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BMA: Review Adult Dependent Relative Rule for Doctors

The British Medical Association, together with other leading medical bodies, has issued a call for the Adult Dependent Relative (ADR) rule to be amended to allow settled migrant doctors to bring adult relatives, such as elderly parents, to the UK so that they can look after them.

The BMA’s joint letter to the Home Secretary asking her to exempt doctors from the Adult Dependent Relative rule can be read here

Requirements for an Adult Dependent Relative visa

Under the current Immigration Rules, settled migrant doctors who wish to be joined in the UK by their elderly parents generally need to sponsor an application by their parents for an Adult Dependent Relative visa.

In order to qualify for an Adult Dependent Relative visa, the elderly parent must satisfy the Home Office that various requirements are met, including that: 

  • As a result of age, illness or disability, they require long-term personal care (that is help performing everyday tasks, e.g. washing, dressing and cooking); and
  • They are unable, even with the practical and financial help of their family member in the UK, to obtain the required level of care in the country where they are living because it is not available and there is no person (close relative, home-help, housekeeper, nurse, carer, care or nursing home) in their country who can reasonably provide it, or because it is not affordable.

At the same time, applicants must satisfy the Home Office that:

  • They will be adequately maintained, accommodated and cared for in the UK by their family member, without recourse to public funds (if the family member is a British citizen or settled in the UK, they are required to sign a 5-year undertaking to this effect).

The above criteria, introduced in 2012, have long been recognised as presenting an almost insurmountable barrier.  

Even if the person applying for an Adult Dependant Relative visa does experience the high level of ill health required by the first of the above criteria, the second is even harder to satisfy. Most sponsors who are able to afford to maintain and accommodate their dependent relative for five years will find it hard to prove that they cannot afford to provide care for their relative in their country of origin.

A 2016 Home Office review into the effect of the rules showed that, while a total of 2,325 applications had been granted under the more flexible rules in place between April 2010 and March 2011, this number had fallen to 189 successful applications in 2013 and just 135 the following year.

What does the BMA say about the Adult Dependent Relative rule?

The British Medical Association is asking the Home Secretary to remove the restrictive Adult Dependent Relative rule for settled migrant doctors, warning that the rules are effectively leading to the permanent separation of older relatives from their children.  

They say that this in turn is having a significant detrimental impact on the wellbeing of medical professionals in the UK, as well as posing a threat to our future medical workforce.

The BMA’s joint letter states:

“The impact of the rules has been to permanently separate elderly parents from their UK-settled children, and this has had a considerable impact on the mental health of our members, with many reporting increased stress and anxiety over the welfare of their parents, and their care.”

It continues:

“Not only is this extremely challenging for consultants, GPs and experienced doctors who already have busy and stressful lives, compounded by the COVID-19 pandemic, but it means they are often forced to take leave, and even make multiple journeys, at a time when our NHS needs their dedication and experience more than ever. The situation has even left some doctors feeling that their right to a family life is being disregarded and has led to a feeling of despair and a risk of burnout.

“There is no statistical evidence to suggest that the cost of lifting these restrictions for doctors on the NHS would be a burden to the taxpayer. Perversely, the potential loss to the NHS if these doctors, (many of whom the UK has spent money on training) feel they are forced out of the country due to their inability to care for their elderly parents in the UK, would likely be far greater.”

The letter goes on to observe that now that the Brexit transition period has come to an end, the restrictive Adult Dependent Relative rule now applies to EEA nationals who had previously enjoyed greater flexibility to move their elderly parents abroad through EU free movement law.  The concern is that doctors may be deterred from progressing their careers in the UK, in favour of other European countries.

The letter urges the Home Secretary to change the current rules and make it possible for elderly parents of doctors working in the UK to be granted indefinite leave to remain and join their families in the UK.


Amending the Adult Dependent Relative rules in the way proposed would give many doctors working on the frontline the reassurance they need to stay working in the NHS whilst fulfilling their personal caring responsibilities for their elderly parents.

Meanwhile, the experience and dedication shown by doctors throughout the COVID-19 pandemic suggests that public support for such a measure may well be widespread.

It remains to be seen how the Home Office will respond.  The Home Office may well question whether any relaxation of the rules for doctors may necessitate similar flexibility for other health and care professionals including nurses, midwives and paramedics.

However, the recent introduction of the Health and Care Worker visa and the introduction of free visa extensions for health workers during coronavirus suggests that the door may not be entirely closed.

Further Information

The BMA has published a report, Are your parents home?, examining the issues faced by doctors wanting to move vulnerable relatives to the UK.

Contact our Immigration Barristers

For expert advice and assistance regarding an application for an Adult Dependent Relative visa, contact our immigration barristers on 0203 617 9173 or complete our enquiry form below.


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