Leaving Millions of Vulnerable People

Ruby Stockham writes:

Yesterday, the Daily Mail published figures from the Home Office showing that last year, 44,443 medical professionals moved to the UK from abroad to start work in hospitals and GP surgeries.

It is not the first time this issue has hit the headlines in recent weeks.

In evidence given to the Treasury Select Committee earlier this month, senior OBR economist Stephen Nickell warned that the NHS would be in serious trouble without immigrants.

Rejecting claims that the UK cannot accommodate any more people, he said that ‘the urbanised part of Britain occupies less than 10 per cent of the surface area. The urbanised part of Surrey occupies less of Surrey than golf courses’.

Nickell stated before the Committee his belief that on balance, immigration is both good and bad for the UK.

But he suggested that the health service was a specific case which would suffer if immigration was cut, because ’35 per cent’ of health professionals come from outside the UK.

The Mail worried yesterday that such a heavy reliance on foreign workers could have negative implications for the future of the health service.

But what about the health services in the countries where migrant workers are coming from?

The issue of the effect of incoming migrant workers has been discussed ad nauseam – as Nickell says, there are arguments for both sides, but the NHS is one instance where immigration has a demonstrably positive effect on the delivery of a public service.

Putting UK interests aside for a second, we need to ask whether our NHS is depriving developing countries of the healthcare that they need.

According to a study by the HSCIC published in January, Indians form the second largest group of NHS workers after British people.

There were 2,708 Indian consultants in January, seven per cent of the total whose nationality was known.

In India, there are approximately 600 million people with little or no access to healthcare. Accountability is driven by a private system, but a significant percentage of the population simply cannot afford it.

Experts have pointed to a lack of infrastructure -clean water and technology – but also say that the lack of skilled people, especially in rural areas, means that even if there was appropriate infrastructure there would be an insufficient number of skilled people trained to utilise it.

The Philippines is identified as the country that provides the second largest number of overseas health workers after India.

The HSCIC report found that as of January 2014 The Philippines provided 8,094 qualified nurses, midwives and health visitors, and 12,744 NHS staff overall.

In 2013, Prince Philip famously commented to a Filipino nurse that her country ‘must be half empty’.

A 2013 UNICEF report into ‘brain drain’ in the Philippines found that ‘nurse migration from the Philippines has become so common that some doctors have undergone training in nursing just so they can have a chance at being employed abroad’.

Clearly, ‘brain drains’ are a vicious circle, and the more public services are affected by the emigration of skilled professionals, the more people will want to leave.

Indeed, Unicef reported that ‘the more prominent trend [from the 90’s onward] was that more professional migrants left the Philippines than professionals who joined the country’s workforce’.

The British Medical Association said yesterday that it expects the number of foreign workers entering the NHS continue to rise for at least 10 years.

A spokeswoman said:

“These overseas medics have a vital role. At the moment, we need about 10,000 more GPs, and 10,000 more consultants. It takes 10 years to train as a GP, and about 15 to train as a consultant, so even if the Government is pouring money into recruitment now, the effects will not be seen for many years.”

A continuation of this trend can hardly be good news for those living in India and the Philippines (to name just two of the countries affected by it).

The World Health Organisation estimate that (using the most recent available data) the UK has 2.79 physicians per 1,000 people, compared to the Philippines which has 1.15 and India which has just 0.7.

Guinea, severely affected by Ebola, has just 0.1 health workers for every thousand people – the consequences of this kind of shortage are becoming abundantly, brutally clear.

We need to support developing countries to build their own health infrastructures.

Otherwise the UK will continue to be a more attractive option for medical professionals, leaving millions of vulnerable people without access to even the most rudimentary medical care.