---

Commonwealth Doctors and Dentists

I begin by assuring my hon. Friend the Member for Great Grimsby (Mr. Mitchell) that I am pleased to be here to answer this debate, and that I do not believe that I drew the short straw this evening. I welcome the opportunity to talk to the House about the recent change to the immigration rules for postgraduate doctors and dentists. However, before I get into the detail of the change and address the points that have been raised, I want to take this opportunity to set out the Government’s position on migration, and to set the change in context. The five-year strategy on asylum and immigration was published over a year ago, in February 2005. It sets out the premise that we need to be clearer about which migrants we need in the UK, and why. That is the basis of our immigration system, and of our manifesto commitment to introduce a points-based system for managed migration. It is the job of the Government to manage migration into the UK so that the needs and rights of UK citizens are maintained. That is why the points-based system for managed migration, on which we consulted widely between July and November last year, went back to first principles to identify and select the migrants whom the UK really needs, and who benefit the UK by being here. The Government are, and have always been, very clear that migration makes a substantial contribution to economic growth because it helps to fill gaps in the labour market, including key public services, such as health and education. Migration also increases investment, innovation and entrepreneurship in the UK. Culturally, we are enriched by people with diverse backgrounds from other countries. With an expanded EU, there is an accessible and mobile work force already contributing to our growing economy, closing many gaps experienced by employers. Our starting point is that employers should look first to recruit from the UK and the expanded EU before recruiting migrants from outside the EU. Migration needs to be properly managed. It also needs to be robust against abuse. Only those of benefit to the UK should be admitted and, once here, they must comply with the conditions of their leave. That, then, is the underlying strategy. On that basis, we outlined our proposals for a five-tier managed migration system in the Command Paper, ““A Points-Based System: Making Migration Work for Britain””, which was presented to the House on 7 March. The aim of the new system is to develop a more efficient and transparent migration system that sets out clearly who is permitted to come to the UK and why. We want to design a system that is better able to identify and attract those migrants who have the most to contribute to the UK—one that offers a more efficient, transparent and objective process and that improves compliance while reducing scope for abuse. As part of that work, we have reviewed existing routes for employment, training and study with a view to identifying which are of most benefit to the UK. Underpinning the new migration system will be a five-tier framework, which will replace more than 80 work and study routes. That will help people to understand how the system works and will direct applicants to the category that is most appropriate for them. Tier 1 will cover those highly skilled individuals who can contribute to growth and productivity. Tier 2 will be for skilled workers with a job offer, who can fill gaps in the UK labour force. Tier 3 will provide for limited numbers of low skilled workers, needed to fill temporary labour shortages. Tier 4 will accommodate overseas students. Tier 5 will cover what we describe as youth mobility and temporary workers: people who are allowed to work in the UK for a limited period of time, primarily to satisfy non-economic objectives. We also intend to set up an independent body to identify employment shortages across all sectors of the economy. It will be known as the skills advisory body and will build on existing structures and expertise—in particular the skills for business network, which is funded in part by the Department for Education and Skills. Shortages identified by the skills advisory body will inform Government decisions on the use of migrant labour within tiers 2 and 3 of the points-based system. I want to turn to the place of doctors and dentists within the migration system. The massive investment that we have put into NHS staff and reforming medical training to build up UK NHS capacity has worked. We now have more than 117,000 doctors working in the NHS—27,400 more than in 1997—as well as record levels of doctors in training in UK medical schools and we do not need to rely on overseas doctors as much as we did in the past. That investment and expansion, coupled with the reform of medical education, is leading to increased competition for medical posts. It has become clear that, due to the changing labour market, the specific category within the immigration rules for doctors and dentists that allowed permit-free training could lead to the displacement of UK graduates. There has been a growing consensus that changing the rules is the right thing to do.