Thursday, 28 November 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Work Permits Eligibility
I thank the Leas-Cheann Comhairle for selecting this matter for discussion.
We all appreciate that the critical skills visa is an important one and we all want it to function. It has criteria, including an income threshold, a guaranteed contract or an offer of a contract of employment etc. I will provide an example because, when people approach Deputies with a problem, trying to resolve it often gives an insight into the kinds of challenge that people face. I have raised this issue with three different Ministers, but I cannot get a resolution to it. I will use this specific example to discuss the general issue.
I was contacted by a husband and wife, both of whom are in Ireland on critical skills visas. One is a medical doctor and the other is an engineer. There is no issue for the engineer, but there is for the medical doctor, who is not in employment. She had employment at the beginning, but that contract did not last. Many of our GPs are self-employed, as are many of the locums who fill in for them. GPs want to employ locums on a self-employed basis because of reasons of taxation and so on that would lead to problems otherwise. As such, I am discussing a specific category.
The doctor in question is highly skilled but not working. When I raised her case with three different Ministers, one of the replies I received was that the Department of Justice and Equality had corresponded with the Department of Business, Enterprise and Innovation and the Irish Naturalisation and Immigration Service, INIS, which is a part of the former. According to the reply, INIS had advised that applying for stamp 4 residency permission would permit an individual to establish and operate a business and was reckonable as residence when applying for citizenship and so on. I was trying to find out whether someone in that category could be granted permission to be self-employed and was pointed in this direction by INIS. However, this approach will not work because, as the Minister of State knows, one can only obtain a stamp 4 if one meets the other qualifying criterion relating to one's length of time in the country. I am going around in circles.
Of concern is the fact that we have a deficit of GPs and doctors generally. Their skills are needed. In the case in question, the doctor can stay in Ireland because her husband has a critical skills visa, but I cannot imagine that she is the only example of this situation. Are we failing to retain doctors who have come to Ireland because of difficulties around the types of employment common among GPs? Are people who have come to Ireland in good faith finding that the employment they expected is not available? This is a specific category of a more general issue. Will the Minister of State consider it with the Minister for Health and the Minister for Business, Enterprise and Innovation? I do not see how the issue can be resolved. There is a wider issue of retaining the skills in question.
On behalf of the Minister, who has just had to go to another appointment, I thank the Deputy for tabling this important matter. I was interested in what she had to say. As she knows, individuals seeking to enter the State in order to work as a GP are eligible to apply for a critical skills employment permit from the Department of Business, Enterprise and Innovation. With this permit, an individual may apply to the Department of Justice and Equality for permission to reside in the State for the purpose of employment as a locum doctor. The residence permission - a stamp 1 permission - allows such an individual to remain in the State under a contract of employment for a period of up to two years and can be renewed. At the end of that two-year period, it is open to individuals to make an application for permission to reside in the State under stamp 4 conditions, which grant unrestricted access to the labour market. In instances where an individual or his or her employer does not wish to enter into a contract of full-time employment in this regard, it is open to the individual to make an application under the atypical working scheme, operated by the Department of Justice and Equality, in order to receive permission to work in the State as a medical professional on a short-term basis for up to a maximum of 90 days. This permission allows an individual to work in this manner for up to eight months in a calendar year.
Extension of the atypical working scheme to include locum practitioners in the primary care area was implemented on the basis of consultations in 2015 between the Departments of Justice and Equality; Health; and Business, Enterprise and Innovation and the HSE. As part of those consultations, the evidence available suggested that longer term contracts of employment that would allow an individual to make an application for a critical skills employment permit from the Department of Business, Enterprise and Innovation were not especially desired either by the individual medical professionals themselves or by their employers. Accordingly, it was determined that the expansion of the atypical working scheme to facilitate the HSE in meeting urgent healthcare recruitment requirements was the best course of action.
I can advise that in 2018 a total of 90 individual doctors engaged in employment under the scheme in this manner and that 95 individuals have done so to date in 2019. Further advice from key stakeholders received over the course of 2019 indicates that these figures represent a minority cohort of the total number of overseas medical professionals engaged to provide locum services in the State. The Minister has made some changes this month, but I will probably say more about those in my next contribution.
We are talking about a small number of people, but they have important skills. If we are to attract other people with that skill set, they must not become bound up in a lot of unnecessary bureaucracy. I acknowledge that there have to be safeguards, but this skill set is undoubtedly required.
Is there ongoing engagement with the professional bodies on this matter, specifically as it relates to general practice? If changes are being made, they may be helpful. It is only when problems arise that one gets a fuller understanding of the issues that people encounter.
I would appreciate it if the Minister looked at that.
The policy related to the use of locum doctors in the primary care sector is primarily a matter for the HSE. The role of immigration service delivery of the Department of Justice and Equality is to provide immigration mechanisms for non-EEA medical personnel recruited to fill temporary vacancies in the health sector as and when required and to meet the needs identified by the HSE. These mechanisms are kept under continuous review with the HSE to ensure that the process retains sufficient flexibility to address urgent recruitment requirements as they arise.
The Department continues to liaise with the HSE to ensure that sufficient flexibility is available within the locum scheme. In that regard, I draw the Deputy's attention to the revised arrangements for locum GPs, which the Minister, Deputy Flanagan, announced recently on 22 November. It is very recent and the Deputy may not be aware of it. The revised arrangements, which are published on the immigration service delivery website, provide enhanced provisions in respect of applications processing and intermittent travel for locum doctors and offer a further demonstration of the capacity of the State to operate flexible and fluid schemes to meet fast-changing employment requirements while also promoting ongoing compliance with employment law and taxation obligations, to which the Deputy alluded, under a variety of sectors.
On the Deputy's final point, I understand that the doctors' co-operatives welcome the changes in the atypical working scheme, which were announced only last week. That is on the inis.gov.iewebsite. It means that the waiting time changes and that doctors can take some time within the 90 days to leave the country and go home if they need to do that. They were the two main requests of the GP co-operatives. Those changes were made only last week, and they have been welcomed, but we are open to other suggestions as the need arises. I hope the Deputy will be happy with that response.