they would look
at that from within the EEA as well, would they?
Ms Rogerson: I do not know how
they do it. That would be a question you would need to put to
them.
Q821 Chairman: It seems to me that
with all these people going through medical school now the Home
Office should be taking action against international medical graduates,
but as far as any movement within the European Economic Area is
concerned the Home Office is not making any predictions about
that?
Ms Rogerson: No.
Q822 Chairman: So, no matter what
we are doing here, that could be disturbed if people were applying
to come and work in the UK in years to come?
Ms Rogerson: I think it is something
you need to put to the Department of Health in terms of how that
would relate to their self-sufficiency in graduates.
Q823 Chairman: But you could not
restrict them from a Home Office point of view because they have
the right to—
Ms Rogerson: Freedom of movement,
yes.
Q824 Dr Naysmith: We still have not
had an answer to whether the Home Office and the Foreign Office
have been discussing these numbers with the Department of Health.
Do you know if they have or not?
Ms Rogerson: Which numbers, sorry?
Q825 Dr Naysmith: Predictions about
where doctors are going to come from if you cut off the supply
from, say, India, but there are more coming in from the European
Economic Area. Has there been any discussion about what these
numbers mean between the Department of Health, the Foreign Office
and the Home Office?
Ms Rogerson: Not that I know of.
Dr Naysmith: This is talking about joined-up
government. There are at least three departments involved, and
each one seems to be taking a different point of view, so avoiding—I
am not supposed to say this—the Sir Humphrey effect.
Q826 Jim Dowd: Ms Rogerson, the number
you quote of 3,000 to 5,000 in 2009 was included in the Department
of Health's press release announcing the consultation on the restriction,
which goes on to say that because of the high level of potential
IMG applicants that will be exempt from the Home Office regulations,
apparently estimated at around 10,000, without further action
on behalf of the Immigration Rules the department estimates that
around 71,100 UK doctors will be displaced and unable to secure
a training place in 2009, 2010 and beyond, so even that figure
you give us of 3,000 to 5,000 is not going to be enough to reduce
the potential fall?
Ms Rogerson: The potential IMG
exempt are the people who are here already and because the rule
change we are making is prospective in order to not to destabilise
that is why the Department of Health needs to be looking at ways
of managing this. We have made a change which would have that
estimated impact in 2009.
Q827 Jim Dowd: Right, so essentially
you are saying you have done the best you can to help them with
this position, there is still more work to be done but it is the
Department of Health that has the lead on that?
Ms Rogerson: We will continue
to discuss with them and review what happens in terms of migration
changes but at the moment the migration change we have made has
that predicted impact, yes.
Q828 Mr Bone: My questions are about
joined-up government and who is talking to whom. I have to say
I am a bit miffed at the moment. We have had to rearrange this
meeting to get both ministers here and they do not seem to be
able to co-ordinate their diaries and have left you to take the
flak. It is not a really good start. I think your two departments
probably come out better in this because the Tooke Review really
said it was leadership from the Department of Health that was
weak in the implementation of MMC, so that is probably helpful
from your point of view. Do you think that is why the failure
was, that there was not better communication between the departments,
because of lack of leadership from the Department of Health, as
Tooke suggested?
Ms Rogerson: Our part of this
has been trying to see to what extent the immigration system which
we manage can and should be used to help to solve a problem that
is government-wide, which we do quite a lot, but our part in that
is to advise and implement when agreed and to support, and that
is the role we played.
Q829 Mr Bone: Now that this has happened
and MMC has been a pretty miserable event for the Government,
I wonder if within your departments something from on high has
come down saying, "We really must not do this again. We have
got to improve our communication between departments". Has
there been some sort of memo or seminar or have ministers been
exploding? Has anything happened?
Ms Rogerson: We have been asked
to continue to work closely together, yes.
Q830 Mr Bone: "Continue to work
closely together" means no change really because clearly
you were not working closely together, or do you think you were
working closely together?
Ms Rogerson: We have been working
closely in terms of advising and supporting the implementation
of this as part of the overall package.
Q831 Mr Bone: Can I try a different
way? What are the current mechanisms for communicating with the
Department of Health? Do you have a meeting every Monday morning
or do you just wait for the phone to ring?
