22 December, 2022
1. The UK’s asylum grant rate at the initial decision stage was nearly three times that of France (72% compared with 25%) in 2021, a year during which 28,500 people came to the UK from France in boats. The UK grant rate is now a permissive outlier compared with most of Europe and, by September 2022, had risen by more than 40 percentage points since 2016, when just a third of applications were approved at first instance. In contrast, France’s grant rate fell from a third in 2016 to a quarter in 2021. The recent rise in the UK grant rate may be motivating a rising number of boat crossings from France. 94% of arrivals then claim asylum. A sensitive, internal Home Office study found that the decision to come here ‘may reflect an unsuccessful asylum application in France’ and secondary movement from Europe -including from Greece and Germany – is an increasingly important factor. The Home Office research also noted that social networks and diaspora populations are likely to spur migrants to reach certain destinations. This suggests that if a claimant is rejected in one place, and another (adjacent) country has a higher grant rate then anecdotal information to this effect may spread via social / familial networks, helping to drive illegal immigration.
2. There has been much speculation as to why the number of migrants travelling to the UK in small boats has increased significantly in recent years. A record 45,100 people have been recorded crossing the English Channel illegally in over 1,000 boats since the start of the year to 15 December 2022. This is 1.6 times the 2021’s then-record total (of 28,501) and 151 times the number of people who crossed in 2018.
3. One reason for the rise in arrivals has clearly been the failure of the government to take early decisive action that would have deterred deadly crossings. This was noted by the former Independent Chief Inspector of Borders and Immigration in a damning report on the government’s small boat response published in 2020.
4. However, a recently revealed sensitive, internal Home Office document has also admitted that ‘secondary movement of those who have already applied for asylum elsewhere in Europe is an important aspect of the UK’s asylum intake’. It adds that, in terms of hits on the European Union’s Eurodac fingerprint database showing prior asylum applications in other European countries, the UK ranked 5th only behind Germany, France, Italy and Greece. In 2019, for example, there were around 13,000 Eurodac hits for UK asylum applications linked to previous claims in other European countries. In 2019, UK applications linked to prior claims in Europe included 55% of Eritreans, 44% of Afghans, 38% of Sudanese nationals and 27% of Iraqis.
5. The report also suggests that a decision by small boat migrants to come here ‘may reflect an unsuccessful asylum application in France’. Of particular interest, in light of the fact that more than 11,000 Albanians have crossed by boat to the UK in the past year, the document says that France was ’the top destination country for Albanians’ between 2017 and 2020 (averaging 11,000 per year) despite having a relatively low grant rate (9%). The document adds that Albanians, as well as Sudanese and Afghan nationals (who also account for major small boat nationalities) ‘apply for asylum in France in large numbers’. This surely suggests Albanians are choosing to travel in boats to the UK after being rejected in France.
6. Finally, the document notes that ‘Eurodac data suggests an important portion of Sudanese and Afghan applicants to the UK have previously applied for asylum in France: of the 2019 UK asylum intake, at least a quarter (24%) of Sudanese asylum applicants had previously applied in France as had at least 1 in 10 (9%) Afghan nationals’ 
7. In 2016, Migration Watch UK said that the illegal migration crisis which engulfed the EU from 2014-15 onwards would lead to significant secondary movement to the UK should the UK remain part of the EU. Indeed, we suggested that large numbers of irregular migrants to Europe could subsequently arrive in the UK in the years following 2020 should we remain subject to free movement rules. Now, even despite the UK’s departure of the EU and the end of free movement, it appears that major secondary movement is occurring. The government’s own data suggests that 80,000 people have come here by boat or lorry since the end of the Brexit transition period.
8. Meanwhile, Frontex data suggest that more than four million people have been recorded entering the EU without permission since 2008. Such arrivals are now at a five-year high, with more than 300,000 such entries during the first 11 months of 2022 - 68% higher than in 2021 when the total was just over 180,000. However, this is much lower than in 2015 when more than a million people entered illegally, an event unprecedented in European history (see Figure 2 below).
Figure 2: Illegal arrivals at the Schengen frontier (Source: Frontex).
