With 57,000 EU workers set to leave, NHS now depends on South Africa, Nigeria & Egypt post Brexit
The NHS is now very heavily dependent on medical and other healthcare professionals who qualified outside Europe following an anticipated mass return of EU national after Brexit. Majority of the 57,000 EU nationals working in the NHS do not feel welcomed anymore in the UK according to a leading think-tank.
The Institute of Public Policy Research (IPPR) says “It is critical to public health that these workers do not seek jobs elsewhere. All EU nationals who work for the NHS, or as locums in the NHS system, should be eligible to apply for British citizenship. This offer should be organised by the regional NHS and mental health trusts, who would be responsible for writing to all NHS staff who are EU nationals to inform them of their eligibility.”
The report further said, “There are currently around 57,000 EU nationals working in the National Health Service (NHS), accounting for 5% of its workforce; one in 10 of the UK’s registered doctors is an EU national. Without them the NHS would collapse.”
The report therefore recommends that the government should offer concession and wavers for migrant health workers applying for British citizenship while those who have lived in Britain over six years should enjoy automatic qualification.
In another report by Migration Watch citing analysis of data from the Labour Force Survey, it indicates that in the UK almost a third of medical practitioners and approximately a fifth of dentists, pharmacists and nurses were born outside the European Economic Area (EEA). Based on registration data for the UK’s medical regulator the General Medical Council (GMC) 11 per cent of all medical practitioners working in the UK received their qualifications in India. Others qualified in South Africa (3 per cent), in Nigeria (1.4 per cent) and Pakistan and Egypt.
The report said, The NHS has been heavily dependent on migrant labour for a number of reasons. It listed challenges in the Employment of Health Care Professionals from non-English Speaking Countries.
Following concerns about the English language competence of medical staff from Europe working in the UK, the Health Secretary, Andrew Lansley, announced in October 2011 that doctors from Europe who wished to work for the NHS in England would be tested to ensure that their language skills are adequate. Doctors from non-European countries, like India and the Philippines, are already tested for language competencies.
Other staff, such as nurses, health care assistants, and auxiliary workers from non-English speaking countries will not be subject to such formal testing despite having contact with patients but the need in terms of patient safety is arguably less critical.
“Evidence provided by the Department of Health (DH) indicated that, as of September 2009, 24 per cent of medical professionals working full-time at consultant level and 33 percent of medical professionals working full-time in the registrar group (doctors that are below consultant grade) graduated from medical schools outside the EEA. Although some of these graduates may be UK and EEA citizens who studied abroad, it is likely that a large proportion of these medical professionals are non-EEA migrants.”
Employment of health workers from outside the EEA is more intense in some clinical sectors than others. Paediatric neurology (25 per cent), paediatric cardiology (18 per cent) and chemical pathology (13 per cent) are areas with greater than average dependence. In contrast, in some other occupations the proportion is much smaller in diagnostic radiography it is 3 per cent and in orthoptic therapy only 1 per cent.
The Migration Advisory Committee noted in its report that: “According to DH (Department for Health), the NHS has historically relied on the recruitment of migrant workers to fill vacancies in specific regions and specialisms, and also to rapidly expand the workforce in areas that would normally depend on long lead times to train sufficient numbers of the existing UK workforce. DH told us that the UK is moving towards greater self-sufficiency in terms of NHS workforce supply, although this will not be achievable in the short term or in all occupations and regions.”
Global Shortage of Health Care Professionals
The WHO estimated in 2006 that there was a worldwide shortage of 4.3 million health workers, highlighting 57 countries where there were particularly severe shortfalls; 36 of these countries are in Sub-Saharan Africa. Sub-Saharan Africa, has 11% of the world’s population and 24% of the global burden of disease but only 3% of the world’s health workers. Available data shows health care provision in the UK and in those countries from where many immigrants to the UK have been recruited to work in the NHS. South Africa and the countries of the Indian Sub-Continent are conspicuous as having major health care needs and deficient health care provision. In India for example, where NHS recruitment has not been subject to the same curbs that have been applied to the countries of Sub-Saharan Africa, and where over a tenth of physicians working in the UK originated, life expectancy at birth is 15 years less than in the UK and infant mortality is nine times higher, whilst TB incidence is fifteen times higher.
The report noted that, “In response to this situation, British Government issued guidance in 1999 for NHS employers which listed those countries mostly in Sub-Saharan Africa from which it considered it would be unethical to source health workers. It is not clear that the private sector followed a similar policy.
Kampala Declaration
In March 2008, the WHO convened a conference in Kampala, Uganda, to discuss the shortage of health care staff and agree a programme of action. A statement of intent, the ‘Kampala Declaration’ was issued at the end of the conference which, inter alia, stated that:
“ While acknowledging that migration of health workers is a reality and has both positive and negative impact, countries [are asked] to put appropriate mechanisms in place to shape the health workforce market in favour of retention. The World Health Organization will accelerate negotiations for a code of practice on the international recruitment of health personnel.
“All countries will work collectively to address current and anticipated global health workforce shortages. Richer countries will give high priority and adequate funding to train and recruit sufficient health personnel from within their own country”
