Fixing Public Perceptions of Foreign Health Workers Could Help UK Cope With GP Shortage

In recent times, you may have noticed the increasing number of foreign doctors practicing as GP’s in the UK. While some people don’t even give this a second thought, many others feel that this is a cause for concern. Are these foreign doctors taking places that rightfully belong to British doctors? Are they going to be able to provide the same quality of care that British doctors can provide? The list of concerns goes on.

In this article, we’ll try to clear up some of the misunderstandings and confusion surrounding the debate over foreign doctors working in the UK, and we’ll provide some information that hopefully will be useful to both doctors and patients alike.

The Root Cause

The fundamental issue is that there is a shortage of qualified doctors. This is not just a problem in the UK, but in most countries of the world. A rare exception may be Cuba, which despite decades of US-enforced trade embargoes, has invested heavily in education, with the result being that Cuba has one of the highest doctor-patient ratios in the world. Unfortunately that is not the case here at home.

A key issue is that all doctors eventually retire at some point. We also hold doctors to a very high standard, and rightly so, but inevitably this also means that some doctors will lose their right to practice if they fail to maintain the high standards required. Many doctors also migrate for various reasons such as being offered more money, or because they would like to work in a warmer climate. And, of course there is a fine tradition of doctors volunteering in places where they are even more desperately needed than in the UK.

Meanwhile, the general population continues to increase. When the number of new doctors graduating is not in balance with the number of doctors leaving for one reason or another, taking into account the population increase, a shortfall in the number of practicing doctors is created.

So it is quite clear that foreign doctors are not taking places from UK doctors, but are in fact filling an urgent need at our own request and in a way that actually helps our own doctors to cope with the demand.

Creation of a Vicious Cycle

Even with doctors arriving from other countries to help with our shortfall, there still are not enough to really meet the demand. This is why it is so difficult these days to get an appointment and why you usually must wait such a long time before the doctor is able to see you.

Consequently, doctors find themselves having to see more and more patients, which eventually takes a toll on them, and hastens their early retirement. This means there will be even less doctors, and thus places even more stress on those who remain.

You may be interested to know that medical doctors have one of the highest suicide rates by comparison to other professions. While the actual number of suicides is not incredibly high, the statistics do show that doctors are almost twice as likely as the average person to commit suicide, and female doctors are nearly three times as likely to commit suicide.

It must be suspected that the stress caused by patient overloading could be a contributing cause to this problem. And, unless the void left by that prematurely departed doctor is filled quickly, the burden placed on other nearby doctors will increase.

What is the government doing about this?

Surprisingly little. Politicians on all sides know that health care is a serious concern for many people, and so they are all promising pretty much the same thing, while there is little hope of actually being able to keep those promises because they can’t just magically summon doctors from nowhere.

Increasing the number of available medical school graduates significantly is unlikely in a situation where the government has made drastic cuts both to higher education and the NHS, and many students face education cost increases of up to 300%.

Encouraging more doctors to move to the UK from overseas is definitely a possibility, but enticing them in the numbers promised by politicians could prove very difficult. So this problem is not really going to go away that easily and the promises are pretty much worthless as they stand at the moment, which is why politicians of all persuasions are dishing out these promises so freely.

A promise to provide more doctors and nurses is a hollow one that will not make much progress towards fixing our shortages. Voters who care about this issue should not be persuaded by such promises, but instead look to those who pledge more support for the NHS, hospitals, higher education, education in general, and winding down privatisation. These are promises that can be kept, and that will do something to help reduce the crisis.

When considering these issues you have to look at the bigger picture, and the truth is that under the previous coalition government, more than 4 times as many British doctors have been leaving their jobs. At the same time, the government drastically cut funding to higher education and approved a raise in tuition fees. The worst part is that these austerity measures, like all austerity measures, simply do not work, and end up costing more money than they are meant to be saving.

While researching information for this blog we came across some really surprising things. One of the revelations we stumbled upon was that even in the midst of a medical shortfall, knowing that the UK needs to increase its number of medical professionals, the Higher Education Funding Council for England (HEFCE) recommended to the Department of Health in its Health and Education National Strategic Exchange (HENSE) Review of Medical and Dental School Intakes in England that the medical schools should decrease the number of medical school intakes for 2013 (recommendation 5), and that similar reviews should take place in subsequent years (recommendation 6). This serves to highlight the difference between the ways economists see the world compared to the rest of us.