9. The most heavily used route since 2018 has been in the Eastern Mediterranean, between Greece and Turkey. This route was particularly prominent in 2015/16. However, use of that route has fallen from 885,000 in 2015 to just 40,000 this year. In contrast, the most heavily used route in the past year has been the Western Balkan route, with migrants attempting to cross the southern common borders with Greece and Bulgaria before heading north and trying to exit the region largely at the northern common borders of Hungary, Romania, Croatia or with Serbia. 140,000 people have used the route in 2022.
10. The chart shows that, since 2008, the Eastern Mediterranean route represented 39% of arrivals, the Western Balkan route 29% of arrivals. Use of the Central Mediterranean route – between Libya and Italy - has also expanded in recent years, from 24,000 in 2017 to 94,000 in 2022. The latter figure included 50,800 people from Egypt, Tunisia and Bangladesh – all major sources of economic migration.
Figure 3: Use of different illegal routes into the EU, 2008 to 2022.
11. Eight million people have made asylum applications in the EU since 2008. This compares with around 4 million recorded illegal arrivals. One reason why the asylum figure is so much higher than recorded illegal arrivals is that a number of arrivals may go undetected, while many people also claim asylum after coming to Europe via legal routes e.g. on work or study visas, or Albanians on visa-free travel etc.
Figure 4: Asylum applications in the EU, Eurostat, 2008-2021.
12. The EU+ recognition rate (for initial applications) was 37% in September 2022, compared with 77% in the UK. Recognition rates at the EU level were especially high for Ukrainians, Syrians, Yemenis, Eritreans, Belarusians and Malians. This compared with 77% in the UK in the year to September 2022.
13. Nearly three million asylum applications have been rejected in the EU since 2012. One factor is the scale of illegal economic immigration which the continent is facing. It was Ylva Johansson, the EU home affairs commissioner, who said: “The huge majority applying for asylum are not refugees”. She echoed Frans Timmermans, a vice-president of the European Commission, who said something similar in 2016. A portion of those rejected will have made the onward journey to the UK, with those rejected in France now likely forming a significant share of these. The increase in travel by Albanians to the UK (who claim asylum in France in large numbers according to the government) suggests this is a growing phenomenon. In contrast Home Office data shows that those who previously applied in Germany and Greece accounted for thousands of those subsequently claiming asylum here in 2018/19.
14. The UK’s grant rate of 72% in 2021 at the initial stage was one of the highest in Europe. Meanwhile, France’s was fifth lowest. Why has the UK rate risen so much recently? The government has said that the grant rate ‘increased following changes in the Asylum system service standards. This has led to changes in the way cases are prioritised to help reduce support costs. As a result, more decisions are being made on cases with a higher chance of success.’
Figure 5: Distribution of first-instance asylum decisions (from non-EU citizens) by outcome, 2021. Source: Migration Watch UK adaptation of Eurostat graphic
15. A country's acceptance rate for asylum claims depends upon how it interprets and implements the wording of the Refugee Convention. France interprets it more stringently than the UK as, for instance, does Japan, which takes less than 100 refugees per year (but both are signed up to the Convention). Of around three million rejections in the EU between 2012 and 2021, 1.9 million were in just France, Germany and Greece (the three top countries of prior residence for those subsequently coming to the UK). It is unknown how many rejected asylum claimants in these countries have subsequently travelled to the UK but they are likely to form a large portion of the 84,000 who have come in boats since January 2018.
16. In 2021, France received 120,685 asylum applications, of which 103,790 were applying for the first time. In the same time, France made a total of 137,015 decisions on outstanding asylum applications. As detailed below, of those 137,015 decisions, 33,875 ended in grants of asylum or some other form of leave. This equates to 24 per cent being granted asylum and 76 per cent being refused at initial decision.
17. In contrast, of the 14,532 asylum applications processed in the UK in the same year, 10,468 of them were granted asylum or another form of leave. In contrast to France, this equates to 72 per cent being granted asylum and 28 per cent being refused.
Figure 6: Initial asylum decisions compared in France and UK, 2021
18. Taking the total appeals decisions from 2021, in France of 46,540 appeals, 14,990 resulted in a grant of asylum or other leave equating to 32 per cent of the total. In the UK, of 3,332 appeals made (excluding 564 withdrawn appeals), 1,633 resulted in a grant of asylum or other leave, equating to 49 per cent.
