Foreign doctors are a quick fix for the NHS

The UK is a net loser of its doctors. We can’t solve this problem until we face up to the reasons why

The UK has never trained enough doctors to meet the needs of the NHS. Last year, of the 12,771 new doctors registered by the General Medical Council, 44 per cent qualified abroad: 17 per cent from other countries in the European Economic Area and 27 per cent in countries outside the EEA.

For decades, we have imported almost half the doctors we need – and at the same time, many of our brightest young doctors are abandoning the NHS for medical careers abroad. The Government’s announcement that it is softening immigration rules for medical staff from outside the EU is a quick fix that will not solve the bigger problem of our doctor drought.

There is no shortage of young British people aspiring to train in medicine. The annual number of applications to UK medical schools fluctuates between 70,000 and 85,000 for approximately 7,000 places. Tens of thousands of British students with the required A-level grades are rejected because of insufficient training slots. The Health Secretary has announced that medical school places will increase by 25 per cent from 2018 so that the UK is “self-sufficient in doctors by 2025”. But this is an impossible goal, even taking into account the five new medical schools we have been promised.

The crisis is mainly in general practice. The Department of Health has promised 5,000 extra GPS by 2020, but recruitment is well behind schedule. In January 2017, it announced that 500 doctors for Lincolnshire were to be urgently recruited from Poland, Lithuania, Spain, Romania and Greece, with promises of relocation packages of £90,000. Successful applicants would undergo a 12-week training programme which would include lessons in the English language and on British culture.

It must be said that some or most foreign-trained doctors working in the NHS are among the best and most able of their kind. However, it is equally true that many are economic migrants, coming here because working conditions, salaries and pensions are far better than in their own countries. Most of the 31,000 EU doctors practicing in the UK are from Eastern Europe and countries worst affected by austerity; few doctors from affluent Western European countries choose to work in the NHS.

Primary medical qualifications are reciprocally accepted across the EEA, meaning that all non-uk, EEA doctors can register here without any skill checks. The GMC has to assume that these doctors are as well selected, trained and as competent as our own graduates. Of greater concern, English is not the first language of most of these doctors. A language proficiency test has been in place since June 2014, but as we leave the EU, it is essential that non-british doctors should pass a competence exam before being allowed to register with the GMC to prove that their skills are equivalent to UK graduates.

Medical graduates from outside the EEA must pass an examination to register here, which is intended to test clinical competence, language and communication skills. The standard of clinical skills expected is modest, and pitched at the level British graduates are meant to have reached within one year of graduation, yet the pass rate falls between 35 and 69 per cent.

Our shortage of doctors is also being driven by the record numbers of British graduates working abroad or using their medical qualification as a springboard to other careers. The most alarming statistic is that in 2016, only 52 per cent of the 7,168 British qualified doctors who completed their two-year foundation training programme chose to progress to specialist training either in general or hospital practice, down from 71 per cent in 2011. Junior doctor morale is at its lowest ebb. When Jeremy Hunt wrongly blamed 11,000 “unnecessary” weekend deaths on junior doctor weekend rostering, it alienated and disincentivised a generation of doctors. Their subsequent strike will be his legacy.

There is a global market ready to attract the best doctors. Education and universities in the UK are among the best in the world. Only the brightest can secure a place in our medical schools. Yet the UK is a net loser of the best doctors. We must train, respect and retain our own.