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The Guardian - UK
The Guardian - UK
National
Miranda Bryant

Trained medics who could ease NHS crisis stuck in asylum limbo

Hashem Salim, a doctor from Gaza who is seeking asylum in the UK but is frustrated by Home Office delays.
Hashem Salim, a doctor from Gaza who is seeking asylum in the UK but is frustrated by Home Office delays. Photograph: Adrian Sherratt/The Observer

After five years studying to become a qualified dentist in his home country of Sudan, Omar (not his real name) spent seven years mainly treating children in Khartoum.

But since arriving in Britain last June – despite a desperate shortage of NHS dentists – the 32-year-old has not been able to put his skills to use.

Instead, he is struggling with depression in a hotel in the north of England and trying to take his mind off its oppressive conditions by volunteering for a mental health charity – because, 10 months on, he is still waiting for the Home Office to assess his claim to asylum.

“No one cares about you or your qualifications or your study. No one cares that you’re volunteering to help the community or to serve the people suffering,” he said. “You feel that you are just a useless person.”

Despite his in-demand profession, Omar was one of the more than 160,000 asylum seekers still waiting for an initial decision on their asylum claim at the end of last year.

Among those trapped in the Home Office backlog and unable to work, experts told the Observer, there are thousands of doctors, nurses and other medical professionals.

Meanwhile, the NHS in England is facing a recruitment crisis that has left it with 154,000 fewer full-time staff than needed and could leave it short of 571,000 staff by 2036.

Robina Qureshi, the chief executive of the refugee charity Positive Action in Housing, which is providing resettlement grants to asylum seekers to help them work in the NHS, said that Brexit had led to an exodus of people leaving the UK for a cheaper life elsewhere in Europe, while NHS waiting lists soar. “Yet here in the UK we estimate there are thousands of potential nurses, carers and doctors who are available to work and contribute to our society right now,” she added.

The Doctors’ Association UK called on the government to allow qualified asylum seekers to work and called on ministers to act urgently to resolve the “ridiculous situation”.

A spokesperson for the campaign group, which is led by frontline doctors, said: “It is a clear failure of government thinking to not allow qualified individuals who are present in the country and willing to work, but are prevented from doing so due to bureaucratic failures.

“Nobody benefits from this situation, neither the public nor the individuals caught in this traumatic set of circumstances.”

At first, when he arrived in Britain, Omar felt relief at finding protection, but uncertainty over his status, but not being allowed to work has made him spiral into stress and depression.

Nearly a year out of practice, he is worried about losing his skills. “Now I am helpless,” he said. “You are living this life to eat and sleep.”

With Home Office contractors allowed to enter his hotel room without warning, and asylum seekers shouted at if they take extra food at mealtimes, he said that his only sense of day-to-day normality comes from volunteering.

Dr Shabbir in Glasgow. She said: ‘When I see the NHS struggling, it breaks my heart knowing that I can help.’
Dr Shabbir in Glasgow. She said: ‘When I see the NHS struggling, it breaks my heart knowing that I can help.’ Photograph: Katherine Anne Rose/The Observer

The negative rhetoric around asylum seekers does not help. “Even when you are walking in the street, it feels like everyone will know that you are seeking asylum and that it’s something bad,” Omar said.

Others in the same situation are just as frustrated. Dr Shabbir applied for asylum in the UK in 2016, fearing for her life after being threatened with death by family in Pakistan, and has been an asylum seeker ever since (her appeal was refused multiple times; she is now trying to get a judicial review).

A qualified doctor, she has a master’s degree in public health and has passed her General Medical Council (GMC) professional and linguistics exams, but is still not allowed to work in Britain.

“I have no hope, I have nothing,” said the 33-year-old. “Even though I’ve passed my exams, I’ve done everything in my capability, I still have nothing. I’m standing exactly where I was in 2016.”

She added: “I lost my youth in this country waiting to start my life.”

Dr Shabbir suffers from anxiety attacks and feels isolated in her asylum accommodation in Glasgow. “I just want to practise as a doctor, that’s the only thing I’m living for. Nothing else matters for me.”

Knowing that there are huge shortages of doctors in the UK makes it even worse. On a New Year’s Eve during the Covid pandemic, she was left crying for hours by the fireworks when they paid tribute to NHS workers.

“When I see the NHS struggling, it breaks my heart knowing that I can help. I can make a difference.”

Asylum seekers may apply for permission to work if they have not received an initial decision on their claim within 12 months – so long as the delay is not considered to be the fault of the applicant – but they must be from the Home Office’s shortage occupation list.

Solicitors report that, because of the government’s processing backlog, it is now taking much longer – four to 12 months after they reach this threshold – for permission to be granted.

Jelina Berlow-Rahman, a solicitor specialising in asylum cases, said: “This is extremely frustrating for asylum seekers as they are keen to contribute to society and not be a burden on the state.”

Even when their work permit is granted, asylum seekers in sought-after occupations can still face more barriers. Hashem Salim, 28, a Palestinian doctor, arrived in the UK just over a year ago after escaping war in Gaza. But after passing his GMC exams, borrowing money from a friend to register, being offered a job at a hospital in Devon and getting permission to work, he found there were still significant hurdles.

He had to rely on help from a charity to fund his journey from Liverpool, where he was staying in an asylum hotel, and connect him with a host family to stay with.

He has now started work, but is unable to open a bank account to get paid, and desperately misses his wife, Sama Awad, 26, who is also a doctor and is struggling while she waits in Egypt for permission to join him.

He has a yellow homemade button badge that he wears to work that states: “I miss my wife.”

But he said: “To be honest, I’d prefer to go and die. I don’t mind. Because it’s going to ruin my life. Death is much more compassionate and merciful than staying away from my wife.”

Patients are shocked that they are being treated by an asylum seeker, he said. “They just imagine that asylum seekers are economic migrants or drug dealers, criminals, illiterate people. However, it’s not true at all.”

He added: “I’m seeing between 20 and 30 patients every day and almost all of them are surprised by this fact: that their treating doctor today is an asylum seeker.”

Asked to confirm that thousands of healthcare professionals are waiting for their asylum claim to be processed, a spokesperson for the Home Office said: “We do not recognise these figures.”

The spokesperson repeatedly refused to say what the figure was, or if the government had even calculated one.

“Allowing asylum seekers the right to work sooner would undermine our wider economic migration policy by enabling migrants to bypass work visa rules,” the spokesperson said.

“Asylum seekers can take up jobs on the shortage occupation list if their claim has been outstanding for 12 months or more, through no fault of their own.”

• This article was amended on 10 April 2023 to correct the spelling of Sama Awad’s first name.

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