Figure 7: Asylum appeal outcomes compared in France and UK (excluding withdrawn appeals), 2021
19. It may be that the most recent data from the UK is unreliable thanks to a backlog of well over 100,000 applications. With that in mind, in 2019, 52 per cent of applications were approved alongside 44 per cent of appeals. In that year, 25 per cent of applications were initially approved in France alongside 21 per cent of appeals.
Table 1: Grants at initial and appeal stage, UK and France.
|Initial grant rate 2019||Appeal grant rate 2019||Grant rate 2021||Appeal grant 2021|
20. Despite these differences between 2019 and 2021 grant rates, it is clear that a far greater proportion of asylum claims are being approved in the United Kingdom. This begs the question, why are two countries, both signatories to the 1951 Refugee Convention, accepting such significantly divergent proportions of those applying for asylum in their countries?
21. Is it the case that, rather than the UK being particularly lenient, that France is instead especially strict? Such a suggestion is easily rebutted. The grant rate in Germany in 2021 was 45 per cent, in Italy 42 per cent and in Spain and Sweden it was 29 per cent. Regardless of minor differences that may be symptoms of the UK backlog, the country still approves far more asylum claims than many other countries.
22. There are a few clear differences between the asylum systems in France and the UK, some relatively minor and others more pronounced.The process by which asylum interview recordings are handled differ significantly. In the UK, recordings are provided as soon as possible. In contrast, in France audio recordings generally are not provided until a claim is rejected and an appeal lodged, and even then can only be listened to in a specific government office in Fontenay-Sous-Blois. While minor might on the face of it, this means asylum seekers cannot check their wording in the interview which could later make the difference between a grant or a rejection.
23. In the UK, it is the applicant who has the burden of establishing the veracity of his/her claim and the accuracy of the facts on which the refugee claim is based. The burden of proving the asylum claim lies on the person seeking asylum, but the standard of proof is relatively low. The Home Office is meant to assess whether there is a “reasonable degree of likelihood” the person seeking asylum is telling the truth, also described as a “real possibility” or “real risk”. ‘Reasonable degree of likelihood’ is less than the civil standard of ‘the balance of probabilities’ (i.e. ‘more likely than not’).' Indeed, as the government admitted in 2021, 'under current case law the standard to which a claim must be assessed is low'.
24. The Nationality and Borders Act 2022 raises the standard of proof for which an asylum seeker must satisfy for certain elements of the test of whether they face a ‘well founded fear of persecution’ in their place of origin. However, only the first part of the new 2-limb test (the characteristic test) is assessed to the higher balance of probabilities standard, while the vital second stage (the likelihood of persecution element) is still assessed to the lower ‘reasonable degree of likelihood’ standard.
25. Decision-makers are required to take into account a claimant’s conduct when applying the benefit of the doubt to unsubstantiated material facts.  However, lying is common in asylum applications and Home Office staff are even told that, if an applicant tells untruths, it does not mean that their claim for protection should be rejected. As Home Office asylum guidance has stated: “A claimant’s testimony may include lies or exaggerations for a variety of reasons, not all of which need reflect adversely on other areas.. Falsehoods… do not mean that everything the claimant has said must be dismissed as unreliable.”
26. In contrast, the French Office for the Protection of refugees and stateless persons (Ofpra) and the National Court of Asylum (CNDA - the specialised administrative court handling appeals on asylum decisions) interpret the Geneva Convention more restrictively than the UK. A 2018 bill in France shortened asylum application deadlines - shortening the time asylum seekers have to submit an application after entering France from 120 to 90 days, and made changes to speed up the processing of claims.
27. This more rigorous fast-track procedure expedites claims by asylum seekers under a number of certain other conditions which are listed below:
28. The UK did have a Detained Fast Track procedure whereby it was decided the claim could be decided quickly, but this has been suspended since 2015. Although the Nationality and Borders Act does provide for an expedited detailed appeals procedure, the present UK fast-track arrangements do not compare with France’s in their effectiveness at dealing with bogus claims.
