AIBU to question relying on overseas-trained NHS staff over training our own?

[Wingedbat]

its often talked about that we need immigration for staffing the nhs, but I’m wondering how much of a good idea for two main reasons.

1. How can we be assured that they have as strict protocols and rigorous training as we do here?

(According to the guardian 63% of drs who are struck off have been trained overseas)

“A study finds over 50% of surgeons and GPs working in the UK, but who trained abroad, would fail exams set at the UK standard.” sky news.

Wouldn’t it be better to train our own drs, nurses, midwives?

2. There are not enough jobs for our own drs/nurses/midwives.

“Half of resident doctors finishing foundation training say they have no job secured for next month, according to a major survey from the BMA“

I believe the issue is the same for nurses and midwives.

I can only assume it comes down to cost, so they can pay them less. But this isn’t ethical or cost effective in the long run. I don’t really see too many people talking about this aspect specifically, but I see a lot of people saying we NEED immigration for the nhs. I don’t think we do, it’s not an ethical or sustainable practice.

If qualified they get paid the same as they’re paid to the NHS pay scales according to band like everyone else.

Good point, I forgot about the nhs bands. So what would be the reason for pushing our own graduates out, if it’s not for pay?

It does seem strange that with youth unemployment at an all time high we aren’t able to utilise some of that workforce into the healthcare sector instead of bringing in workers from abroad. These are the jobs which will continue to be necessary in the AI era.

I only have experience in nursing so can't comment on the rest but there isn't enough people going into it. Possibly the aftermath of the change in funding of nursing training still but there are vacancies all over, so noone is being pushed out hence why they are trying to fill the shortage with overseas nurses. When they first come over, they're on a programme to convert their qualification and ensure skills are up to standard, they then have clinical skills exams similar to that of the UK nursing programme before they are allowed to register as a nurse here. It's quite an intense programme although my trust have now stopped this programme.

I know graduate doctors need to do several years of vocational training post qualification don’t they? So perhaps cheaper to pluck an already fully trained doctor from abroad? Is this the same with nurses? Or are they fully competent day one following graduation? Perhaps using foreign workers keeps the wages suppressed overall. Perhaps they are less likely to strike. Could be any one of a number of things.

My BIL's gf has come over from the Philippines. She was a qualified Nurse there and then has had to work as a care assistant here in a nursing home until she has passed some additional exams here and now working as a qualified nurse. Much as I like her I don't see why we are doing this. My dd is training to be a nurse and many of the year above her cannot get jobs as qualified nurses once they have graduated. Why are we allowing them to come from abroad when our own newly qualified Nurses can't find work?

I don't know the answer OP but as a midwife, I racked up £95k in student loans and I earn less than £40k per year. It is by no means a lucrative career and the stress isn't worth it for many new graduates and they leave shortly after qualifying.
The majority of the international midwives in our trust are amazing and absolutely do deserve to be there and they are employed in separate cohorts to newly qualified midwives so don't take their jobs.

I have been on many interview panels and sometimes the international staff are much better than those trained here. I cannot speak for nurses or doctors though.

Great points I've been thinking about too.

A nurse friend told me that the nursing system relies on trainees being linked with more experienced nurses to mentor them through early years on the job (I forgot the proper name of the process) and the NHS doesnt have enough mentor suitable staff so the whole system isn't working.
https://www.england.nhs.uk/looking-after-our-people/supporting-people-in-early-and-late-career/legacy-mentoring/

While I understand that many people want to move to other countries and have good skills, the ethical element of relying on staff educated & trained in developing nations, effectively poaching staff trained in their countries of origin, is a brain/skills drain from those counties to our benefit & their detriment.

Beyong the NHS,how can we have high youth/young adult unemployment alongside a policy/need to issue so many working visas to foreign nationals?

Like so many things, policies and reality feels very disconnected and there is a lack joined up thinking.

I think nursing should be fully funded for UK nationals. It was an error make students pay. It puts off mature students as well making a career change.

