I absolutely agree. In terms of financial cost and complexity, it is so easy to put a foot wrong. Far too often in the process, when a foot is put even a tiny bit out of place it can result in someone losing their leave altogether, falling off the conveyor belt to settlement and not being able ever to get back on it. It can have dire consequences for people if they make one mistake in this complicated process. The hon. Gentleman makes a very powerful point.
In light of the Petitions Committee’s survey, the question is whether the Home Office and the Department of Health and Social Care agree that the fees are having such an impact. Are people deciding not to apply for ILR, or to put off their applications for it? If the Home Office does not agree that that is the implication of the high fee, on what basis does it reject that? Has it done research and decided that the fee does not have that impact? If so, can we see that research? If it accepts the implications of the Petitions Committee’s report, what is it going to do about it?
Otherwise, the Home Office is providing another reason for medical professionals to decide that it is no longer worth remaining in the UK, and to take their expertise elsewhere. There is evidence that recruitment agencies in Australia, Canada and elsewhere are aware of those challenges and are proactively advertising here to attract medical professionals. The British Medical
Association believes that one in three junior doctors is considering a move abroad. That is all a function of the Home Office handing skilled staff an incentive to leave rather than stay.
That brings me to the point about fees in general—but this fee in particular. Our whole process of setting immigration fees has become absolutely obscure and is not subject to enough scrutiny. That is another reason the Petitions Committee should be praised for bringing the subject to the Chamber for debate. As it stands, the Home Office can lawfully take into account only the following criteria when it sets fees: processing costs; the benefits that will accrue to the applicant and others; the costs of other immigration and nationality functions, hence its profit; economic growth; international comparisons; and international agreements. There are problems with that framework that we should revisit, but we will come to that another day. There are problems with how it is applied in cases regarding children and families.
In another debate a couple of years ago, the point was made that it is the other way around with visit visas. We actually subsidise them. It will be interesting to know whether people who are applying for a visit visa are still paying less than the cost of processing that visa. It would be quite extraordinary if we were taking money from healthcare professionals and using that to subsidise folk to come visit. I understand that the Home Office wants to encourage visitors, but I think we would struggle to justify that arrangement.
Even if we just apply those factors to the visa for healthcare workers, it still makes sense to set a greatly reduced fee. We know that the processing costs are a fraction of the fee. As for the criterion about benefits that will accrue to others, the NHS is in crisis—what bigger benefit could there be than people to help get us out of the crises that we face?
We are also supposed to consider international comparisons. It would be interesting to hear what work has been done there. For example, on citizenship fees, the UK is a wild outlier in how much we charge folk for citizenship. I do not know whether the same is true of permanent resident fees. I suspect that it is, but I would be interested to know whether the Home Office has done research on that—otherwise I am sure that hon. Members will do that themselves.
We also have to speak about Brexit. My party thought that Brexit and the end of free movement was an utterly awful event. It does make a difference, because it makes it particularly difficult to attract NHS workers from the European Union. A talented doctor or nurse from any one of our neighbours has 27 other countries they can go to with barely the need to fill out a form, never mind pay a fee. The NHS visa helps—it is right to acknowledge that—but it does not change the fundamental position that we are less competitive in attracting people from our nearest neighbours. Until we fix those problems, we are going to struggle to recruit the people we need. All the action plans in the world— announced by the Prime Minister, the Health Secretary or anybody else—whatever their merits, are going to struggle to be fulfilled until we resolve that issue.
It is not just about the fees; other things have been raised. For example, my hon. Friend the Member for Rutherglen and Hamilton West (Margaret Ferrier) mentioned social care workers. We had a debate on the functioning of GP visas for international graduates; I would be interested
to hear what further work has been done on that. We heard about families; that was not something I had thought about, but how we treat families is really important. We expect people to come and work, but to leave their families behind sometimes. That is completely illogical and counterproductive.
Some steps have been taken, which should be welcomed. The existence of the NHS visa is of course one of them. The non-application of the immigration health surcharge is another. I thought that this was a really powerful point: by taking those steps, we have encouraged people to come here to work; why do we now discourage them from staying? That seems utterly illogical. The Home Office has gone halfway down the road of treating NHS staff in a fair and supportive manner; let us just complete that journey.
A powerful case has been made by the petitioners. I acknowledge that this is not a straightforward matter for the Home Office. There are arguments as to whether a similar case can be made for others. But the hon. Members for Delyn (Rob Roberts) and for Streatham (Bell Ribeiro-Addy) made powerful points. The Home Office does make special rules for special categories all over the place. This is the most special of categories and it requires a bespoke response—something that the Home Office itself has argued by coming this far. Let us just complete that journey. The Home Office needs to look at the matter very carefully, because real damage is being done to the NHS now by persisting with this high fee, so I hope that the Minister will be open to engaging on the matter and will look again at the fee and listen sympathetically to the case that the petitioners are making.
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