How Will Brexit Affect Spanish Doctors?

Dr Javier Cotelo

June 17, 2019

We've heard how Brexit is affecting one French doctor practising in the UK, but what about his Spanish counterparts?

EU doctors have been given reassurances from the British Government about their rights to remain and applying for settled status.

The NHS relies heavily on workers from Europe and other foreign nationals.

Brexit is due to happen at the end of October 2019 but the exact arrangements will be put in place by Theresa May's successor as prime minister. The winner of that contest will be named in July.

One Spanish Doctor's Story

Spanish doctor Eliezer Ramírez has been registered as an occupational medicine specialist by the General Medical Council (GMC) since 2013. He started his professional career as a specialist in 2017 and since then has been living in London. He has worked in the NHS and as an independent specialist for various companies in the transport industry.

   

Dr. Eliezer Ramírez

Dr Ramírez told Medscape Spanish Edition: "I didn't have to follow any procedures to move to the United Kingdom as a European citizen.  Currently the government states on its web page that the rights and status of European citizens who are living in or arrive in the United Kingdom before 30th June 2021 will remain unchanged.

"Despite this the government opened pre-status and immigration status applications on 29th March.  Applying for this status guarantees you can continue to reside and work after 30th June 2021.  From what I know the process is free and personally I still haven't applied, until Brexit becomes effective, although, as I said, it is my personal choice," he pointed out. 

From 1st July 2021, EU citizens and their relatives in the United Kingdom must apply for immigration status to legally live in the country.  If you meet the requirements, obtaining this status means you can continue to live and work in the country as previously, under British citizenship, and you will continue to be eligible for public services such as health and schooling, public funds and pensions. This would be in accordance with the same regulations as today, as stated in the bulletins produced by the Organización Médica Colegial de España [Spanish College of Physicians] in updated information on 29th March.  There is also the option to sign up online to receive email alerts from the UK when it is time to apply.

Monitoring the Professional Suitability Certificate

One document necessary for a Spanish doctor to register and work in other EU countries is the Electronic Professional Suitability Certificate.  This certificate is issued by the Consejo General de Colegios Oficiales de Médicos [General Council of Accredited Medical Colleges] in Spain, based on the data provided by the Colegio Oficial de Médicos [Accredited Medical College] of the provinces where you are or have been registered.

In 2018, according to data in the bulletins published by the Spanish College of Physicians, the number of these certificates issued to doctors wanting to leave Spain had increased by 7.4%.  In particular, the request for professional suitability certificates in 2016 was 3402; in 2017, 3282 and 3525 in 2018.  The majority of professional suitability certificates were requested for work outside of Spain (63.2%); others to a lesser extent were for studies and collaboration etc.

Which are the preferred destinations for Spanish doctors working abroad? The first two countries have not changed much in the last few years. However, they switched positions in 2018. The most requested countries were France with 583 and the United Kingdom with 572 certificates. 

This suggests that Brexit has not deterred Spanish doctors who want to work in the UK.

With regard to specialisms, data gathered in 2018 by the International Department of the Spanish College of Physicians stated that the specialists who requested this certificate the most were GPs (256 cases), anaesthesiologists (92) and ophthalmologists (84).  The figures also highlighted that the majority of doctors requesting these certificates, more specifically 46.1%, were between 31 and 35 years old.

Dr Ramírez stated that in his professional and personal experience he has not had a problem since he arrived in the UK. He has felt very settled working in this country.  "How Brexit will affect me is something I still cannot confirm as the government is negotiating its departure and the specific terms. Currently I don't have any intention to return to Spain as I would like to continue to develop my professional career in the United Kingdom."

Finally, Dr Ramírez thinks that Brexit should not be a hurdle, nor the main factor, when deciding to live and work in the UK.  He thinks that people's personal circumstances and professional aspirations should take priority.

Deal or No-deal?

Experts have said a no-deal Brexit would be the worst possible outcome for the NHS.

In fact, the British Medical Association (BMA), and the General Medical Council, are advocating a second referendum regarding Brexit, considering that leaving the European Union presents a serious threat to the system and the health of citizens.

Dr Íñigo Iruskieta, a Spanish doctor with extensive experience, who has been practising in the United Kingdom for more than 20 years, since 1991, has spent time in different hospitals in different locations such as Norfolk and Brighton. He is currently based in Southend-on-Sea in Essex, where he has been practising family medicine within the NHS since 2000.

Dr Iruskieta told Medscape Spanish Edition that "in order to work in the United Kingdom, the first thing you have to do is contact the General Medical Council. They are the accrediting body with whom you are registered and with whom you need to meet the necessary requirements to practice medicine in the country, providing them [with], among other simple documents, degree certificates translated into English by a specific accrediting body."

Subsequently it is necessary to contact the Spanish consulate to process the appropriate residency permits which, from what he can remember were easy and free or did not cost much when he did them.  "It is necessary to inform the consulate of your change of address within the country to keep them up-to-date with your location and so they can contact you if necessary", he added.

According to data from the BMA, the UK needs approximately 10,000 more doctors.  Furthermore, 5% of all doctors come from an EU country, and many of them are planning to leave the country. This means that approximately 62,000 of the 1.2 million NHS workers in England are from other EU countries, including 11,000 doctors, who represent around 5.6% of the UK workforce.

Downturn and Breakdown in Primary Care

Dr Iruskieta cites recent BBC News reports that "this is the worst crisis in the last 50 years for health professionals. General practice has problems with staffing and retention leading to a lack of appointments for patients.

"This current state suggests that Brexit is not going to have any consequences on Spanish doctors who are practising there, because the system needs them.  The logical thing to do is to help them as best as possible with all processes or permits to allow them to stay in the country, including motivating more doctors to come," he stressed.

The situation may change in future depending on how the UK leaves the EU. If it remains in the European Economic Area people, services, goods and capital can continue to move between borders. Directives like the recognition of Professional Qualifications should also apply to all member countries.

Translated and adapted from Medscape Spanish Edition.

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