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We need more staff for the NHS, but not from the poorest countries | Letters

It’s exasperating that when NHS staff are buckling under significant workforce shortages and growing patient need, one government department continues to ignore a quick win that could alleviate that pressure and improve patient care. (‘No-brainer’ plans to allow more foreign doctors into UK blocked by the Home Office, 4 November).

Clinicians are putting our faith in the next government to get to grips with the health and care workforce crisis. Time after time the stats show just how short of staff we really are, but anyone working on the frontline will tell you the real situation is even worse.

The next government must deliver for hardworking and dedicated NHS staff. We need to double the number of medical students and rapidly increase the numbers of doctors, nurses and other clinicians in training, while also creating an environment where our people are valued, recognised and rewarded.
Prof Andrew Goddard
President, Royal College of Physicians

Your article fails to consider the impact of the loss of those doctors on the source countries. The UK already employs over 66,000 doctors from outside the EU, mostly from low- and middle-income countries (LAMIC), which have much lower doctor-to-population ratios than our own, and whose populations suffer a much greater disease burden. Thus despite decades of medical training schemes in LAMIC, Africa still has only 1.3% of the global health workforce and 25% of the disease burden. The numbers returning to their source countries after specialist training in the UK is extremely small – only 175 over the last five years.

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The UK is a signatory to the World Health Organization code of practice on the international recruitment of health personnel 2010, which recommends that member states discourage active recruitment from LAMICs facing critical shortages of health workers (and never recruits from the 57 poorest countries), and create their own sustainable health workforce.

At present the UK is employing over 7,000 doctors from the 57 poorest countries. It is time to stop behaving like a plumber who, when called to mend a burst pipe, instead pours in more water, and indeed acquires such water from countries suffering extreme drought. The UK has unfilled medical posts because of a very high rate of premature retirement across all age groups, and it is this issue that needs to be tackled, together with further expansion of UK medical training, rather than continuing to damage health systems in LAMIC.
Rachel Jenkins
Professor emeritus, Kings College London; and former director of WHO Collaborating Centre, Institute of Psychiatry, 1997-2012

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