As thousands of Indian doctors make plans to return home or move to other countries for training and employment, Britain's medical community has expressed disappointment over Friday's adverse high court ruling that refused a judicial review of changes to immigration rules.
Indian doctors have historically made significant contributions to the National Health Service (NHS). Thousands had moved to Britain in the 1970s and 1980s, following job offers to meet shortage of medical professionals at the time.
The competence of that generation of Indian doctors has been widely acknowledged and valued, and many others followed in subsequent years under the category called permit-free training. This facility was abolished under changes announced in March 2006.
The changes to rules were since criticised by British doctors at several forums, including in the professional British Medical Journal. Friday's ruling has disappointed not only the Indian community of professionals but also British doctors.
Commenting on the ruling, Edwin Borman, chair of the British Medical Association's International Committee, said: "The government's recent treatment of overseas doctors has been very disappointing.
"They were given the impression that they'd be able to contribute to the NHS, and spend their whole careers in the UK, then the rules changed overnight and many were forced to leave. The failure of the government to consult with the medical profession meant that they had little opportunity to prepare to leave the country."
Andrew Rowland, vice-chairman of the BMA Junior Doctors Committee, added: "We're in the middle of the recruitment process for new junior doctor posts and it is crucial that the Department of Health issues full and transparent guidance immediately.
"The deadline for short-listing job applications is two weeks away, so those involved in selection need to be absolutely clear about what this decision means. If they're not, the whole recruitment process will fall apart.
"The government must learn lessons from this episode. It needs to undertake rigorous long-term workforce planning so we can be honest with overseas doctors about opportunities in the UK. If that had happened in the past we wouldn't be in this situation now."
Borman added: "We are disappointed that the high court has not ruled in favour of doctors on the Highly Skilled Migrant Programme. It has always been our opinion that they should be treated the same way as their UK counterparts when applying for posts."
Meanwhile, the British Association of Physicians of Indian Origin (BAPIO), which went to the court against the changes to immigration rules, is consulting its legal team to consider launching an appeal against the decision.
Several doctors had raised funds to fight the legal case, but the BAPIO is faced with launching another fund-raising drive to launch the appeal. The judge has permitted BAPIO to bring an urgent appeal against his ruling before the Court of Appeal because of its widespread impact on foreign doctors.
However, Indian doctors currently in training or awaiting employment are not optimistic about a positive outcome of any appeal. It is considered unlikely that British authorities would now relax the immigration rules because of Indian doctors' contribution to the NHS in the past.
The logic of the changes put forth by Health Minister Lord Warner in March 2006 virtually precludes any relaxation. He said: "We now have more than 117,000 doctors working in the NHS, 27,400 more than in 1997, as well as record levels of doctors in training in UK medical schools.
"This investment and expansion, coupled with the reform of medical education, is leading to increased competition for medical posts as vacancy rates fall. There is therefore no longer a need for a specific category in the immigration rules to enable doctors and dentists to train in the UK for many years.
The General Medical Council, which conducts the qualifying PLAB (Professional and Linguistic Assessment Boards) test, has been cautioning doctors from India and other non-European Union countries about the competitive job situation in Britain.
It states: "The job market in the UK is very competitive and you should think very carefully about whether you are willing to take the risks involved in competing for posts.
"A recent survey of International Medical Graduates (IMGs) who have passed the PLAB Part 2 exam has shown that finding employment is increasingly difficult. We anticipate IMGs employment prospects will significantly worsen following the Department of Health announcement that from April 3, 2006, IMGs who wish to work or train in the NHS will need a work permit".