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.

It's not that different from other jobs. If you train too many people some won't get a job.

In my trust the management was happy to employ non British staff. They were often cheaper. Often they didn't knew their rights very well and didn't complain over the daily sh*tshow in the worst wards.

My mum works for a big NHS Trust and last year they had 3 open days for support workers, followed by interviews, 80 prospective candidates turned up and not a single British person turned up, whether white, brown or any other shade. They were all immigrants 14 went on to be employed. Makes my blood boil when people say they are taking our jobs, bear in mind starting salary for any NHS support worker Band 3 is £25, 760, and over £27,000 if you have experience. Immigrants don't get paid less contrary to popular belief, they are taking all the jobs while simultaneously claiming all the benefits, pick a lane which is which.
😒

It’s a huge issue and it’s clear successive governments have no desire to change it because ultimately it saves them money. Funding for so many routes to the medical field have been cut for young people in the UK, there aren’t enough training places for what we need to run the NHS and students in the UK have to pay so much to train in them.

The problem focusing on immigration is always too narrow, the problem isn’t who can come or how, the issues is the systems in place in the UK which actually encourage recruiting outside the UK rather than internally.

My DD is a ward sister. She says that her nurses who qualified abroad are far better trained than she was here in the UK. They're also more compassionate than most British nurses. She thinks they're amazing.

When I was studying to be a nurse, then a midwife, I was never promised a job.

@Signalbox
A reasonable question, 'vested interests' is the answer.

But it absolutely does happen across all sectors.

My relative working in the NHS employed a man from overseas through the recruitment process. After he had accepted the job he said that he couldn’t work Fridays , but that didn’t suit the job, so she asked HR and was told to give him what he wanted as they’d already spent too much time and money on processing him.

Likely the same reason as to why many local authorities are needing to look abroad to recruit social workers - crap Pat, stressful work, high case loads, people retiring or leaving for less stress/better pay in droves, not enough younger blood coming through degree pathways which means local authorities have been having to rely agency staff (horribly expensive) and so are recruiting from abroad.

Workers from overseas have more to gain from working in the UK. They gain access to the country for themselves and their family and all that offers them, maybe not straight away - but in the future.

Whereas UK workers have almost nothing to gain from working in an overstressed NHS - other than debt, physical risk from the job and patients, and a fairly poor lifestyle if they're in the South east - very hard to live on Band 5 salaries in that area (especially if single).

The UK has done nothing to retain their UK trained staff -there are hundreds of thousands of experienced NHS staff that have left in protest at the pay and working conditions.

Management are happy to see them go whilst they welcome overseas workers who are less likely to complain (about patient safety) and to do as they're told.

It has made health and social care a worse place to work in and a worse place to be a patient.

Completely agree. The international midwives we employ come from countries where they don’t have emergency buzzers that bring in a whole team of medical staff so they are incredibly on the ball at preempting and dealing with situations that uk midwives couldn’t. They are also extremely hard working.

Its not that simple though .
Are you suggesting a non UK born doctor or midwife should lose a job they have already been doing successfully for several years to employ a newly qualified midwife or doctor? That is not only unfair but it doesn't make any sense.
A Trust isn't allowed to employ someone from overseas newly arriving over someone already qualified and living here.
But it takes many years to train doctors the issue is that not enough doctors have been trained in previous years which is why there has been recruitment from overseas.

Have to be cynical here - having experienced Surrey's adult social services, I got the impression that hiring foreigners - or at least first generation immigrants - is a way of keeping scandal 'in house'. I just got the sense they were less likely to whistleblow and like the Council itself were more likely to be susceptible to 'othering' - that thing where you see the public as different, and the enemy.

If some scandal hit the fan, they could also be made to 'disappear' - flee overseas and become 'unavailable' for any investigation or inquiry. That said, the Surrey coroner has been known to simply allow social workers to not show up if they produce a note saying the distance to Woking is too far! Thus letting them off the hook.

There is perhaps the sense that foreign workers may not be so proprietorial about scandal in the UK, as I would be I daresay if I worked abroad, you'd just accept their ways. They might not put the gossip out for all to here.

One care home my mother was at in Banstead, Surrey, hired Filipino staff who turned out to be illegals. This only came out because the chef had a row with the manager and whistleblew it to the authorities. I didn't dislike the staff but it later occurred to me that they too were hardly going to whistleblow anything because they'd want to stay off the radar, it might mean a flight back home.

Once those staff were got rid of, the manager didn't bother hiring much in the way of replacements and residents began dropping like flies - my mother was very nearly one of them. This presumably benefited Surrey County Council however because many were Council-funded, so it saved them ££££.

Should also add that I daresay the Surrey safeguarding heads could date their lineage back to the Norman Conquest and were total utter bastards - but it turns out if you work for the LA in that sort of role, you are unaccountable anyway; it attracts a certain type who be employed for decades cos you can't get fired.

