Last week, my mother turned the grand old age of 100! Like myself, my mother worked as a nurse within the NHS. She came from Dominica in the Caribbean, and like many nurses from outside of Britain, she helped support the NHS workforce. Foreign staff have had a significant and vital impact on the NHS since its development, and their contribution must not be underestimated.
The NHS was established to tackle social and economic issues in a post-war England. The Second World War had caused immense destruction, and labour shortages were a huge problem. Recruitment was problematic from the beginning, and due to the chronic shortage of nurses, Britain found itself with an expanding health service that it was unable to staff. Subsequently, since the 1930s, successive governments have resolved staffing issues by recruiting staff from overseas.
The first major nursing recruitment drive was in the 1950s, during which recruitment centres were set up within the islands of the Caribbean. This drive proved successful, and nurses signed up to the contracts offered. The number of women entering Britain to work in the NHS from the Caribbean subsequently grew well into the 1970s (Snow and Jones, 2011). Although immigration controls were tightened in the 1960s and 1970s, the demand for overseas health workers remained unrelenting. By the late 1980s, there was a return to the serious issues of retention and recruitment of nurses that had been seen in 1948 (Snow and Jones, 2011). Once again, recruitment from overseas was necessary to fill the gap, and nurses from overseas became crucial to the maintenance of the NHS workforce.
At present, over 12% of the NHS workforce state their nationality as not British. With approximately 45 in every 1000 foreign NHS workers coming from the EU, they make up the largest group. Non-EU foreign staff come from countries such as the Caribbean, African nations, India, the Philippines and those in South Asia. These workers provide a crucial source of expertise and skills and fill gaps left by reduced training places seen in recent years (King's Fund, 2018). They are valued and necessary and must be appreciated.
With the recent appointment of the new Prime Minister, Boris Johnson, we are moving closer to the UK leaving the EU. However, the UK's vote to leave the EU has generated major uncertainty for the NHS workforce.
According to a briefing by the King's Fund, there is a shortage of over 100 000 staff across NHS trusts (King's Fund, 2018). One of the main factors responsible for this current shortage is the restrictive immigration policies exacerbated by Brexit. The Royal College of Nursing (RCN) stated that the number of EU nurses and midwives registered to work in the UK dropped by 2385 in the last year (RCN, 2017; 2018). We must hope that this trend reverses.
The significance of the dependence of the NHS on overseas health workers since its introduction in 1948 is unquestionable. For the NHS to survive, we need to ensure that recruitment and integration of non-British nurses into the NHS continues.