Are the nurses really leaving?

Politicians give their opinions on every element of human life.  Consequently, many people blame politicians, or even voters, for changes in supply and demand.  After all, these issues were brought up before the election.

It is true that, while there is net migration into the country, many people are leaving the UK (and perhaps doctors and nurses have a net outward migration).  One British man gave the following reasons for becoming French:

The list of dead ends seems grotesque, worthy of a Marx Brothers’ film: the record number of European nurses leaving the NHS, for fear of not being allowed to stay in the country; people in poverty-scarred Cornwall having massively voted Brexit then worrying, just a day after the vote, that their (vital) European subsidies would stop; the British farmers, pro-Brexit, also getting indignant at the stopping of subsidies – a detail they seem not to have thought of; the Home Office considering recruiting Polish customs officers, because there are too few Britons for the job – yes Britain needs Poles to help keep out the Poles!

It sounds interesting indeed, although it may be difficult to verify those facts.  Let’s just focus on the one related to nurses leaving the UK (in record numbers, the press tells us.)

European health workers have left the NHS.

The Guardian cited NHS digital, claiming that:

in the 12 months to June, 9,832 EU doctors, nurses and support staff had left, with more believed to have followed in the past three months.”

This is an increase of 22% on the previous year and up 42% on two years previously. Among those from the EU who left the NHS between June 2016 and June 2017 were 3,885 nurses and 1,794 doctors.

I couldn’t find the data on NHS digital, but I haven’t seen a fact check to deny this information either.  Let’s assume that it’s true.  That means they lost 9832-(3885+1794)= 4153 support staff from the EU.

Considering the increases in departure since the year of the Brexit vote, one might assume that Brexit is the cause of leaving.  It may be a factor, but it’s doubtful whether Brexit is the sole cause.  After all, there are many other foreign nurses who do not come from EU countries, and support staff might be recruited locally.  (That said, I have spoken to people from Nigeria who said that Brexit is a factor in talented Nigerian doctors considering alternative destinations.)

In July, for instance, the Guardian reported that:

Language tests introduced by the government to restrict immigration are stopping the NHS from recruiting foreign nurses – including highly qualified native English speakers.

These tests are apparently too difficult for English speaking Australian nurses, and many believe they wouldn’t be passed by locals.  However, as more nurses leave the NHS, and fewer new applicants register, not everyone sees a downward flow in nurses.  At least one agency reported an increase.

Agency staff

“HCL has registered more European nurses in the year following the EU referendum than the year before,” says Steven Burke, head of HCL workforce solutions.   Perhaps it’s not just Brexit, but there are problems within the NHS itself, or with other government policies.

Reports on the increasing use of expensive agency staff are relatively easy to find, dating back to at least 2014, and continuing to this year.  The Independent may now blames Brexit, but in 2014 it reported that the NHS was already spending £2.5 billion on agency staff in 2013.  Among those agency staff may be European workers who are leaving the NHS because of poor working conditions.  Leaving the NHS doesn’t necessarily mean leaving the country.

For those of us who worked as agency staff in other industries, the idea that it would be better to work for an agency seems preposterous.  However, NHS workers do not have the same rights as workers in other industries, and Jeremy Hunt infamously said in 2015 that doctors must work seven day weeks.  It is possible that many NHS staff see the agencies as a way of improving working conditions.

Poor working conditions

It is also possible, however, that as worker’s rights are expected to deteriorate in a post-Brexit tory government, that hospital staff are especially persuaded to leave the country altogether.

Xenophobic government

Terms like “NHS tourists” used in the run-up to the Brexit vote sounded more xenophobic than the outcome of the vote itself.

The actual voters could have any number of reasons for voting, from regulation to spending.  Even if immigration was an issue for some, that doesn’t mean they wanted to see the nurses go.  And, despite the odd xenophobic attack, few (if any) doctors and nurses think Brexit voters are xenophobes.  Rather than citing a fear of the population, most doctors worry about their immigration status, and perhaps retaining any pensions earned.

As a new agreement seems to have been reached, perhaps these fears may be calmed somewhat.

Other strange schemes

The current government has all kind of hair-brained schemes that drive Britons to Australia, such as the so called bed rental scheme.  And, with all kinds of newspaper reports of the NHS being short on funds, well, it’s natural that many of its workers would fear for the future of their jobs and pensions.  If I were working for the NHS, I’d consider my options right now.

But, with all these reasons to move abroad, why do people still want to come to the UK?  Net migration to the UK is still nearly two and a half times the government’s target, even as the NHS has a recruitment crisis.  However, although net migration is still significantly higher than in 2012, there was a huge drop in 2016.  Perhaps it is among those skilled workers that the drop is the highest.

There could be gaps in the NHS recruitment strategy, and it is possible that many positions can be filled locally, if this strategy is adapted.  Perhaps a lot of the negative news stories, or other issues, that drive away European doctors, nurses and support staff are also affecting recruitment of local talent.  And, significantly, maybe there are opportunities abroad that are a stronger pull than bad news about the NHS and immigration status a push.  For instance, last year Forbes magazine reported that despite 1/4 of all US doctors being foreign born, there was still a skill shortage.

Leave a Reply

Your email address will not be published. Required fields are marked *