@JulietteHasAGunsee my other post that explains my reasonings but to add to it.

in my trust we ask lots of questions but there are two seen questions that candidates get prior to interview. At least one emergency scenario question, a CTG based scenario and then a scenario for antenatal, Intrapartum, postnatal and neonatal.

To break it down:
Seen questions: Would you employ someone as a midwife that cannot answer (they can bring notes) questions they have had time to prepare? To me it shows laziness and lack of motivation.

Emergency scenarios: These are part of your uni exams every year. They are drilled into you, practiced and tested often in practice and in uni. If you come to interview and cannot talk me through what to do in a specific emergency, and we do prompt and allow for nerves, you don’t get the job as you aren’t safe.

CTG interpretation: we give a very straight forward trace that anyone who has done 3 years of midwifery training would understand. We ask candidates to talk us through what they see, potential causes and what they would do as a midwife. They don’t have to give correct answers, just be methodical and explain what they are seeing and potential causes. We are more lenient on this one but on one interview day, TWO candidates were reading it upside down!

Then the other questions test knowledge, autonomy etc and are all situations that happen all the time, so would not be a surprise.

Finally, we give loads of time. There are 2 interviewers, we are friendly, we prompt if appropriate, allow them to go back to questions and add to it if they think of something else.

You don’t forget your entire 3 years training and your 2400 hours minimum practice because you are nervous.

Would you want someone who couldn’t pass an interview and were nervous to deliver your babies or grand babies? I certainly wouldn’t.

GMC data shows overseas trained doctors account for 42 percent of doctors in UK. Between 50-75 percent of doctors struck off are trained overseas. Overseas doctors are twice as likely to have complaints escalated to disciplinary hearings than are UK trained doctors with poor communication issues raised frequently. I have visited a consultant whose English was so poor I didn't have any idea what she was saying. English standards both spoken and written should be a much higher standard as a requirement to practice in the UK.

My sister retrained to be a doctor as a mature student (forgive my inevitable errors on the detail here). She's completed the general training (so has been an F1 doctor in a hospital, and maybe an F2?) and now is at the stage where she and the rest of her cohort needs to apply for training placements to specialise.

She wants to be a GP so sat the exams, did ok, but now can't get a training placement. Most of her cohort are the same, can't get a spot in the next bit of training where you specialise.

So she's in ££££ debt, a trained doctor and can't progress. She's had to get a different job to pay the bills and needs to resit the exams next year and try again. To be clear, she did fine in the exams this time but there simply aren't enough training places for all the students to progress to specialisms (GP, surgery, whatever).

When she started training (maybe 6 years ago) this wasn't the case. She'd never had started the training if she'd have known this was likely to happen. It's a total mess. She's 48 now, has spent 6 years training for a thing that's literally useless if she can't progress.

The student nurse places were increased but in the meantime we employed many overseas nurses to fill the gaps. Now our home grown newly qualified aren't guaranteed a job. Don't know what the answer is.
When I qualified 10 years ago we were all pretty much guaranteed a job.

Yes, the reality is that seasonal, inflexible jobs disproportionately concentrated outside of large population areas aren't very popular. The revealed preference of people in the UK is not to do them, and some of the people who'd be up for it will be excluded by logistics.

There's room for a discussion about whether it would be best to try and encourage a home grown (no pun intended) workforce for agriculture, but that's also going to require putting the infrastructure in. People would have to be able to move to areas, access stable housing not tied to their employer and either an annualised wage or a top up benefits system that doesn't fuck them around during the months of the year where there's not so much work in the localities.

This is my experience too, not in every case of course. But enough times that it’s a pattern.

This is not true. Especially in wales. There has been a massive recruitment drive of overseas nurses. Now there are no jobs for the newly qualified nurses. I’m with a student currently who is qualifying in two months and has no job to go into!

Birth rates are falling therefore there isn’t a demand for more midwives.

I agree that nursing shouldn't require student loans but there was an issue under the old system where people were entering degree nursing and leaving upon qualification for other graduate careers.

In my view, and it is never received favourably, nurses (and doctors) should not have to repay their srudent loans but that should come hand in hand with a requirement that that they work for the NHS for a minimum of seven years, unless illness prevents it.

I have some knowledge of university nursing progammes and on some of them, the quality of the undergraduates is woeful. The qualifying new nurses are nowhere near the calibre of degree nursing candidates 30 years ago.

The other point about foreign doctors is that the med schools will be after candidates who have world leading research behind them for their research and bid submissions.

I fully believe we should go back to the free or paid apprenticeship system for training nurses, especially considering so many school leavers are desperately seeking work

The birth rates might be falling, but we still have a midwife staffing crisis in the nhs. There are not enough staff and they won’t hire more.

I always wonder about the (poorer?) country where they were trained. Surely they are needed there?

Yep. Its long been a problem. Any profession wants to be in demand. If there is enough supply its harder to demand higher pay.

Its a bit like how builders are never gonna build enough homes. Why would they, they can charge more if there's a shortage of supply.