Baroness Lister of Burtersett (Lab)

My Lords, Amendment 11 would add to the list of priority groups people who have been recognised as in need of international protection, who have arrived as a Hong Kong British national or who have arrived on a safe and legal humanitarian route. I will speak simply to this amendment, but I have some sympathy for the amendments in the name of the noble Baroness, Lady Gerada. I apologise for popping up at this late stage of the Bill’s passage. This issue was brought to my attention by the Refugee Council, which recently spotted that, as it stands, the Bill will exclude those recognised as refugees from prioritisation for medical training posts. This will potentially make it harder for people with medical backgrounds who have been displaced and given protection in the UK to contribute fully to the NHS. This resonates with me because my father, as a young man with a medical qualification, came to the UK in the 1930s as an early refugee from Nazi Germany. He was able to requalify at Glasgow University and, after the war, eventually went on to have a long career as a medical officer in Manchester in what was then the DHSS. As such, he contributed to British society in a way that would now be difficult for medically qualified refugees. Programmes such as the Refugee Council’s Building Bridges programme support qualified refugee doctors and other health professionals to utilise their skills and experience in the UK. These programmes are based on close collaboration between charities and the NHS. This is beneficial for the refugees themselves, as well as for the UK. That support can include helping refugees to pass the necessary language requirements and get professional registration in the UK. Some refugees will also progress to accessing medical training posts. This has included foundation programmes specifically designed to support refugee doctors into the NHS workforce. During Second Reading in the other place, the Secretary of State said that the UK “must break our over-reliance on international recruitment”.—[Official Report, Commons, 27/1/26; col. 803.] This amendment does not run counter to that aim. Refugees have not come to the UK because they have been recruited. First and foremost, they have sought protection and have been given it. My amendment would simply ensure that those refugees who are also doctors would be able to put their medical backgrounds to good use and continue to develop their expertise for the benefit of the wider community, as well as for themselves. At the same time as the Bill is progressing through Parliament, the Government are proposing significant changes to settlement for refugees as part of the earned settlement plans. Ministers have said that these changes are supposed to incentivise integration and ensure that settlement is earned. Ensuring that refugee doctors are not placed at a disadvantage because of this Bill would help the Government meet those aims. At Second Reading, my noble friend the Minister explained: “Internationally trained doctors with significant NHS experience will continue to be prioritised for specialty training, recognising the service that they have given. This year, immigration status will be used as a practical proxy for NHS experience in order to allow prioritisation to begin swiftly. For following years, we have taken powers in regulations to enable us to refine this approach in consultation with key partners. I have been asked by noble Lords what this means for those with refugee status. This status is not a stand-alone priority group, although refugees will be prioritised for specialty training in 2026 if they fall within another priority category, such as holding indefinite leave to remain or having completed the foundation programme. Refugees who do not fall within a prioritised group may still apply for specialty training posts and the Bill will not change their eligibility to apply for locally employed doctors’ roles”.—[Official Report, 4/2/26; col. 1648.] The noble Lord, Lord Patel, responded positively with particular reference to Ukrainian refugees. I am not sure that my noble friend’s response was quite as reassuring as he perhaps thought, especially as Ukrainians who have arrived on the Ukrainian scheme will not be in any of the priority groups. If I understand the proposals correctly—this relates to the previous amendment—indefinite leave to remain is being used for places on specialty programmes in 2026 as a quick proxy for recognising doctors who have been trained abroad but who have been employed within the NHS for some time. It is not such a useful proxy for anyone who, like those on the Ukrainian schemes, have no route to settlement or who, under the proposed earned settlement changes, could have to wait 10 years, or even longer, to qualify for indefinite leave to remain. My amendment also addresses the impact of the Bill on doctors who have come to the UK as part of the Hong Kong BNO visa scheme. As with other refugee doctors, they have sought safety in the UK. Indeed, the scheme is frequently described by the Government as a safe and legal route. The case for their inclusion has been put to me eloquently in an email from an anaesthetic registrar who is a BNO visa holder and is currently working in the NHS. Like many colleagues in a similar position, he migrated to the UK for political reasons before completing his training and now regards the UK as his permanent home, where he wishes to dedicate his career to the NHS. They argue that “deprioritisation to the point of exclusion would leave us without any pathway to complete training, despite our qualifications and NHS contributions, effectively ending specialist careers for a group formally invited to settle here”. They also point out that BNO doctors in the NHS form a small, finite cohort. Their main argument is that, “unlike many other International Medical Graduates who can return home to complete training, those of us on the BNO scheme face unique barriers. Due to the political situation in Hong Kong, returning is not realistic nor possible for many of us. The UK is now our only place to practise medicine and pursue specialist training”. Although their situation is not quite the same, the argument also applies to other displaced persons covered by this amendment. At a time when the Government are making it much more difficult to achieve refugee status, should they not at the very least ensure that those who are so recognised and who are medically qualified are able to requalify and use their medical expertise to the benefit of our society? I hope my noble friend will be able to accept this amendment, but I suspect she will not. At the very least, I ask her to give a commitment to further consultation with a view to giving serious consideration to including the groups specified in the amendment, even if only in modified form, in the regulations to which she referred at Second Reading and which were mentioned earlier today. I beg to move.