Cutting to Spite Part One

by Michael Patrick O'Leary

This article appeared in Ceylon Today on Friday 18 May 2018.

My readers may be familiar with the expression “cutting off your nose to spite your face”. In the 12th century it was associated with legends of pious women –  Saint Eusebia, Saint Ebba, Saint Oda of Hainault and Saint Margaret of Hungary – disfiguring themselves in order to protect their virginity. Why is the UK government in 2018 so determined to cut off its nose to spite its face? Is their immigration policy worth all the hassle?

The National Health Service is already chronically underfunded and understaffed – even before Brexit comes into operation. A study by the Health Service Journal showed that 96 per cent of hospitals failed to meet their own safe nurse-staffing levels for daytime shifts in October 2016 and 85 per cent did not hit their targets for night-time shifts. For years, Conservative and Labour governments have not trained enough nurses to care for an ageing population. Hospitals have tried to deal with shortages by recruiting overseas staff.

There is also a severe shortage of home-grown doctors. Professor Jane Dacre, President of the Royal College of Physicians, wrote: “There are huge gaps in rotas. As a result, doctors are unable to deliver the standard of care they were trained to, and patients are at risk… We may wish there were more homegrown doctors, but there simply aren’t. At the same time, the future remains uncertain for doctors from the EU, and the number of doctors who are able to train in the UK for two years under the medical training initiative (MTI) is capped.

Antonia Moore is a general practitioner in Rochester, Kent. She writes: General practice is collapsing. There aren’t enough GPs to provide safe care. GPs are good at managing risk but overload means that risks are less manageable… I am working in a system that isn’t safe: no longer a balance of risk but a balance of least harm.”

The official Quarterly Performance Report of the NHS Provider Sector: Quarter 3 2017/18 warned that staff shortages are affecting performance. Saffron Cordery, NHS Providers’ director of policy and strategy, said: “These figures show how the NHS has been pushed to the limit. Despite working at full stretch with around 100,000 vacancies and a real risk of staff burnout, and despite treating 6% more emergency patients year on year in December, trusts cannot close the gap between what they are being asked to deliver and the funding available.”

In the immediate post-war years, Britain tried to deal with its acute shortage of labour by inviting people from the Commonwealth to become citizens and to help run the health service and the transport system. There is still a labour shortage but it is now government policy to force people to leave the country.

Overall, 12.5% of NHS staff say that their nationality is not British. 62,000 NHS staff in England are EU nationals – 5.6% of all staff. Nationals of other EU countries make up almost 10% of doctors in England’s hospital and community health services. They also make up just over 7% of all nurses and 5% of scientific, therapeutic and technical staff. The percentage of doctors and nurses with EU nationality grew between 2009 and 2016. 36% of hospital doctors gained their primary medical qualification outside the UK. 20% qualified in Asia and 9% qualified in the EU. For GPs, 4% qualified in the EU and 13% qualified in Asia.

In November 2017, data published by the Nursing and Midwifery Council showed a 67% year-on-year increase in EU staff leaving its register – as well as a precipitous fall in new EU registrations.

The government has made a pledge to increase the number of GPs by 5,000 by 2020. The NHS plans to spend £100m bringing in doctors from abroad. Recruitment agencies will earn about £20,000 for each GP they succeed in placing in a family doctor practice in England. This surprised Dr Luke Ong, who had worked in the NHS for five years and was five months away from becoming a GP, when he was told he was being deported because of an error in his visa application.

The NHS confederation said seven London trusts had reported that 53 foreign doctors had been denied visas. More than 30 health trusts in the North-West have written to the Government demanding that around 100 junior doctors from India be allowed to work in their hospitals and health centres.

The UK has to compete globally for clinical talent. There is no point in spending taxpayers’ money on foreign recruitment while at the same time maintaining a hostile environment on immigration. Doctors born in Britain will emigrate if UK hospitals cease to be regarded as international centres of excellence, which is what will happen if foreign talent is kept out and standards fall because of understaffing.