The United Kingdom has twice as many foreign doctors and nurses as the Western average, a report has revealed. Photo / 123rf
The United Kingdom has twice as many foreign doctors and nurses as the Western average, a report has revealed.
The study, by the Organisation for Economic Co-operation and Development, found that foreign-trained doctors made up 38.3% of Britain’s medical workforce in 2023, compared with an average of 19.6% across 28 developed and developing countries.
More recent data from the General Medical Council, which regulates doctors in the UK, found that number has continued to rise and now stands at 42%. In contrast, the figure is 15% in Germany, while in France it is 11%.
The influx of foreign doctors to Britain, which now tops 20,000 a year, has come as UK medical graduates struggle to secure training places.
Junior doctors, now called resident doctors, cited foreign medics taking limited speciality training places as one of the reasons for their pre-Christmas strike.
Stuart Andrew, the Conservative shadow health secretary, said the “growing reliance on foreign-trained healthcare professionals is a wake-up call”.
“As we bring in more from abroad, UK-trained doctors are left fighting for fewer spots,” he said.
“To secure the future of our NHS, we must reform the system to not only recruit internationally but also invest in and prioritise domestic talent.”
Gareth Lyon, head of health and social care at the Policy Exchange think-tank, said: “The UK needs to train more doctors and to establish more medical schools to train them”.
He said the Government was “relying on a quick fix of recruiting ever more clinicians from overseas” and could “secure a healthy return to the Exchequer of £260,000 to £505,000 for each student” by expanding the number of medical graduates it trained.
The health service is hiring in large numbers to fill vacancies, but the amount of specialist training posts to become consultants has long been capped by successive governments, largely because of short-term costs. Places are open to global competition.
As a result, British doctors can be left without a training place, even as trusts recruit from abroad to meet immediate staffing needs.
Training a UK doctor costs the British taxpayer about £160,000 ($370,000).
The ratio of applicants to medical school places in Britain is about three to one, while for junior doctors applying to speciality training posts it is four to one.
National Health Service trusts were legally required to prioritise British graduates until 2019, when doctors were added to the UK occupation shortage list.
This change was made permanent by the overhaul of the visa system in 2021 under the former Prime Minister Boris Johnson – described as the “Boriswave”.
This saw the removal of the resident labour market test, requiring employers to advertise jobs domestically first, and resulted in an influx of doctors from Africa and Asia.
A recent report into medical training in the UK, co-authored by Professor Sir Chris Whitty, the Chief Medical Officer, cited problems with the system, including the significant number of immigrants being admitted to work in the NHS.
It concluded: “Getting the right balance between domestically trained graduates, international graduates with experience in the UK and new international graduates is an important issue of policy, and the recent major changes to these ratios have contributed to some of the bottlenecks in training.
“We cannot shy away from addressing this issue, while supporting the excellent international graduates in the NHS providing patient care.”
Wes Streeting, the Health Secretary, has promised to boost “home-grown talent” as part of an update to the NHS’s workforce plan.
He committed to prioritising British doctors by undoing the changes made to the visa system in 2021, but the British Medical Association rejected the Government’s offer to introduce emergency legislation to prioritise British graduates if the union called off its recent strikes.
According to the report by the OECD, an international organisation that aims to develop economic and social policies, while four in every 10 doctors in Britain are trained overseas, it is not the country most reliant on foreign doctors.
The UK ranked sixth of 28 in 2023, with Israel, Norway, Ireland, New Zealand and Switzerland ranked as more reliant.
However, Britain is more reliant than comparable countries, including Australia and Canada, where foreign doctors make up 31.4% and 24.6% of the medical workforce respectively.
The proportion of foreign doctors has risen by 29.8% since 2010, while the OECD average was 15.9%.
The OECD report said: “In 2023, OECD members employed more than 600,000 foreign-trained physicians, a rise of just over 50% since 2010.
“Their distribution is uneven: nearly three-fifths practise in only three destinations – the United States, the UK and Germany.”
Just three of the 25 countries that provided data for 2010 and 2023 have seen a reduction in the reliance on foreign doctors. Israel and New Zealand both dropped slightly, but remain in the top four.
Nowhere has been more reliant on foreign nurses to grow its workforce than the UK.
The proportion trained abroad and migrating to Britain accounted for 23% of the total – the fourth highest, and more than twice the OECD average of 9%.
The authors said, “their contribution was especially marked in the UK”, with numbers increasing from 70,000 to 170,000 over the period.
They said 60% of foreign-trained nurses were concentrated in the UK, US and Germany, but that foreign-trained nurses accounted for 7% and 10% of the US and German nursing workforces. Canada, Italy, France, Denmark, Norway, the Netherlands and Finland were all 10% or less.
Data from 2020-21 show that the main countries from which foreign nurses are recruited are the Philippines, India, Poland and Nigeria.
The World Health Organisation has drawn up a list of “55 countries facing the greatest workforce pressures, noting that active recruitment from these countries should be avoided unless accompanied by compensatory measures”.
About 257,000 nurses working in OECD countries were born in one of these 55 countries, most notably Nigeria, Haiti and Ghana.
The report identified that the “UK illustrates both intensive international recruitment efforts and a challenging new profile as a ‘stepping-stone’ to other destinations”.
It said many may come to work in the UK but then move on to countries such as the US, Australia, or New Zealand, and pointed to a “sharp” increase in applications for certificates of current professional status, required to register as clinicians abroad.
“This underlines the risks of relying heavily on international recruitment,” the authors said.
A Department of Health and Social Care spokesman said: “We hugely value the contribution of doctors and nurses from around the world who have chosen to work in the NHS, but these figures expose the absurd legacy we inherited. A failure to train enough home-grown medical professionals has left us overly reliant on international recruitment to plug the gaps.
“We have committed in our 10-year plan to prioritise UK medical graduates, to undo the policies introduced by the last government, which opened up competition for jobs to doctors from around the world.”
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