Ms Rogerson: We have been working
with them closely on this particular area of work, so that is
phone calls and meetings, and supporting the Domestic Affairs
Borders and Migration Committee. Officials will meet co-ordinated
by the Cabinet Office.
Q832 Mr Bone: In some businesses
where you have diverse departments they will meet once a week,
say, on a Monday morning, to discuss anything that goes across
their department. Does that happen? Do key officials meet regularly
on a particular day to see how policy in one area is affecting
policy in another department?
Ms Macgregor: The Border and Immigration
Agency and the Foreign & Commonwealth Office obviously have
very regular consultation across a range of immigration and migration
issues. We have quite a few, including at ministerial level, where
we have fortnightly meetings also to review progress, particularly
on illegal migration, which is somewhere where we are particularly
looking to foreign partners for assistance, but also across the
board in legal migration as well. With the Department of Health
I would say that our contacts have been, as Lorraine says, regular
over this particular issue over the recent period.
Q833 Mr Bone: But more back office
than formalised?
Ms Macgregor: They have not been
formalised. Obviously, there have been ministerial exchanges as
well by letter. On the figures point I wanted to say that we have
worked very much on the basis of the figures that have been supplied
to us by the Department of Health in terms of the numbers of applicants
that they were expecting to have in this competition and in 2009,
but we have not made any independent or separate estimates of
figures beyond that.
Q834 Chairman: Obviously, the Domestic
Affairs Committee involves the Treasury as well. What role does
the Treasury play in any of this?
Ms Rogerson: They put in views
and ideas and query proposals in the same way as anyone across
government would.
Q835 Chairman: Have they been helpful
in terms of getting the business sorted out from your perspective?
Has it been a helpful situation?
Ms Rogerson: Yes, I think so.
What we have been doing collectively is looking at what the issues
are that need to be addressed, looking at the options for addressing
the issues and trying to come up with proposals which would do
that.
Q836 Chairman: Were the Treasury
involved from very early on?
Ms Rogerson: Yes, I think so.
They were not closely involved at the point that we made the changes
to the postgraduate doctors and dentists route, but they have
been closely involved in all of the development of proposals for
the points-based system, so they have been involved in those discussions
as far as I know from the outset.
Q837 Chairman: Do you have much discussion
with the Treasury?
Ms Macgregor: Certainly. The Treasury
have been involved in all the discussions that I have been involved
in and they are very closely involved in the whole concept and
rolling out of the points based system, particularly Tier 1, obviously,
to attract the best and brightest and talents to support and sustain
the UK economy, very much so.
Q838 Dr Taylor: Could I come back
to something I did not quite clarify before? When we were talking
about the other jobs, the non-training jobs that are still open
to foreign applicants, are we really talking about those sorts
of staff grade jobs that are perhaps in the back of beyond without
any supervision at all and are we thus going to have a second-class
group of doctors with no formal training?
Ms Macgregor: I do not think it
has been our intention that it would be jobs in the back of beyond.
I think the understanding has been that the restrictions are limited
to the speciality training slots; therefore, all other jobs that
foreign applicants have been applying for and have been taking
up are not affected by that.
Q839 Dr Taylor: And the Tooke Review
does suggest that staff grades probably have a route into higher
training. Is that going to queer the pitch as well?
Ms Macgregor: I think it is probably
a question that the Department of Health could advise on in terms
of what course leads into the next. As I say, our understanding
is that these particular slots are affected but other slots are
not affected.
Q840 Dr Taylor: But it is not very
attractive, I would have thought, to people from the Indian sub-continent
to be coming to purely service jobs without any training. What
do the Indian authorities feel about that? Has that been put to
them?
Ms Macgregor: I certainly have
not been aware of that particular point being made to the Indian
authorities. As I say, the point that we were discussing in India
two weeks ago was specifically this particular scheme, so I cannot
really comment further on that.
Dr Taylor: It has long been felt that
some of these people are brought in just as drudges to do the
unpopular jobs, so it is very sad if that continues.
Chairman: Maybe we could take that up
in the next session, Richard. Could I thank both of you for coming
along this afternoon and helping us with our inquiry.
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