NHS recruitment

SIR – Many medical trainees who come to this country to work for the National Health Service (report, May 16) do so under fixed-term programmes, which are as much about developing their own skills to take back home as they are about helping the NHS with its current recruitment crisis.

The fact that the NHS and our patients benefit from these skills makes it a truly win-win situation.

Some countries, such as Nepal and Malaysia, actually have medical unemployment, so some programmes are vital in order to help doctors maintain and enhance their clinical skills.

The NHS has always been part of a global health economy, and I am proud that this College is part of a programme that is helping individual doctors, the NHS, and countries around the world to tackle health challenges and share expertise.

With the number of unfilled posts in the NHS predicted by the Nuffield Trust to rise to 250,000 by 2030, programmes such as this that are mutually beneficial should be expanded, not attacked.

Professor Derek Bell President, Royal College of Physicians of Edinburgh

SIR – The UK has never trained sufficient doctors. In the past, it relied on male doctors who worked all hours (I was one) and colleagues from the Indian subcontinent. Those days are over.

Successive governments have been oblivious to the facts that the population has risen, people are living longer with multiple conditions, many more treatments are available and expectations are higher.

Doctors are no longer as well paid as they used to be for the length of training involved – you can earn more driving an Underground train – and recent pension changes have led to senior doctors receiving large tax bills for working extra hours, causing them to limit their sessions or to retire early.

Dr Graham Read Standish, Wigan