Lower migration and the tax gap: raise taxes or ease restrictions?

@BIossomtoes

Straight from the horses mouth, the people who actually work in these hospitals. The government has just made legal changes this year, 2026, to prevent it.

Sounds like an urban myth to me. Unless of course you have some evidence.

@Blossomtoes

Hospital departments now have contracts to recruit all their nurses from abroad. So British trained nurses cannot get a job and also have to go abroad.

@Blossomtoes

It’s laughable because British trained junior doctors, 7 years into their training, I believe, were having to compete for their next placement against half the world, before the rules changed this August.

Because foreign doctors were so desperate to come to the UK, they would apply even if it was a downgrade for them. So British students were at an immediate disadvantage.

They had no choice but to go abroad if they wanted to continue their training.

Do you have any idea why they are leaving in droves?

Would you suggest we stop training them at all? why should we subsidise US and Aus?

Why is it laughable? The health care workers we train are departing for the US and Australia in droves. Why would we train more so other countries can benefit?

Out of interest, is there a reason why you are opposed to training and recruiting young British people to take up the roles as doctors and nurses in the NHS?

I agree, it's just crazy. An absolute scam. We need to train our own resident workforce and recruit them for the work that needs doing.

The idea that the NHS recruits so heavily from abroad because it wants to recruit 'the best' is just laughable.

Absolutely. If we don’t other English speaking countries will.

@5MinuteArgument

There did use to be a requirement for employers to at least pay lip service to trying to recruit locally through the Resident Labour Market Test.

Boris Johnson abolished this requirement along with any other controls, such as employers even having to pay minimum wage to immigrants.

The NHS then started contracting with foreign countries such as Nigeria, so that entire departments’ nurses came from abroad. The verification process was so slack that nurses were able to use proxies to take their competency tests.

The process has supposedly been tightened up, but given at least 2 recent scandals I can think of, who knows.

This is just part of our utterly mad immigration system where we train our own staff to a high level of competency, then force them abroad to make way for people from countries where you can lie and cheat your way into a job, putting patients at huge risk.

It's pragmatic to recruit nurses from abroad

Does this apply to doctors too? It's OK for the NHS to recruit doctors from countries where the ratio of doctors to patients is far lower? All fine and dandy.

How interesting that there simply isn't the capacity within the NHS to train more doctors at the moment ... when much poorer countries seem to be able to train a surplus of them, so that they leave to work in other (much richer) counties.

Agree. It's crazy that poorer countries are supposedly training a surplus of doctors and nurses so that they leave to go to work in richer countries.

Yet we don't train enough of our own because we don't have the capacity, ie we can't afford to. Makes no sense at all.

We should train up our own young people and recruit our own young people. Then the wages they earn, instead of being sent abroad, will be recirculated into our own economy.

Not if those trained elsewhere are better. I want the best regardless of where they were trained.

The NHS also doesn't prioritize recruiting British trained doctors into the NHS which is completely crazy.

Other countries don't do this. They prioritise their own workforce before recruiting from abroad. The proportion of foreign healthcare workers in comparible countries is much lower.

I can when it’s nurses from a country which has a policy of training more nurses than it needs in order to export them. And who will migrate to other countries whether or not they came here.

You're the one focusing on the Philippines though, when I was focusing on African countries. You can't say "pragmatism " to a brain drain of medics from some of the poorest countries on earth, surely?

It’s called pragmatism. Take it up with the Filipino government.

But I thought the left had principles? This seems really quite a strange approach. What about all the poor people in the countries without health care? It's really terrible. On some African countries they have a single doctor to cover thousands of women for neo natal care for example.

We have plenty of kids wanting to train as doctors but I hear loads of stories of straight A* pupils being rejected from medical school.

And my point is that they’d leave anyway. I’d rather we had them than another country.

My original point is that developing countries are sending doctors sorely needed by their own populations to us. Its all rather colonial really. Surprised you support it really, being of a lefty persuasion.

It’s a very good example because it’s a deliberate political and economic strategy. If we didn’t employ those nurses the US, Canada and Australia certainly would.

Not that many though. And the Philippines is a bad example as the care throughout the country as a whole is poor. The doctors would prefer to come here than go into rural poor areas.

Oh I know how oversubscribed it is. My dd is a medical student at the moment and I know what it's like.

They have actually increased the numbers a bit recently but my understanding is that there simply isn't the capacity within the NHS to train more doctors at the moment. And of course, there are costs to consider as well.

Not sure about the situation with nurses - I had heard that applications were significantly down so not sure if they could fill additional places even if they offered them?