For midwives you do a year to 18 months preceptorship where you learn more skills, consolidate your uni training and gain experience. Then you get the next band up and are fully fledged. I don't know how it works for nurses. Midwives are autonomous practitioners so are a band higher than nurses and you have to learn how to use your autonomy (which is hard!) and takes experience.

preceptorship - that's it!

Training of healthcare staff, even at undergraduate level, costs the government a huge amount of money. It's parasitic and immoral to be swiping huge numbers of healthcare workers from other countries and I think people are starting to wake up to that. It's also self-evident that we are heading for oblivion if we don't actually make the effort to educate and train our own population to meet its own needs.

But a lot of our newly qualified Nurses and midwives cannot get jobs?

This is difficult to answer as in my trust and the surrounding ones, there are lots of jobs, but too many applicants. Personally, this works as we only employ the best. I can tell you that some awful candidates have come through my trust for interview and they absolutely would not be safe (in my opinion) to care for women and babies without very close monitoring (which defeats the object).

Not everyone who trains for a job, is good enough to then do that job once qualified.

The government gives money to those employing foreign people so we do have unemployed British nurses etc here… it’s ridiculous. British people must be prioritised for jobs…

It does seem crazy and immoral that 50% of youth are being encouraged into universities studying for subjects that society has no need for, taking on massive tax payer backed loans which most will never pay back and with no job at the end of it all. In the meantime healthcare and social care sectors are desperate for workers. It’s not logical.

How are they qualifying in the first place if they aren’t good enough?

Exactly this. You could find an excellent consultant in India but if they come to England they can’t just become a consultant here in the NHS and be paid as such until they’ve jumped through several hoops to qualify as a consultant here so in tge end up you’re paying an experienced consultant a registrars wage.

Also the statistics about 63% of Drs being struck off being trained overseas doesn’t necessarily point to issues with their clinical abilities. If you look through the MPTS outcome a large proportion who end up there are not due to a lack of clinical competence but often due to integrity issues, behavioural issues or criminal offences. There is quite a rigorous process to check their clinical competence overseas Drs have to go through before they can practice here.

It's cheaper to let overseas counties pay for training. Too bad it then leaves those countries short of medical staff (particularly when they paid for the training).

True. At the trust I work in the British NHS staff who train here are unable to get jobs and yet the vacancies that are put out are filled with people from overseas.

Failure to fail.

Oh absolutely it was the wrong call! I completely agree. My mum looked into doing her training after I completed mine but once she found out it was now charged she couldn't make it work financially.

There was a midwife student on here I think last week saying she's now been told there will no longer be a guaranteed job when she qualifies. It is wrong. If we train people and they pass the standards they should be given a job above immigrants.

And point 3, it continues to lead to .massive brain drain in those countries which sevelry affects their already struggling healthcare sectors leading to continued dependence on foreign countries for aid.

Or example Nigeria is a big source of nurses and doctors to the NHS has 29 - 38 doctors per 100,000 people while the UK has 310 - 340 per 100,000. And the numbers in countries like Nigeria continue to drop and drop. Of course this causes serious issues in those countries with very very poor healthcare and look at what's happening in Congo as they struggle to contain the recent Ebola outbreak.

Now I'm not saying the UK is entirely at fault here, doctors face poor conditions in those countries with poor pay, corruption, poor facilities etc so they are attracted by the higher pay in the NHS but for the NHS this is purely a way to get cheaper resources to prop up the struggling NHS.

It also has the long term risk of the UK losing the capability to build and maintain its local talent due to dependency on cheaper doctors and nurses from abroad. It's very hard to rebuild your talent pipeline than it is to destroy it.

We see this also in the University sector where there has been over dependency on international students to the extent many universities can't survive without them but now many UK universities provide very poor value and service and you can see quality decline in many universities because they are his money mills to prop up the sector and subsidize local students.

These are bandaid solutions that will work short term but are not long term permanent solutions and infact lead to more serious issues in the medium to long term.

My husband recently had surgery done by a fantastic Palestinian specialist surgeon which obviously we were both incredibly grateful for, but in the back of my mind there was a level of guilt that this wonderful doctor was here in the UK saving our lives and not in Palestine which one could argue needs and deserves his care and dedication more? Its a tricky one definitely