Foreign doctors – including from south Asia – are increasingly filling shortages in the NHS as the proportion of medics hired from within the UK has gone down over the past seven years, analysis by the BBC has revealed.
International doctors accounted for 34 per cent of the recruitment in 2021, up from a modest 18 per cent in 2015, NHS workforce data, analysed by the BBC’s Shared Data Unit revealed.
The proportion of homegrown doctors hired during the same period declined to 58 per cent from 69 per cent.
The pattern was similar for UK nurses whose share of recruitment declined from 74 per cent in 2015 to 61 per last year as the country continued to grapple with a workforce crisis.
While the government said the number of doctors had risen 34 per cent since 2010, there have been calls to reduce the "disproportionate reliance" on international recruits.
The nationalities of the medical professionals coming to the UK from the rest of the world are not clear from the data, but experts have previously warned the recruitment of doctors and nurses from developing countries like India and Pakistan amounted to “poaching”.
The share of professionals from the European Union and European Economic Area leaving NHS England went up consecutively during 2015-2018. The trend was also similar for nationals from the rest of the world between 2015 and 2021.
According to the British Medical Association (BMA), the NHS faced a challenge in retaining overseas staff because of the "financial and bureaucratic barriers" they faced.
Its international committee chair, Kitty Mohan, said the NHS data illustrated the workforce emergency facing the NHS, which has become “increasingly dependent on international recruitment”. He blamed the “chronic staffing shortages” on the lack of effective workforce planning by the government.
“The NHS has grown heavily reliant on doctors from overseas who have and continue to make an enormous contribution to our health service. This was evidenced during the pandemic as international doctors were front and centre of the battle on the NHS frontline – with a disproportionate number sadly losing their lives to the virus,” Mohan said.
His deputy at the BMA, Amit Kochhar, pointed out the financial issues overseas recruits faced.
He said medical graduates were charged up to £2,400 to apply for indefinite leave to remain and their dependents also faced the same fee.
Kamal Sidhu, a GP partner working across two practices in County Durham highlighted the challenges foreign-origin professionals face in the UK.
After 17 years working for the NHS since his relocation from India, Sidhu had been considering whether he needed to uproot his family to care for his sick father.
He brought his parents to England last year, but their visitor visas expired in April. He waited six months for a decision about their ability to stay in the UK. That has now been granted.
The doctor’s wife works for the NHS as a dentist in Sunderland.
Immigration rules were a disincentive to medical graduates to work in England's NHS, Sidhu said. This is in contrast with the immigration systems in Canada, Australia, New Zealand,
France and Ireland which allowed dependent relatives to join health workers without the need for such visas, he added.
"We are losing people who've gained NHS experience and who we've invested in, and in many cases senior consultants and very experienced GPs," Sidhu said.
"You are torn apart going to bed at night worrying about what we would do if we did not get permission for my parents to stay in the UK. Between us, my wife and I, we have worked for 33 years for the NHS.
"My sons were born in England; they consider themselves English. Our lives, our social circle, friends - everything we've worked for. We feel so disappointed."
Royal College of Nursing (RCN) Director for England, Patricia Marquis, said ministers must do more to reduce the "disproportionate reliance" on international recruits.
Chief executive of NHS Employers, Danny Mortimer, said it was "high time for the government to commit to a fully-funded, long-term workforce plan for the NHS" to tackle "chronic workforce shortages".
He said "relentless demand" was affecting staff due to vacancies which stood at around 110,000 - "gaps which cannot and should not be filled through international recruitment alone".
The Department of Health and Social Care (DHSC) said the annual percentage decline in EU nationals joining the health service could have been down to more rigorous language tests introduced by the Nursing and Midwifery Council (NMC).
International recruitment had "long been part of the NHS workforce strategy", a spokesperson added, with around one in seven staff reporting as non-British.
The DHSC also "rejected the assertion that immigration restrictions were a key reason for healthcare staff leaving the UK".
There was "no obligation on healthcare professionals to apply for [Indefinite Leave to Remain] and they could, under the new Points-Based System, remain in the UK on a Health and Care Visa which was a key promise of the government's manifesto", the department said.
It added: "The government is committed to ensuring that the number of medical school places is in line with England's workforce requirements.
"The government has funded an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25 per cent increase over three years - and there are record numbers of medical students in training."
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