The NHS is a national service, but it has always relied on staff from all over the world to enable it to provide the healthcare the people of this country need.
One in eight NHS staff, including more than a quarter of doctors and one in six nurses and health visitors, are from outside the UK. Clinical staff are more likely to come from overseas than non-clinical staff. In some vital and life-saving medical specialties, close to half of all NHS doctors are foreigners including 45% of cardio-thoracic surgeons, 45% of paediatric cardiologists and 41% of neurosurgeons. In contrast just 5% of managers and 3% of senior managers are from overseas. If you or someone you love needs an operation, the chances are that at least someone who plays a vital role in your or their treatment will be from abroad.
This is something we should celebrate. Our NHS, a symbol of British national identity and a source of national pride, is also an institution with international co-operation and teamwork at its heart. The NHS is the best of British, but it relies on the world’s best to make it what it is.
That will continue to be the case for the foreseeable future. Put simply, there are not enough trained health professionals in the UK to meet the NHS’s needs. The new medical training places recently announced by the government will not produce any new doctors for six or seven years.
In the meantime, we are set to leave the EU and design a new immigration system – and we need to ensure we do not leave the NHS, or its patients, short-staffed.
Already, the NHS has recruitment problems – and Brexit is making it worse. Surveys have shown that almost half of nurses and midwives from the European Economic Area (EEA) have considered working outside the UK since the Brexit referendum, and between 40 and 60% of EEA doctors are considering leaving the country.
At a time when waiting time targets are being missed and the NHS is spending hundreds of millions of pounds a year on agency staff, the last thing the service needs is an exodus of foreign doctors and nurses. Yet the number of European nurses in the NHS has fallen since 2016, and there are signs that the same could well happen with European doctors. Analysis by Global Future shows that fewer doctors from the EU are gaining a licence to practise medicine in the UK year on year, and that the proportion of EU doctors gaining a licence has fallen from 25% of the total in 2014 to just 16% last year.
If the Government wants non-EU doctors to help solve the NHS’s recruitment problem, we are going to have to let them into the country – and Sajid Javid will have to stop the Home Office working towards different goals from the Department of Health.
The government’s target of getting immigration down to the tens of thousands is a soundbite driving bad policy – especially when it stops your local hospital getting the doctors and nurses it desperately needs.
Thanks to the government’s annual Tier 2 visa cap on skilled workers from non-EU countries, which applies to doctors and nurses amongst others, nearly 2,000 doctors and health professionals had visa applications rejected between December and March. These are people who are needed by our NHS, who want to work in our NHS, who have been offered jobs in our NHS, who have passed a language test, who have acquired a licence to practise medicine here, and who have been refused permission to enter the country by the Home Office. If that sounds crazy to you, it’s because it is.
European health professionals are still allowed to come here without jumping through these hoops – but they seem increasingly unwilling to do so, and those who are here already are increasingly looking to leave. Non-European health professionals who still do want to come here are being turned away, even when the NHS wants to give them jobs. And our NHS – and its patients – are the ones who suffer as a result. If we introduce new restrictions on EU immigration after Brexit, and apply them to NHS staff, then the situation will only get worse.
We should be proud of the fact that we still have a world-class health service. But to keep it that way, we need to make sure we can still attract some of the best clinicians in the world. If we are to have the National Health Service we all want, we need it to continue to be an international health service too.
Liz Kendall is the Labour MP for Leicester West