Tories: UK must train own medical staff

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Britain should stop the recruitment of doctors and nurses from the developing world, the Conservative Party has said.

Britain should stop the recruitment of doctors and nurses from the developing world, the Conservative Party has said.

Responding to the special investigation published in yesterday's Independent into how medical migration was stoking Africa's healthcare crisis, the Tory development spokesman, Andrew Mitchell, said it was a form of "reverse aid ... I feel deeply uncomfortable about the flow of doctors and nurses from developing countries into the UK. These professionals are needed in their own countries."

Andrew Lansley, the shadow Health Secretary, said: "We have repeatedly pressed the Government to ensure the NHS does not recruit doctors and nurses from those countries that desperately need trained healthcare professionals themselves. The long-term solution is for the UK to train its own doctors and nurses. Conservatives would use aid budgets to support health systems in developing countries."

The Independent's report focused on Ghana, where the flow of nurses to the UK has soared tenfold in the past six years and the number of doctors has doubled. The Korle Bu teaching hospital in Accra is 1,000 short of the 2,000 nurses it needs, and 60 per cent of the babies in its intensive care unit suffered asphyxia at birth because their mothers were not properly monitored during labour, owing to the shortage of staff.

The director of the hospital, Professor Kawabena Frimpong-Boateng, described the staff shortage as "devastating" and appealed to the UK and the US to show restraint, by restricting their recruitment to medical staff who had already served at least five years in Ghana. "We don't think we should be paying for the training of doctors and nurses to work in the UK," he said.

The findings were backed by a study in The Lancet that said half of the 16,000 extra staff hired by the NHS in recent years had come from overseas, with damaging effects on health services in sub-Saharan Africa.

Steve Webb, the Liberal Democrat health spokesman, said: "It is appalling that, as one of the richest nations in the world, we are draining developing countries of their doctors and nurses. Overseas staff have a valued place in the NHS but must not be exploited to cover up the failure to recruit and retain home-grown doctors and nurses."

The Department of Health said the NHS was halfway towards meeting its target of 15,000 more consultants and GPs by 2008 but had already met the target of 35,000 extra nurses by March 2004.

The NHS is heavily reliant on overseas medical staff, with one-third of practising doctors and half of nurses joining the register each year having trained outside the UK. But two in five overseas nurses in London are planning to leave the UK, a study by the Royal College of Nursing and the Kings Fund found. "Once nurses become mobile they are much more likely to make a further move. It is more difficult to hang on to them," an RCN spokesman said.

The British Medical Association called for Britain to become self-sufficient in medical staff by training more doctors and nurses and offering aid to developing nations to build up their health services.

Kate Adams, the deputy chair of the BMA's international committee, said: "The World Health Organisation estimates that Africa needs one million extra healthcare workers to meet the Millennium Development Goals, which include a two-thirds reduction in child mortality under five by 2015.

"The UK has a particular responsibility because with the US it is one of the largest recruiters from the Third World. Other countries such as Ireland and Norway recruit from the developed world. We have our colonial links and a long tradition of hiring staff from developing nations. We must support these countries to develop and build their health systems.

"People don't want to leave their home countries but the pressure to do so increases if the health system deteriorates. We have got to look at the conditions people work in and see how they might be improved."

The Department of Health said the Government had allocated £560m for the development of Africa's health systems over five years. Since 1997 it has increased UK medical school places by 69 per cent to 6,326 and nurse training places by 62 per cent to 24,284. Lord Warner, a Health minister, said Britain was putting "huge investment" into training extra doctors and nurses but in the meantime the NHS had been forced to rely on overseas recruitment. The NHS had led the way in ethical recruitment, including a ban on targeting of west Africa, all of sub-Saharan Africa and the Caribbean.

"However if healthcare professionals are determined to come here we cannot legally deny them that opportunity," Lord Warner said. "The shortage of health workers in many countries is about much more than international migration. The underlying problem is inadequate investment in health services, the effects of HIV and Aids, poor pay, conditions and opportunities. That is why the UK is providing support to many countries in Africa to improve their health services."

Britain's top targets: The top five countries from which the UK recruits doctors and nurses are:

PHILIPPINES
* 4,338 nurses joined the UK register in 2003-4
* 14 doctors were on the UK register in 2004
* It has a surplus of nurses and allows recruitment by the UK.

INDIA
* 3,073 nurses joined the UK register in 2003-4
* 18,006 doctors were on the UK register in 2004
* It has an agreement to allow recruitment by the UK, except from certain states.

SOUTH AFRICA
* 1,689 nurses joined the UK register in 2003-4
* 6,208 doctors were on the UK register in 2004
* Active recruitment by the NHS is banned but South Africa has a memorandum of understanding with the UK allowing medical staff to come for a couple of years.

AUSTRALIA
* 1,326 nurses joined the UK register in 2003-4
* 2,648 doctors were on the UK register in 2004
* Australia is competing in the same market and on the same terms as the UK for medical staff.

NIGERIA
* 511 nurses joined the UK register in 2003-4
* 1,661 doctors were on the UK register in 2004
* Active recruitment is banned but medical staff cannot be prevented from seeking employment in the NHS of their own accord.

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