Viewpoint: International staff play a vital role in the NHS

The NHS would not be able to function without the contribution of international staff and ministers and healthcare leaders need to acknowledge their contribution, says Dr Pushpo Hossain.

Dr Pushpo Hossain
Dr Pushpo Hossain

The role played by international staff in the NHS received widespread media coverage recently after current head of NHS Test and Trace Baroness Dido Harding said she wanted to make the NHS less reliant on foreign doctors and nurses if she became the next head of NHS England.

As a ‘foreign’ doctor myself, comments like this sadly echo the racist statements we are increasingly hearing from patients. These include things like: ‘I want to be seen by a white doctor’ or ‘Why don’t you go back to where you came from’.

At a time when abuse towards NHS staff is becoming the norm, and all areas of the service, especially primary care, face overwhelming demand, we need the next leader of the NHS to understand that the NHS relies on its workforce to function.

International staff

Almost 200 different nationalities are represented within the NHS in England. The majority of staff are British, but as of January 2020, 169,000 (13.8%) report a non-British nationality, with Indian, Filipino and Irish representing the highest numbers. Some 67,000 members of staff are nationals of other EU countries.

Despite being the biggest employer in the UK, the NHS doesn’t have enough staff to meet demand. According to recent data from NHS Digital, the NHS has a shortfall of 84,000 FTE staff, and this does not include primary care where we know there is a shortage of GPs, and is before absence figures for COVID-19 are factored in.

Since its inception in 1948, the NHS has been heavily dependent on overseas healthcare workers, demonstrating that ‘foreigners’ are not only important, but vital for the smooth functioning of NHS services.

COVID-19 pandemic

This is even more apparent as we emerge from the challenges of the last 18 months, where international healthcare workers have stood shoulder to shoulder with their British colleagues.

Last month, former health secretary Matt Hancock told the parliamentary inquiry into COVID-19 that 1,500 health and social care workers have died during the pandemic and we know that with those from a Black, Asian or ethnic minority background are at an increased risk.

‘Foreigner’ comments make international healthcare workers sound like a burden on the NHS and completely undermine their contributions. Not only do they offer their skills and experience as healthcare workers, but they pay the same amount of tax as any British worker without having any recourse to public funds.

After residing in the country for 5-6 years, they then have to pay over £2,000 to apply for Indefinite Leave to Remain. They are also frequently seen investing in property, shares and tourism.

In 2015, the coalition government introduced the Immigration Health Surcharge (IHS), an annual fee of £624 that migrants need to pay to use the NHS. For a family of four, this charge, along with visa fees can easily reach £10,000 a year – which for tax paying NHS staff is an extortionate amount of money to pay in order to access the very system they work within.

In October last year, after lobbying by the DAUK, the Prime Minister announced that international health and care staff and their dependents would be exempt from the IHS, in view of their efforts during the pandemic.

It is time we valued our migrant healthcare staff, which is why DAUK will be supporting the bill to grant indefinite leave to remain to overseas staff, like myself, who have given their all to the NHS during the pandemic.

The NHS relies on the goodwill of its workforce to stay afloat, and the next leader of the NHS, whoever that is, needs to take this onboard

  • Dr Pushpo Hossain is junior clinical fellow, acute medicine and a committee member of the Doctors' Association UK (DAUK)

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