Never again must ministers seek to penalise those who come from far and wide to our shores to serve and give their lives to our NHS

By Dr Chaand Nagpaul, Chair, British Medical Association.
Location: UK
Published: Sunday 24 May 2020
Chaand Nagpaul smiles with crossed hands

The government’s decision to finally end the immigration health surcharge for healthcare workers followed vigorous BMA campaigning since its introduction in 2015. Illogical and insulting it penalised workers from over 200 countries who come here from across the globe to provide a vital service in our NHS.

The announcement to end it needs to result in a step change and an open acknowledgement of the debt of gratitude the nation and our politicians owe to our overseas workforce who have in many ways been the beating heart of our health service since its inception. This is all the more poignant given that the vast majority of doctors and healthcare workers who have tragically died in the battle against the virus have come from overseas.

Prior to the pandemic the NHS had 10,000 unfilled medical vacancies on a backdrop of a fraction of doctors per head of population compared to EU averages. The government has been actively seeking recruitment from overseas to try and plug this gap. This workforce shortage still exists now and will become acutely evident once again as we begin to resume normal NHS services.

Our dependence on our international doctors to care for the sick and save lives could not be clearer. Last year more than half of new registrations to the General Medical Council register were from doctors from abroad compared to those qualifying in the UK.

But we as a nation also gain economically. It costs approximately £250,000 to train a doctor in the UK, and overseas doctors clearly bring a substantial saving to the nation so the idea of charging them to work here and use their knowledge and expertise was both churlish and punitive. Of course, we should ideally be training enough doctors within our shores, but the NHS has for decades not invested in sufficient medical student numbers and even allowing for recently announced expansion of medical schools capacity, it will not translate to adequate doctor numbers for the foreseeable future.

The UK is world-renowned for excellence in training, and many overseas doctors come here for defined periods of time to acquire esteemed postgraduate qualifications and take this experience back to their home countries when they return. Whilst here, these same doctors provide essential services to the NHS, highlighting the mutual benefit of hosting our international doctors. Surely we should ensure that their experience is rich, positive and welcoming, and which will enhance the reputation of our nation and health service globally.

Let us not forget that we live in an ever-connected world, and that overseas doctors can - and do - choose to go to other parts of the world rather than come to the UK. Also, that working in our NHS, which is overstretched and under-resourced can be challenging, added to by experiences of race inequalities in the workplace. If fewer doctors come here from abroad this would deepen our severe workforce shortages and exacerbate our lack of capacity to meet the needs of patients.

The NHS is built on the principles of fairness, equity, and respect in caring equally for all our patients regardless of their background. We need to extend these same values to our international doctors and to treat them with a hand of friendship and the respect they deserve.

Never again must ministers seek to penalise those who come from far and wide to our shores to serve and give their lives to our NHS.