29. There are also Non-Suspensive Appeals in the UK, whereby, the appellant can be returned to their country while an appeal takes place. This can happen when the claim is clearly unfounded, or their home country is considered safe. Generally speaking, however, very few UK claims are non-suspensive. In contrast, in France appeals that have resulted from an inadmissibility decision (such as making their claim after 90 days in-country) or ones made from detention are not suspensive and mean the appellant can be issued an expulsion order immediately with the appeal decision continuing despite their potential deportation.
30. The advantage of this accelerated procedure is that it allows French authorities to expedite cases that are likely to be unfounded and expel those with no right to refuge much more quickly than would otherwise be the case. This makes France a less appealing destination for those who would try to gain refuge illegitimately as their expulsion is likely to happen sooner. It also means that taxpayers’ money is not being spent on those with frivolous applications any longer than necessary.
31. Furthermore, the 90 day window in France, mentioned at paragraph 26 and 27 above, has the duel effect of encouraging claims to be made quickly while ensuring any who apply for asylum after that period are penalised for failing to do so.
32. The UK is presently spending more than £2 billion per year on asylum support including accommodation in more than 400 hotels, some of which are four-star establishments. The UK and France offer seemingly similar packages of support to asylum seekers who are awaiting the processing of their claim, although there are distinct differences. However, those on section 95 support (the main form of UK support for pending and failed claimants with children) are given cash cards (called ASPEN cards) with which to withdraw money (about £40 per week per person). The most recently available information shows that the number of Aspen Cards in use in the UK had risen from 23,800 in Q2 2017 to 41,274 in Q1 2021. However, the rules regarding cash withdrawals by people awaiting an asylum decision are also stricter in France - claimants in France also get about £40 per week to support themselves (as here) but cannot withdraw it as cash as people can here using Aspen Cards.
33. The UK government also suggested that the differential rates by which the UK and France provide accommodation to asylum seekers may be one of the root causes of people choosing to leave the safe country of France and cross the Channel to claim asylum here. In the sensitive internal document referred to above, the Home Office noted that only 52% of eligible asylum seekers were accommodated in housing at the end of 2019: “Many asylum seekers are forced to live in informal makeshift camps in the absence of access to official accommodation.”
1. Medicine is amongst the UK’s most popular higher education course categories attracting tens of thousands of applicants every year who compete for 7,500 limited places in England and around 1,500 places in the rest of the UK.
2. However, the number of places has not kept up with the increasing demand for doctors within the NHS. As a result, the government have stepped up recruitment of doctors from abroad which has led to a significant increase in the proportion of overseas-trained doctors working for the NHS.
3. This briefing will consider: the number of UK and foreign medicine graduates; what impact this has on the NHS; and what can be done to increase the number of UK-trained doctors and reduce the increasing reliance on recruiting overseas.
4. Between 2016 and 2022, an average of 37 per cent of Hospital and Community Health Services (HCHS) doctors have come from overseas each year. In 2021 and 2022, this figure rose to 44 per cent.
Table 1: HCHS doctors by nationality joining the NHS, year ending December 2020-2022, year ending June 2016-2019
|Of which: EU/EEA||2,212||2,252||2,036||2,113||2,077||1,940|
|Of which: rest of World||3,115||3,820||4,186||6,012||6,733||7,963|
|Proportion of non-UK joiners of the total (%)||31||33||34||39||37.2||41.9|
5. This increase in overseas doctors joining the NHS was clearly deliberate. Skilled workers, including doctors from outside the EU/EEA, used to be capped at 20,700 per year. In 2018, however, following lobbying from various groups, including former Health and Social Care Secretary Jeremy Hunt and former Home Secretary Sajid Javid, doctors were removed from the work permit cap of that time. Since then the number of doctors coming from outside the UK or EU/EEA has increased by X per cent, from 4,186 in 2018 to June to X,XXX in 2022 to December.
6. An alternative set of figures, however, indicates the proportion of new doctors who trained overseas is higher still. Looking at the number of first registration doctor applications granted by the General Medical Council in 2022, for instance, shows that 63 per cent of applications to register were granted to individuals who gained their Primary Medical Qualification outside of the United Kingdom. Unlike NHS joining figures as detailed in Table 1, this includes local General Practitioners (GPs), doctors working for private healthcare companies and those potentially not currently practicing at all. It will also involve UK nationals who gained their accreditation abroad.
