A reliance on overseas-trained medical professionals could leave the NHS vulnerable to severe staff shortages after Britain leaves the EU, a report published this week has warned, as unions campaign against ‘Victorian’ working conditions in some hospitals.
The General Medical Council’s (GMC) The state of medical education and practice in the UK report revealed that the number of NHS doctors trained outside the UK averaged 34 per cent over the past six years, with highs of 43 per cent in East Anglia, 38 per cent in the East Midlands and more than a third in London, compared with 18 per cent in the south west.
The number of international graduates or graduates from the European Economic Area (EEA) on the UK medical register fell by 6,000 in the six years to 2017, which could mean the NHS is left particularly vulnerable to staff shortages after Britain leaves the EU, the regulator found.
The uncertainty surrounding the impact of an EU exit on EU nationals who live and work in the UK has led to one in five European NHS doctors planning to quit the UK when the country leaves the EU in 2019, according to a separate survey of doctors by the British Medical Association.
The GMC report also found that while the number of UK graduates on the medical register rose by more than 10,700 between 2012 and 2017, this was offset by the fall in foreign-trained doctors.
The supply of new doctors into the UK medical workforce has not kept pace with changes in demand. As a result, GMC chief executive Charlie Massey said he believed the medical profession was at a “crunch point”. “The decisions that we make over the next five years will determine whether it can meet these extra demands,” he said.
Danny Mortimer, chief executive of NHS Employers, said the findings provided “more evidence of NHS services under increasing pressure”, and emphasised the “need to make sure the UK remains an attractive prospect for the brightest and best from the EEA and the rest of the world – as we know we won't be able to fill gaps with domestic recruitment in the short to medium term”.
The government’s clampdown on using staffing agencies to fill NHS vacancies, announced by health secretary Jeremy Hunt in October 2015, could also affect staffing levels once Britain leaves the EU.
The GMC report revealed that stress was prevalent among NHS medical staff, particularly junior doctors. It concluded that doctors were “pushed beyond their limits”, contrasting the 2 per cent rise in register doctors with a 27 per cent increase in A&E attendances in 2012. More than half of junior doctors took a break after finishing foundation training, a rise from 30 per cent in 2012.
Massey said that the underlying challenge for all in healthcare is retaining the “good doctors” already working for the NHS.
“Everything we hear from the profession tells us that we need to value them more; nurture cultures that are safe and supportive, and do what we can to help staff achieve the right balance between their professional and personal lives through more flexible working arrangements,” he said. “This level of sacrifice is neither right nor sustainable.”
Protests also took place yesterday against “Victorian workhouse” conditions for porters, cleaners and security staff in NHS hospitals.
The GMB union held demonstrations outside four London hospitals against contractor ISS, which is reported to pay workers as low as £7.88 an hour, higher than the national living wage of £7.50 but below the voluntary living wage of £10.20 in the capital.
The union also claimed that cleaners were followed to the toilet by supervisors demanding to know where they were going and why they had stopped working, and that pay had been withheld.
The report follows the launch on 13 December of a consultation by Health Education England on future workforce provision for the health service, designed to improve working conditions, boost training and retention and make the NHS a ‘model employer’.