Medical school is already very difficult to qualify for, and is a lengthy degree programme with high tuition fees. The last thing our government should be doing if we want to reduce our reliance on imported doctors is to be reducing the number of available places for medical students.

Bear in mind that the UK is only one of the many possible destinations that doctors – both foreign and domestic – may choose to live in. The government needs to look at making the UK a more attractive option so that doctors will want to live in the UK.

Concerns About Quality

While encouraging more doctors and nurses to immigrate seems to be a good strategy to combat the shortage we face, some people naturally enough have concerns that foreign doctors may not be able to provide the same quality of care and expertise that British doctors provide.

Fuelling these concerns are abhorrent cases such as that of the Filipino nurse, Victorino Chua, who was convicted in 2015 of murdering and intentionally harming patients at Stepping Hill hospital in Stockport in 2011.

An even worse case occurred in Australia, where Dr Jayant Patel has been implicated in at least 87 deaths, and several more before that in the United States (but has been acquitted of manslaughter after accepting a plea bargain deal to plead guilty to fraud instead, and consequently served no prison time).

But these are exceptional cases and the fact that these people were not citizens of the places they were working in had nothing at all to do with the deaths they caused. In the case of Dr Patel, he had received training from a prestigious American medical school and had been practising medicine in the US for decades before moving to Australia, and so the fact that he was born and raised in India would not have influenced the outcome.

Based on his own comments and bizarre confession note, Victorino Chua had entered the UK already planning to commit the heinous atrocities for which he has been convicted. There was no way that anybody could have foreseen what he was plotting, and the fact that he was trained in the Philippines was not a factor in what happened. It was not his training that was at fault, but his mind.

These cases attracted a lot of media attention because they were very tragic and because the accused persons were identifiably foreign. But it is unfair to stereotype all foreign doctors based on the actions of these two exceptional cases. It is also unfair to ignore the numerous British and American medical personnel who have been found guilty of serious crimes against patients, for example:

Harold Shipman, UK. Doctor, 215 victims.

• Beverley Allitt, UK. Nurse, 13 victims (4 murders, 3 attempted murders, 6 others)
• Michael Swango, US. Doctor, 60 victims
• Colin Norris, UK. Nurse, 5 victims (4 murders, 1 attempted murder)
• Benjamin Green, UK, Nurse, 18 victims (2 murders, 16 attempted murders)
• Dorothea Waddington, UK. Nurse, 2 victims
• Charles Cullen, US, Nurse, at least 40 victims (suspected of up to 300 murders)
• Henry Holmes, US.       Doctor, at least 9 victims (suspected of up to 200 murders)

While the crimes of Harold Shipman are at least as horrific as those of Victorino Chua, subsequent media attention to the case did not have the effect of casting doubt upon the quality of British doctors in general.

Chua’s story is different, however, because his foreignness is a pivotal point, not a mere aside, and could cause some people to doubt the safety of foreign-trained medical personnel, especially Filipinos. This is despite the fact that there are thousands of dedicated and skilled Filipino doctors and nurses working in the UK who have never caused any intentional harm their patients.

There is no need to worry because there are strict standards that foreign-trained doctors and nurses must meet in order to be allowed to work in their professions in the UK. You can read about these requirements here and here.

How Hylton-Potts is helping

The current crisis of inadequate numbers of medical personnel to meet the needs of the public is a grave concern to all UK residents. There have been horrific revelations arising out of the austerity measures, and we urgently need to attract more qualified doctors and nurses to the UK to ease the pressure on the system.

Here at Hylton-Potts, we are doing our part by simplifying the process for applicants who want to practise in the UK, cutting through the red tape and ensuring applications are complete and acceptable to the authorities that will receive them.

Hylton-Potts are experienced EC Rights legal consultants and we have already helped many doctors and dentists to become registered with the GMC and the GDC in the UK. We welcome clients from anywhere in the world, and we are pleased to have the opportunity to assist professionals who wish to practice in the UK to gain the right to do so.

We would be interested in your comments, please leave them by clicking on the title to this blog above.