7. Comparison of the number of overseas doctors recruited each year (see Figure 1 below) alongside the number of students enrolling onto medical training shows that in almost any given year a higher number of overseas doctors are being recruited than UK students are being accepted for training. Although not strictly comparable, due to student data being for the year ending August while the recruitment data is for the year ending June, this is nonetheless highly indicative of the trend of overseas recruitment outstripping domestic education.
Figure 1: Comparison of England-domiciled medical students enrolled and overseas HCHS doctors joining the NHS in England, 2016-2022.
8. The growing tendency to recruit overseas largely stems from a failure both to train a sufficient number of doctors in the UK and to anticipate the increased demand resulting from a burgeoning population driven by immigration. According to the British Medical Association (BMA) the UK is short of 46,300 doctors in England alone. Other analyses have identified a need for between 5,000 and 11,000 extra medical trainees per year to close the shortfall.,
Figure 2: Outcomes for UK-based applicants of medicine courses 2019-2022 - UCAS
9. Notwithstanding the greater need, large numbers of would-be medical students are being turned away every year from medical courses for which they may be qualified, yet for whom limited capacity allows no space. In 2022, there were 19,235 UK applicants to study general medicine, a 25 per cent increase on 2020. Of these, 9,050 were accepted onto courses while 10,185 were turned away.
10. This has seen the acceptance rate plunge from 63 to 47 per cent in the space of just two years.
11. The high rejection rate is the result of the funding cap on government-funded medical training places which, in 2017, the government said cost £165,000 each (excluding student loans). The official position is that numbers are capped to maintain high standards within funding constraints. This policy leaves high numbers of students without a place at a medical school. As Consultant Surgeon J Meirion Thomas has said: “Tens of thousands of students with the required A-level grades and aptitude have failed to gain entry to our medical schools because places are strictly limited by cost.”
12. One Member of Parliament, Anthony Browne MP, recently remarked that the majority of Bulgarian-trained doctors in Britain are not actually Bulgarian, but British graduates who had no option but to get training abroad thanks to the low training capacity.
13. Table 2 below shows the total number of medical and dental students enrolled by domicile over the past decade. It shows how gradually the number of students paying ‘Home’ fees (including EU students prior to 2017-18), who are subsidised by the government, have increased very slowly over time with a temporary uplift from 2020-21 to 2021-22. It also indicates the upper limit of how many medical students can be trained in current facilities. Figure 2 below, displays the total of students paying Home fees.
Table 2: Total medical students enrolled by fee status and domicile, 2012-2022
|Year||Home students (incl. EU to 2016-17)||Overseas Students||Grand Total|
|Total (excl. EU)||England||Northern Ireland||Scotland||Wales||EU|
14. Between 2018 and 2020, the cap in England permanently rose by 25 per cent from 6,000 to 7,500. However, this was partly due to a fall in students from Europe after the UK’s departure from the EU (who were previously treated the same as British students). In 2020 and 2021 the cap was temporarily increased further to over 9,000, only to be re-imposed at 7,500 in in 2022. Commenting, the then-Education Secretary James Cleverly initially blamed the difficulty of increasing capacity before later admitting that funding was the main issue.
Figure 3: Total no. of UK-domiciled medical students enrolled in English medical schools 2012-23
15. As may be inferred from what happened in 2020-21 and 2021-22 when 800-1,000 more places were funded each year than 2019-20, it turned out that training capacity was actually higher than funding had previously allowed. In 2021-22, for example, the cap on the number of British students was raised and medical schools ran at (what appears to be) capacity. That medical schools were able to take on 1,000 more students without apparent difficulty indicates that real capacity was and is greater than funded capacity. In 2021-22, across the UK, there were a total of 9,535 British students enrolled on medical courses, as well as 965 overseas students. If the cap were to be permanently raised to this level of capacity, that would result in 590 more British students enrolled this year.
16. If, in addition, places allotted to overseas students were allocated instead to British students, that would mean approximately a total of 1,500 more places for ‘Home’ students per year. This is a low-end estimate as there may yet be further unidentified excess capacity, such as at the new Chester University Medical School whose 50-100 places, all designated to overseas students, are not included in Office for Students targets for 2022-23.
