What’s driving the UK’s shortage of medical doctors?


PHOTO/DFID – UK Department for International Development – CC BY 2.0

At the beginning of the first lockdown two years ago a friend told me about a relative of his who was a nurse in a London hospital who had caught Covid-19. She said that her manager had told her “to go home and tell nobody about it”.

His response to bad news was to hide it, which is in keeping with secretive traditions of the NHS, as it is with all large institutions protecting their own interests. In the case of the NHS, the secrecy may be less obvious because a sympathetic media has been giving wall-to-wall coverage to its heroic efforts to treat victims of the pandemic.

Reporting today focuses largely on the shortage of doctors and nurses, their numbers depleted by Covid-19. Much publicity is given to short-term fixes such as sending in the army and re-employing retired medical staff.

Unfortunately, what is lost in this tidal wave of information are fundamental questions about the state of the health service from which flow most of these short-term problems.

Most important of these is why Britain trains only half the number of doctors that it needs, which is far less than in other developed countries. England has 28 doctors for every 10,000 people compared with 37 in comparable EU countries according to a report by the British Medical Association.

The chair of the Commons Health Committee and former health secretary Jeremy Hunt cites figures from the royal colleges showing that the country is short of 2,500 GPs, 2,000 emergency care consultants, 2,000 midwives, 1,900 radiologists, 1,400 anaesthetists, and 500 obstetricians while the NHS has 100,000 vacancies.

Britain has never trained enough doctors, but the deficit has got a lot worse in recent years – and so too has the dubious means used to bridge the gap between demand and supply. The solution is to rely on foreign-trained doctors and nurses, often from poor countries with health systems already crippled by staff shortages.

“In 2019 more doctors joined the [NHS] workforce from outside the UK than were UK-trained, a ratio never before seen,” says Rachel Jenkins, professor emeritus of epidemiology and international mental health policy at King’s College London. She says that the number of medical student places in Britain needs to be double from the 10,403 currently available, so as not to rely on attracting scarce doctors and nurses from Africa and South Asia.

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