Brexit and foreign doctors (parking fines and other things)

David McNarry’s latest foray into controversy has been to float – and then retract the suggestion that foreign workers (specifically a hypothetical Polish surgeon) be deported for minor crimes such as parking tickets.

Although this may play well with a few it seems something of a gaffe: maybe UKIP’s leadership will not be too sorry to lose their sole NI MLA when McNarry stands down at the Assembly elections (to be fair retiring at 67 seems pretty reasonable). It also demonstrates one of the problems with Nolan’s shows and his interviewing style. I remember a DUP politician refusing to go on the show with some sort of line to the effect he wanted to go on a politics show not a comedy show.

McNarry’s point, however, is the exact opposite of a legitimate point to be made by Brexit supporters: namely the fact that by no means all people with heritage from abroad support the UK remaining in the EU.

One overarching point which is often made but bears repeating is that the UK has always been a nation or indeed nations made up of immigrants. Be they the Celts, Angles, Saxons, Vikings, Normans etc. of the Dark Ages or the more modern Huguenots right up to the Poles, Czechs and others who fled fascism and then so heroically defended their adoptive nation most iconically in its skies.

Since the war we have had waves of immigration from what was once the Empire and became the Commonwealth. Although that has been far from perfect in terms of integration we now have people of Afro Caribbean and South Asian heritage at every level of British society. The failure of integration has been a problem for many but looking at the rest of Europe it is not possible to single out the UK as having more of a race or racism problem than most other countries. Indeed arguably the situation is less bad here.

Coming back specifically to migrants and even more specifically to doctors raises an issue which should be seized on by Brexit campaigners though for different reasons to David McNarry’s.

There is not a hospital in Northern Ireland nor the rest of the UK which does not have doctors from abroad often in very senior positions. The majority of hospital departments in the UK have consultants from outside the UK and especially from South Asia. In many ways going to the UK was historically a right of passage for South Asian doctors. In both India and Pakistan medical education is conducted through the medium of English; the structure of junior doctors and consultants mirrors that of the UK and historically passing the assorted UK postgraduate examinations has been extremely beneficial for doctors in advancing their careers.

In the past the NHS also benefited from doctors from the likes of Australia and New Zealand but with the changes in medical practice and great superiority of terms and conditions for doctors in both those countries as opposed to the UK the flow is now almost entirely in the other direction. Indeed there is also an increasing trend for some Indian consultants to go home as that country, now far richer than it was a generation ago, offers many openings to practice state of the art medicine again with better terms and conditions than the UK.

Despite this there remain large numbers of South Asian doctors (though now more from Pakistan than India) keen to come to the UK. A series of obstacles, however, are set in their paths that make their position less favourable than for doctors trained in non UK EU member states.

Firstly there is the fact that despite all medical training occurring in India and Pakistan through the medium of English, non EU doctors have to pass exams in English for which they must pay. Prior to 2014 there was no specific requirement for doctors from EU states to demonstrate proficiency in English (it was only assessed at interview) and indeed since 2014 when the rules were introduced almost half of doctors applying from EU states have not been deemed competent enough to be allowed to practice.

A further problem is the arcane visa requirements: indeed it was an anecdote on this subject which started my thinking on this issue long before Mr. McNarry’s intervention and is maybe worth repeating.

A doctor acquaintance of mine is a Pakistani doctor has for a number years been a hospital doctor. He was a “Speciality Doctor” which is a sub consultant grade from which training to become a consultant is apparently difficult. He is, however, talented and hard working. He applied for and gained admission to the training scheme (becoming a specialist registrar and likely in time a consultant). This has necessitated a change in his visa status and the new visa is going to cost him several thousand pounds. This is an individual who has worked for the NHS and paid taxes for many years and yet now has to pay what amounts to a further tax due to his being promoted.

Such a situation does not affect any EU citizen and creates what for many foreign workers is seen as an unfairness even a form of racism.

Although the argument above is about doctors it could apply to many different jobs. The opening up of the labour market to EU citizens especially from the poorer countries in Europe has created a huge draw to immigration to the UK (Northern Ireland has seen less of this than many areas – most especially the East of England). The rise in the population has created a significant backlash and the government has sought to decrease immigration. That decrease has, however, not been allowed to be a decrease in migration from EU countries (by EU laws) and as such the pressure to reduce immigration has been most acute on non EU migrants. This can often impact on non EU persons with family ties to the UK who cannot come over as other members of their families (extended or otherwise) have in the past. As such the complaints about EU migration have had the effect of reducing not EU but non EU migration.

Many communities in the UK are aware of this and a small number of people from ethnic minorities have joined UKIP and such like. However, there is a potentially much bigger constituency of people from Afro Caribbean, South Asian or other non EU “minority” groups who are wholly British, have been for some time and now see people in a similar position to them or their ancestors being treated in a fashion which could very easily be seen as racist in fact even if not in theory.

Highlighting the benefits of Brexit to these groups would have a number of advantages. Firstly in what may be a tight referendum every vote counts. Furthermore a focus on this detracts from one of the standard Remain arguments that those supporting leaving the EU are “little Englanders” or more bluntly racists. Brian Walker has recently identified a nostalgia for the Commonwealth as one of the drivers of Brexit. That may be so but those originally from “Commonwealth” countries who in both current and past generations have helped massively enrich the UK materially, culturally and in so many other ways deserve to be recognised. As indeed do those from other countries be they EU or non EU who wish to enrich our society.

The jibe against Brexiters of “Little Englander” may have validity for some. However one can equally turn it round and describe those pro EU as being “Little Europers” (indeed little partial Europers as they forget half of Russia is in Europe and indeed Europe’s biggest country is Russia) nostalgic for a past when European nations ruled most of the world and unwilling to accept the new order. No group is better placed to make that point than those who’s parents are from outwith the EU but have become as British as any of the rest of us: no matter what the racists of both pro or anti EU camps, or it seems some in the European elite think.

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