The NHS is recruiting more doctors from outside the UK and the European Economic Area than from within for the first time, triggering a moral argument about the health service’s growing mentality to ‘poach’ from the developing world.
Unpublished figures from the General Medical Council (GMC) show that 7,377 (37%) of the 19,977 doctors who started working in the NHS in 2021 had a British qualification.
A total of 10,009 new doctors learned medicine outside the UK and EEA, so-called international medical graduates (IMGs), compared with 9,968 inside. Many were from countries like India and Egypt who are dealing with a shortage of doctors.
IMG’s count of 10,009 new hires last year was almost triple the 3,431 that started in 2016. At the time, IMGs accounted for 27% of NHS new hires, while UK-trained doctors they accounted for 56%.
Hospitals are unable to hire more local doctors because the number of medical graduates the UK produces has risen only slightly, from 7,180 in 2016 to 7,377 last year.
Jeremy Hunt, the health secretary in 2012-18, said recruiting from abroad was “morally dubious”. Others accused the UK of violating WHO guidance on recruiting health professionals from countries with much less developed health systems. The aging of the population has contributed to an acute global shortage of doctors and nurses.
Hunt, the chair of the Commons health select committee, said: “The NHS would simply go down without doctors from abroad and we should welcome them with open arms. But relying on immigration from poorer countries for our NHS staff as a long-term strategy is morally dubious when these doctors are desperately needed in their home countries.”
Hunt’s new book Zero identifies NHS staff shortages as a key reason medical errors occur. He added: “These figures demonstrate the urgency of the workforce planning crisis in the NHS. The workforce strategy promised by the government cannot come soon enough.”
J Meirion Thomas, a retired NHS cancer surgeon who obtained the figures from the GMC, said “poaching so many foreign doctors” was unethical. He said most of the IMGs came from low-income countries “where they are desperately needed to provide essential services.”
Thomas said: “The largest cohorts come from India and Pakistan, although according to WHO recommendations on the ratio of doctors to patients, India has a shortage of about 600,000 doctors and Pakistan 200,000 doctors. This continuing practice…raises serious moral and ethical questions.”
In 2021, a total of 1,645 doctors from India started working in the UK, as did 1,629 from Pakistan, 1,250 from Egypt, 1,197 from Nigeria and 522 from Sudan, a total of 6,243. They comprised 31.3% of all physicians who entered the GMC registry and nearly two-thirds (62.4%) of IMGs.
Britain is also increasingly recruiting nurses and midwives from outside the EEA. A total of 23,408 of these professionals started working in the UK in 2021-22, almost nine times more than the 2,719 who did so in 2017-18, according to recent figures from the Nursing and Midwifery Council (NMC). Two-thirds of last year’s recruits trained in India or the Philippines.
James Buchan, an NHS workforce expert and visiting member of the Health Foundation think tank, said the UK was increasingly failing to comply with WHO guidance aimed at limiting the recruitment of health staff. of the poorest countries in the rich countries.
“The UK and all other member states have adhered to the WHO code [of practice] calling for no active international recruitment of health professionals from designated ‘red list’ countries,” he said.
“The latest data from the UK suggests there are questions to be asked and answered about a significant increase in the number of registered nurses and doctors in these red list countries such as Nigeria.” There are 3,000 Nigerian nurses and midwives in the UK, NMC figures show.
Buchan added: “No healthcare professional should be barred from moving abroad to improve their work, career and life. But the aggregate effect of many people making the decision to move, when actively recruited, can be detrimental to low-resource health systems.”
GMC figures also show that Hunt’s promise in 2016 that “at the end of the next parliament [2025] we will make the NHS self-sufficient in doctors” has no chance of being met.
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A spokesperson for the Department of Health and Social Care said: “We are grateful to all those who have come from abroad to work in our fantastic NHS and social care sector. Internationally trained staff have been part of the NHS since its inception in 1948 and continue to play a vital role.
“While we are absolutely delighted that these doctors have chosen to work in the NHS, we know that the world is struggling to train, employ and retain a sufficient and skilled healthcare workforce. We have therefore committed £20m to programs to strengthen the health workforce in a small number of developing countries.”
Reference-www.theguardian.com