17. The same is true for similar new establishments at Worcester and Brunel universities, the latter of which will train over a hundred international medical students. A notable irony exists in the case of Three Counties Medical School at the University of Worcester in having been founded with the explicit intention of addressing local medical needs. Despite this, like many universities they have been strictly ordered by government not to train more/any UK-born medical students.
18. Such an approach would be entirely in line with the consensus reached outside government. Raising the cap and trying to train an adequate number of UK-based doctors is agreed with by the Royal College of Physicians, the British Medical Association and the Migration Advisory Committee, the latter having said: “[We have] consistently emphasised the need to raise British human capital and thereby lessen employer dependence on immigration.”
19. A further policy change that would increase the supply of doctors, thus reducing the need for additional doctors from overseas, would be to end the ‘pension tax trap’ for doctors. At present, because the pensions lifetime allowance has been frozen, many doctors are hitting the annual cap on pension contributions and finding that their tax bill is increased as a result, in some cases to the extent that they are effectively not paid for overtime shifts. This penalises certain levels of work and so has led to doctors working fewer hours or retiring altogether.
20. The government has sought to address this in the Spring Budget, which is scrapping the lifetime allowance, to encourage workers, particularly doctors, to work up to the retirement age.
21. An additional area of contention is whether workforce management is being hampered by the differing work preferences of male and female doctors. The proportion of female doctors to male doctors have reversed in recent decades. For example, just 27 per cent of registered doctors aged over 60 are women, while in the 25-29 age group it is 56 per cent. According to one surgeon, this creates problems in the workforce as female doctors are less likely to specialise and prefer roles with a better work-life balance. Data from the Office for Students shows that 62 per cent of medical students enrolled in 2022-23 are female.Conclusion
19. This paper shows that despite tens of thousands of UK medical applicants being turned away every year and widespread agreement that the UK has a significant doctors’ shortage, Britain has failed to adequately increase funding for medical places. This has left the NHS with little immediate option but to attract doctors from poorer countries with greater health needs. At the same time, harmful taxation policies unintentionally encouraged some doctors to reduce their working hours and others to retire early. By scrapping these tax measures and funding medical training places to capacity, the UK could make significant progress towards addressing the doctors’ shortage.
34. Being a member of the European Union and a signatory to the Dublin Regulation, France has the right to transfer asylum seekers to the EU member state found responsible for relevant asylum seekers. Although occasional landings by boat have been made in France, these are rare (compared with Italy and Greece). This may contribute to the fact that France typically is a net transferer of asylum seekers under the Dublin Regulation.
35. In 2021, for instance, of the 4,157 total inbound and outbound transfers to/from France, 75 per cent of them were outbound. It is common to blame absence from the Dublin Regulation since leaving the European Union for the UK’s failure to return rejected asylum seekers and illegal immigrants. However, as data shows, the UK’s use of the Dublin Regulation to remove asylum claimants to the first country of entry was never as effective as France’s. In the latter years of Britain’s EU membership, the UK generally accepted more transfers inwards than it sent outwards.
36. France has one of the lowest asylum grant rates amongst EU member states while the UK has one of the highest grant rates in Europe. France’s rate at the initial decision stage has fallen since 2016 while the UK’s has risen significantly. The latter now stands at 77%, with the final grant rate after appeal being even higher.
37. Given the growing pressure of secondary migration by asylum seekers in Europe, including 2.9 million people asylum rejects in EU countries since 2012 (not including the UK) – of which there have been 680,000 in France since 2012 - there is a strong likelihood that the significant recent increase in asylum grant rates in the UK has added to the powerful magnetising effect of UK asylum and enforcement chaos, drawing more and more people across the English Channel. This factor may have boosted the likelihood of migrants being enticed to take dangerous and indeed deadly dinghy voyages, in the process paying criminal smugglers, risking the lives of children and breaking UK laws to get here. In the midst of overwhelmed services and an increasingly costly asylum system that is riddled with backlogs and abuse, the UK government must urgently address this worsening problem by toughening up UK asylum procedures to restore common sense and root out and deter more bogus claims, and align our rules more closely with the European norm.