James Johnson: Urgent: practical plan required to end this robbery

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Last year I visited Ghana, a country of 20 million people but only 1,500 doctors.

Last year I visited Ghana, a country of 20 million people but only 1,500 doctors.

It is difficult to conceive how doctors and nurses begin to try to provide healthcare with such pitiful resources, but in Mozambique, a country still recovering from war, the position is worse. With a population similar to Ghana's, only 500 doctors are available.

In large parts of sub-Saharan Africa, practically no healthcare is provided. The incidence of Aids is well documented, and trained staff could make a real impact on many other preventable or treatable childhood diseases, such as malaria. In their absence, the death toll rises. Far from making progress, I was shocked to learn that, since 1999, Ghana has been "losing" or "exporting" more nurses than it has been able to train - a bad situation is becoming steadily worse.

The problem demands a practical and ethical response from the G8, particularly the English-speaking nations who are the main culprits in draining developing countries of their skilled medical and nursing staff. The current prognosis is poor. Since its inception in 1948, the NHS has relied on overseas-trained doctors and nurses - HMS Windrush sailed from the Caribbean in the same year the NHS first opened its doors. We are now training far more nurses and doctors than 10 years ago, and we at last have an ethical recruitment code, but we are a long way from being self-sufficient. In 2003, two-thirds of newly registered doctors in the UK came from overseas.

In America, the position is worse. The US foresees a need for one million more health care workers by 2020 - 200,000 more doctors and 800,000 more nurses, but the concept of self-sufficiency is not on the political agenda there.

The situation is desperate. For well-qualified and intolerably overworked doctors and nurses, the desire to seek a better life in the UK, Canada or the USA is entirely understandable. It has always been a strength of the nursing and medical professions that global travel is possible; skills can be shared and new treatments tested and developed collaboratively. But that is now a rose-tinted and dangerously romantic view.

We have to find ways of encouraging international exchange and development without denuding poorer countries of their intellectual capital and the practical ability to treat disease and care for the vulnerable.

Our responsibility goes wider than training the healthcare staff we need in sufficient numbers, though that would be a huge step forward. We need to offer the practical help that will make life tolerable - and success possible - for doctors and nurses in Mozambique and Ghana. That means backing investment in training and in basic public health facilities, and lobbying our governments to override the diktats of the World Bank and IMF who favour short-term economic expediency rather than investment in health.

These are the issues that the global community must address if it is to prevent millions more lives being lost. I am heartened by the Government's commitment to tackling poverty in Africa, but we must recognise it is counterproductive to help with one hand by cancelling debt, if with the other hand we rob these countries of a precious skilled resource.

The UK will chair the G8 summit in July, and the healthcare-skills drain ought to be high on its agenda. We should press for the developed English-speaking world to produce enough doctors and nurses to meet its own needs within the next decade, and we should lead by example.

James Johnson is the chairman of the British Medical Association