Many of those Indian doctors came over before the restrictions in recruiting from outside the EEA came in. Some will be included because they are junior enough in their career to be working on a student visa (first and second year after qualifying). Then they would likely have to leave despite having done their medical degree here.
Others will come because their role was advertised (for a set period of time) and no EEA candidates came forward. So then (eventually) trusts would have been allowed to advertise again, and applicants from outside Europe could be considered. The Border Agency/Force would visit and require evidence that this whole process had been followed to the letter. Meanwhile, trusts have to manage with one - or more - vacant medical posts whilst all this is going on.
Others will have been able to come because their specialty is on the shortage occupation list.
As for coming to harm, I gave a specific example earlier. I'd think there were plenty more, after all if you aren't allowed to test the language skills of a doctor, what could possibly go wrong?! Fortunately, that was changed eventually, but it took years.
As for other examples of harm/competence, I need to be vague, but after some mass EU recruitment from one part of Europe, a cohort may have been removed from their posts en masse. Let's say that's a rather unusual event.
As for harm due to the EWTD, it's not easily measurable, and it's a really complex area. However, if you visit someone in hospital, you'll notice that almost all junior doctors now work shifts, which is a direct result of these regulations. Consequently the team structures within medicine has been dismantled to an extent, and junior doctors (that's everyone apart from consultants) can't be mentored and learn from following patients through their care when they are working factory hours and have to clock off.
The Royal College of Surgeons were against the introduction of the EWTD from the start, and more recently, here's what they say:
https://www.rcseng.ac.uk/news-and-ev...e-discussions/. I think it's safe to say that if the quality of training is impacted, harm will likely follow.
I agree entirely with your final paragraph. The application process for a tier 2 visa is ridiculously tortuous and takes ages. I'd like to see a much shorter, simpler process for all shortage occupations.
Apologies to everyone else, this is probably really boring!