Nearly 5,000 Indian doctors have so far returned home after failing to find suitable employment in Britain's National Health Service (NHS) that forced them to live with rats, cockroaches and scrounge for free meals in temples and gurdwaras.
The figure of 5,000 returning to India since April 2006 is approximate, and the actual figure could be more. The doctors had passed the requisite tests for employment in the NHS, but failed to find jobs due to changes in immigration rules and a larger pool of available doctors from within Britain and the European Union.
Many more face the prospect of returning home after the Feb 9 high court ruling that disallowed a judicial review of the changes made in April 2006. All attention is now focussed on the ongoing recruitment process for 21,000 NHS jobs starting August 2007, according to leaders of the Indian medical community in London.
The current recruitment is part of a new system called Modernising Medical Careers (MMC) that came into effect this year. From Jan 22 to Feb 4 more than 30,000 doctors applied for the 21,000 available jobs in various specialities — and 10,000-12,000 applicants of them are said to be Indians.
Shortlisting of candidates for the jobs is expected to be completed by Feb 24 and interviews will take place in the first week of March.
Leaders of the Indian medical community are working to ensure that the Indian applicants are not adversely affected in the recruitment process by the Feb 9 ruling of the high court. Those who are not selected in this round will also face the prospect of returning home.
Lakshman Raman, vice-chair (policy) of the British Association of Physicians of Indian Origin (BAPIO), told that if the new rules issued in April 2006 were applied, there would be practically two shortlists for the NHS posts — one of British and EU citizens and another pile of Indian and other overseas doctors.
"The second list would only be considered for jobs that are not filled using doctors in the first list. Since BAPIO went to court and the verdict was announced on Feb 9 we believe so far the new rules have not been applied."
"After the verdict, BAPIO has written to the Department of Health (DoH), asking that they continue to hold the new rules in abeyance as we are going to appeal and we hope they will agree to this request."
"We will need to apply for a stay order only if the DoH does not agree to hold the new rules in abeyance while awaiting the appeal. They are still considering their options and will get back to us on this."
The BAPIO legal team is working on the appeal petition that can be filed within three weeks of the Feb 9 ruling. Raman said that BAPIO had decided to file the appeal before March 2 and had launched another fund-raising drive among Indian doctors to meet legal costs.
Raman added: "We are collecting funds for the appeal process and the initial response from our members and the wider doctor and Indian community has been encouraging. We understand that the judiciary understands the importance of this and will process it expeditiously."
"Since the MMC process only comes into force for jobs starting August 2007, the implications for doctors will be only from August 2007. Doctors who are currently in jobs will be able to continue till August 2007 when if their current job has got over and if they have not managed to get another job they may have to consider returning home."
"We fear that if the new rules are applied there may be many thousands of doctors unable to find a job from August 2007."
Raman added that a major reason for the large number of unemployed Indian doctors in Britain is the increased frequency of holding the mandatory qualifying test called the Professional and Linguistic Assessment Board (PLAB) test.
Every overseas doctor needs to pass this test before being registered for possible employment. Earlier this test used to be held twice or thrice a year. Now it is held twice or thrice a week. The success rate is also higher with the result that there are now more doctors who have cleared the test.
According to official figures, nearly 1,000 passed the test in 1998, but the number sprung to 6,666 in 2005. One part of the PLAB test is held in centres in India while another is held in London.
So high was the unemployment among Indian doctors who had passed the PLAB tests that one of them, Surinder Sareen, wrote a clinical account in the British Medical Journal on the condition of such doctors.
Calling it PPUD (Post PLAB Unemployment Doctor) Syndrome, Sareen detailed a series of ailments doctors suffered from, including depression, insomnia, obsessive-compulsive disorder, hallucinations, somnambulism, omniphagia, dissociative fugue and muskoskeletal deformities.
Sareen wrote: "In an effort to keep up an old medical tradition, I report a new syndrome, prevalent in the age group 25-35, but some cases are seen in the early 40s. Both sexes are equally affected. It is endemic in east London, but sporadic cases can be seen all over Britain. It is mostly found in immigrants from the Indian subcontinent."
His treatment for the PPUD Syndrome: "Love and a healing touch. Patients should be encouraged to go back to their home country, as in Britain even local graduates find it difficult to get a job and nobody is bothered about someone with PPUD syndrome."