Exclusive:SNP ministers urged to create new umbrella body to help GPs stay in Scotland

The Royal College of General Practitioners (RCGP) Scotland said some new graduates were opting to leave the country to find work elsewhere. This is despite unprecedented demand from patients and a target of recruiting an extra 800 GPs in Scotland by 2027.

The RCGP wants the Scottish Government to create a national overarching umbrella body to sponsor international medical graduates' (IMGs) visas.

An estimated 40 per cent of GP trainees in the UK are IMGs, who have graduated from a medical school outside of the UK. Upon completion of their training, most need to find a practice to sponsor their visa, or they will be forced to leave the country.

This is because GP specialty training takes three years to complete, whereas IMGs must be resident in the UK for at least five years before they can apply for indefinite leave to remain.

The RCGP said this posed a unique challenge for general practice as other medical specialty training programmes take a minimum of five years.

Surveys of its members found 49 per cent of all IMG trainees reported difficulties with the visa process.

It previously called on the Home Office to take action, and in 2023 UK ministers announced an extension scheme of four months for GPs who had completed their training, but were still seeking sponsorship from a practice.

However, with issues remaining, the RCGP is now calling on the Scottish Government to create a national overarching umbrella body that could sponsor all IMGs who wish to remain in Scotland, removing bureaucracy and costs from GP practices across the country.

RCGP Scotland estimates the cost of every practice in Scotland becoming a visa sponsor for IMGs would be more than £450,000. Currently, it takes up to eight weeks for a practice to sponsor an IMG, although some report the process taking longer.

The General Medical Council has stated Scotland has a lower proportion of non-UK graduates in the doctor workforce than England and Wales.

Data published in 2022 found 28 per cent of IMGs who finished training in Scotland moved to another UK country while 18 per cent left the profession.

Dr Chris Provan, RCGP Scotland chair, said: "IMGs work incredibly hard during their three years of GP specialty training, caring for patients the length and breadth of Scotland. Medical training in a different culture and language is no small feat.

“It should be celebrated that many IMGs who complete their training here have put down roots in their communities and wish to remain in Scotland to practice as a GP. Unfortunately, the current Home Office law around visas can be incredibly stressful and off-putting for IMGs.

"The number of whole-time equivalent GPs in Scotland has now decreased for a third year in a row. Meanwhile, the number of patients registered with a GP has increased and Scotland's ageing population means that patients often require more complex care. This mismatch between GP numbers and patient demand and complexity is taking its toll, with many GPs lowering their working hours to cope with stress or leaving the profession altogether.

"It makes no sense for governments to add this layer of bureaucracy for GP IMGs at a time when we so critically need to stabilise the workforce. The Home Office must offer all IMGs the opportunity to apply for indefinite leave to remain in the UK on successful completion of GP specialty training.

“In the interim, the Scottish Government needs to use the levers at its disposal by delivering a national umbrella body that can sponsor visas for all IMGs who want to remain in Scotland to serve patients as GPs. Such a body would reduce costs and bureaucracy for practices, and ensure we retain as many talented and committed IMGs as is possible. Such a move would help to reverse current worrying workforce trends."

Dr Turki Alhusaini, an IMG who completed his GP training in September last year, had several practices withdraw job offers due to the complexity of sponsoring visas. He is now a practicing GP in West Lothian.

"The uncertainty of the current job market has been anxiety-provoking for all newly qualified GPs, but especially IMGs facing visa uncertainty,” he said.

“IMGs work hard during their training years, and many want to give back to the communities where they trained.

"Understandably, several practices rejected my applications due to the bureaucracy and costs involved with becoming an approved Home Office sponsor. This was a difficult time for me personally.

“Thankfully, I have now found a practice that has sponsored me, but there was a period when I could have been caring for patients, but was unable to do so due to lack of sponsorship.

"Both the UK and Scottish governments should take steps to simplify the sponsorship process for practices so that we retain the talent and contribution of IMGs in general practice.”

The Scottish Government has a target of recruiting an extra 800 GPs by headcount by 2027, however Audit Scotland previously said this was not on track.

The recent general practice workforce survey showed the number of whole time equivalent GPs in Scotland decreased for the third year in a row, from 3,478 in 2023 to 3,453 in 2024, a decrease of 0.7 per cent.

A Scottish Government spokesperson said: “We are committed to supporting international medical graduates to train and secure employment in Scotland.

“This includes working with stakeholders to improve our understanding of the challenges and opportunities IMGs face. We regret that the UK government’s decision to leave the EU has made recruitment and retention of EU citizens, including vital clinical staff, more challenging.

“Immigration is reserved to the UK government. However, the Scottish Government has established Scotland’s Migration Service to provide information, advice and support to individuals and employers and published specific guidance for individual general practices to become skilled worker visa sponsors and employ IMGs who are subject to visa regulations.”

The Home Office said workers from overseas make an invaluable contribution to the NHS, but said it had no plans to reduce the five-year qualifying period for settling permanently. It said sponsorship is an essential part of the UK’s points-based system.