Britain's National Health Service (NHS) has closed its doors to doctors from India, South Africa and other Commonwealth countries in an attempt to preserve health service jobs for British graduates.
The Home Office announced yesterday that, from next month, doctors living outside the European Union will not be eligible to apply for posts through the Highly Skilled Migrants Programme — hitherto an open door to migrants with the right qualifications.
From April 1, the door will also be closed to migrants from India who apply under a new points system. So-called Tier 1 migrants — those with the highest qualifications — will be barred from applying for higher medical training posts.
Non-EU doctors already in Britain as Highly Skilled Migrants, or those seeking leave to remain as Tier 1 migrants, will still be free to apply, reports The Times.
For generations the health service has been sustained by immigration, but yesterday the Home Office moved to end a crisis that has prevented thousands of highly trained British doctors from advancing their careers.
The change will end a long tradition of importing doctors to the NHS.
Among the 277,000 now registered with the General Medical Council, almost half got their first medical qualifications abroad — the majority from India, Pakistan, South Africa and Australia. Without them the NHS could not have run a service since the 1960s.
Since 1997, however, the number of medical school places in Britain has almost doubled. Last year many UK-trained doctors were denied initial posts, or won only short-term positions, as 10,000 overseas doctors joined the queue for 20,000 posts.
The chairman of the British Medical Association had to resign after writing to The Times to defend the system of applying for training posts, in the face of widespread fury.
The new rules are expected to cut the pool of potential applicants by between 3,000 and 5,000 by 2009. But the Government has admitted that this will still not be enough to ensure that all British graduates who are good enough will get posts. Between 700 and 1,100 young doctors will be denied jobs in 2009 and beyond.
So the Department of Health yesterday announced that it would consult over proposals to impose additional limits on foreign applications.
Its preferred option is to tell NHS trusts that international medical graduates should be eligible for posts only if there are no suitable applicants from Britain or the EU. That would exclude almost all of them.
The new immigration rules gained approval yesterday. Dr Ramesh Mehta, a consultant paediatrician and President of BAPIO, said: "This should have happened four years ago. We don't have enough training posts and our UK doctors should have opportunities."
The British Medical Association was less impressed, however. Dr Hamish Meldrum, chairman of the BMA Council, said: "This is a confusing move, which seems to achieve little apart from adding to the uncertainty for overseas doctors in the NHS."