Reliance on overseas doctors makes NHS vulnerable to crisis after Brexit, warns watchdog

The NHS faces a crisis if the UK becomes a less attractive place for foreign doctors after Brexit, the General Medical Council has warned.

Almost half of doctors in parts of the country were trained overseas meaning the NHS workforce is particularly vulnerable, the UK’s medical watchdog said.

The reliance on overseas doctors, as high as 43 per cent in some areas, is a sign of the system struggling to keep pace with growing demand and an ageing population.

A GMC report revealed that since 2012, the number of doctors on the register has increased by just 2 per cent, while the number of A&E attendances has shot up 27 per cent.

The State of Medical Education and Practice report said the medical profession is at “crunch point”, with the NHS growing increasingly dependent on doctors who have trained overseas.

In the south-west of England, 18 per cent of doctors are educated overseas, but in the east of England the number jumps to 43 per cent.

The number of international graduates or graduates from the European Economic Area (EEA) on the UK medical register fell by 6,000 in six years, the report found.

While it was unable to pin the drop on a single factor, it highlighted improving economic conditions in countries such as India and Pakistan, while Brexit may have prompted some overseas doctors to seek opportunities elsewhere.

A survey of 2,100 EEA-educated doctors conducted in February this year found 61 per cent said they were considering leaving the UK at some point in the future.

Of the doctors who said they were considering leaving, more than 90 per cent said the Brexit vote was a factor in their thinking.

It also said the demands of training put off some people considering a career in medicine, and many doctors now want greater flexibility in how they work and train.

The report follows the launch of consultation by Health Education England on the future of the NHS workforce as a whole, which revealed it would have to fill a further 190,000 jobs by 2027.

On Tuesday, Labour published figures estimating that the NHS already has 100,000 vacant posts, with an average of 9 per cent of jobs vacant across England’s acute, community and mental health trusts.

This is a rise from 8.4 per cent last year, Labour Shadow Health Secretary Jonathan Ashworth found.

Charlie Massey, chief executive of the GMC, said in a statement: “We have reached a crucial moment – a crunch point – in the development of the UK’s medical workforce. The decisions that we make over the next five years will determine whether it can meet these extra demands.”

He added: “We are a professional regulator, not a workforce planning body, but we want to be an active partner in helping each country of the UK to address these priorities.”

He said more needed to be done to “meet the challenges on the horizon” and various NHS bodies have a part to play in making medicine a “worthwhile, sustainable and rewarding career”.

Among the recommendations suggested by the GMC to reduce pressure and stress on doctors was a reform in the law to reduce the number of full fitness to practice hearings, particularly involving one-off clinical mistakes.

It also found that GPs and medical students were under increasing pressure.

The number of GP consultations increased by 15 per cent from 2010/11 and 2014/15.

Between a similar period, the number of medical students in UK universities fell by 5.4 per cent and the number of doctors in post-graduate training increased by only 1.7 per cent.

A fifth of doctors in training said they felt short of sleep while working, with 40 per cent of those surveyed rating the intensity of their day as heavy or very heavy – this figure jumps to 70 per cent for doctors training in emergency medicine.

As a result more and more doctors are taking a break after they finish foundation training, with the number doing this jumping from 30 per cent to 54 per cent between 2012 and 2016.

Dr Chaand Nagpaul, council chair of the British Medical Association, said: “We welcome the regulator’s recognition that the NHS is in the midst of a workforce crisis and that decisions made today will have a significant impact on what the health service and patient care will look like in 20 years’ time.

“As the research notes, the UK is reliant on doctors from abroad, and Brexit could compound difficulties recruiting and retaining these staff.

"Despite pledges from the government to protect European doctors already working in Britain, the tangible effect of the referendum result on the lives of EU nationals is beginning to become clear, with our own research showing that a fifth of EEA doctors have made solid plans to leave the country since last June.”

Additional reporting by PA