The NHS is hiring more doctors from outside the UK and the European Economic Area than from within for the first time, provoking a moral argument about the growing mentality of the “poaching” health service in the developing world.
Unpublished figures from the General Medical Council (GMC) show that 7,377 (37%) of the 19,977 doctors who started working at the NHS in 2021 had a British degree.
A total of 10,009 new doctors learned medicine outside the UK and the EEA, the so-called graduates in international medicine (IMG), compared to 9,968 inside. Many were from countries such as India and Egypt suffering from a shortage of doctors.
The number of 10,009 new IMG recruitments last year was almost three times the 3,431 that began in 2016. At that time, IMGs accounted for 27% of new NHS recruits, while doctors trained in The UK was 56%.
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Hospitals cannot hire more self-produced doctors because the number of medical graduates produced in the UK has only increased slightly, from 7,180 in 2016 to 7,377 last year.
Jeremy Hunt, the health secretary in 2012-18, said recruiting abroad was “morally questionable.” Others accused the UK of violating WHO guidelines on hiring health professionals from countries with much less developed health systems. The aging population has contributed to an acute global shortage of doctors and nurses.
Hunt, chair of Commons’ select health committee, said: “The NHS would simply fall without doctors from abroad and we would have to welcome them with open arms. the long-term strategy is morally questionable when these doctors are desperately needed in their home countries. “
Hunt’s new book, Zero, identifies the shortage of NHS staff as one of the main reasons for medical errors. He added: “These figures show the urgency of the workforce planning crisis in the NHS. The workforce strategy that the government has long promised cannot come soon enough.”
J Meirion Thomas, a retired NHS cancer surgeon who obtained GMC figures, said the “poaching of so many foreign doctors” was unethical. He said most 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 the WHO’s doctor-patient ratio recommendations, India has a shortage of about 600,000 doctors and Pakistan’s 200,000 doctors. This ongoing practice … raises serious moral and ethical issues. ”
In 2021, a total of 1,645 doctors from India started working in the UK, as well as 1,629 from Pakistan, 1,250 from Egypt, 1,197 from Nigeria and 522 from Sudan, a total of 6,243. They accounted for 31.3% of all physicians who joined the GMC registry and nearly two-thirds (62.4%) of IMGs.
The UK is also hiring more and more 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 data from the Nursing and Midwifery Council (NMC). Two-thirds of last year’s recruits were trained in India or the Philippines.
James Buchan, an NHS workforce expert and visiting researcher in the Health Foundation’s expert group, said the UK was increasingly failing to comply with WHO guidelines for limiting staff recruitment. health of the rich countries of the poorest.
“The United Kingdom and all other Member States have signed up to the WHO code [of practice] which calls for no active international recruitment of health professionals from “red list” designated countries, “he said.
“The latest data from the UK suggests that there are questions that need 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 nurses and midwives in Nigeria in the UK, NMC figures show.
Buchan added: “No healthcare professional should be blocked from moving abroad to improve their job, career and life. But the added effect of many people making this decision to move, when they move actively recruiting, it 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 spokesman for the Department of Health and Social Welfare 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 from its beginnings in 1948 and continues 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 £ 20 million to programs. to strengthen the health workforce in a small number of developing countries. ”