Plans to cut NHS international workforce appear overambitious, say MPs | NHS
Ministers’ plans to reduce the international workforce in NHS England appear overly ambitious, MPs have said, as a report revealed the health service had saved more than £14bn by recruiting doctors, nurses and midwives from abroad.
The all-party parliamentary group (APPG) on global health and safety found that most recruiting countries are struggling with staff shortages and that the UK has a moral duty to offer support rather than just extracting what it needs.
The group’s research into the benefits and costs of international healthcare worker recruitment heard that the NHS’s reliance on overseas workers meant the government’s plan to cut international hiring to around 10% by 2035 was overambitious.
Former development minister Andrew Mitchell, who chaired the inquiry, said: “The NHS has not operated at this level for decades.”
36 per cent of doctors and 24 per cent of nurses and midwives in the UK were trained elsewhere in the world.
There has been a sharp decline in the number of visas issued to healthcare workers in recent years. However, the APPG said staff from abroad would be needed “for the foreseeable future”.
Mitchell added: “We must grow our own workforce. But in a shrinking world, it is no longer credible to argue that the health workforce is purely national assets. If we are using overseas-trained health workers, we also have a duty to help strengthen the systems from which they come.”
The World Health Organization estimates that there will be a shortage of 11 million healthcare workers worldwide by 2030. Today, almost a quarter of the world’s doctors, nurses and midwives are concentrated in just 10 high-income countries.
The UK has around 30 doctors for every 10,000 people, while India has nine, the Philippines has six and Ghana has one.
Representatives from Kenya and Uganda, who gave evidence to the inquiry, said they had lost significant numbers of experienced doctors, nurses and clinical educators. They said this would have detrimental effects on the next generation of healthcare workers, as well as on patient safety and care.
Ben Simms, chief executive of Global Health Partnerships (GHP), said: “The NHS is one of the most internationally connected health systems in the world. But when we recruit from countries that can least afford to lose staff, the consequences are measurable in lives.”
The APPG report was published at the UK Global Health Summit in London on Monday. The analysis of savings achieved by recruiting personnel from abroad was carried out by conference organizer GHP and the Center for Global Development.
They used “conservative estimates” that the cost to taxpayers of training a doctor in the UK was around £120,000, including elements such as subsidized university places and paid clinical training, while training a nurse was around £23,000.
The report found that the UK has signed agreements with many of the countries it recruits from, but that they tend to “solely manage the mechanics of mobility” rather than linking recruitment to ongoing investments in training and retention, which could offset its impact.
The APPG investigation recommended a fairer system in which international recruitment is balanced with proportionate investment in health workforce development and health system strengthening in partner countries.
“A model based on partnership rather than extraction offers a path forward that aligns moral responsibility with national interests,” the report says.
Last week, the Guardian revealed that the government had canceled a major health project supporting the development and training of medical staff in six African countries as part of aid cuts to increase defense spending.
APPG president Dr. Beccy Cooper said: “International healthcare workers are part of the DNA of the NHS. In a world where disease doesn’t stop at borders, their global expertise strengthens our healthcare system. Fostering homegrown talent and ethical international recruitment are not competing goals – they are both essential. What we cannot afford is boom-and-bust workforce planning that destabilizes the NHS and also weakens global health systems.”
A Department of Health and Social Care spokesperson said: “The NHS benefits greatly from its international staff and we will continue to support talented overseas healthcare workers who are willing to dedicate their time, energy and skills to healthcare.
“But this should not be at the expense of countries whose healthcare systems are already struggling, and it is right that British taxpayers see a return on the investment they make in training our own medical talent. That is why we are making bold choices to focus on the recruitment and retention of home-grown doctors and nurses, prioritize UK medical graduates for jobs and increase graduate nurse salaries.”
