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Dr Sarah Wollaston MP, Chairman, Health Select Committee


Mail Online NHS recruits thousands of doctors from Third World... while limits on places deny British students chance to study medicine

  • 30.08.2013

- Health Service is hiring one third of its doctors from 143 different nations
- Government quotas mean straight-A students are being turned away from medical degrees
- Those who trained outside EU have to pass language test and medical exam

Doctors trained in some of the world’s poorest countries where medical qualifications are far less rigorous than in the UK are being recruited by the NHS. While some of Britain’s brightest students are unable to get on medical courses at home, the Health Service is hiring a third of its doctors from abroad. Among them are medics from 143 different nations including poverty-stricken states such as Liberia, Belize and the Congo.

Some have studied in countries whose universities have few computers or medical textbooks and trainees are taught from blackboards in cramped classrooms where they are forced to sit on the floor. Critics said it was ‘bonkers’ that British straight-A students desperate to become doctors were being turned away from medical courses due to government quotas while the NHS recruited staff from remote parts of the world with poor medical training. The revelation comes amid fears the health service is becoming too dependent on foreign medics.

One senior doctor recently warned that many of them had ‘little or no knowledge and experience of British culture or of our Health Service’. Professor J Meirion Thomas, a senior cancer specialist who works at the Marsden Hospital in London, wrote in the Spectator magazine: ‘Importing doctors from abroad on a regular and ongoing basis might not be a bad thing if there were any guarantee that the entry criteria to all foreign medical schools were as rigorous and as discriminating as our own. ‘Also, that the quality of teaching and training was always as comprehensive as ours. But too often, it isn’t.’

Foreign doctors are four times more likely to be struck off or suspended than those who trained in this country, while a quarter of all doctors barred from the register qualified abroad – the highest number were from India. Those who trained outside the EU have to sit an exam on basic medical competence and score 7 out of 7 on an English language test before being allowed on the register.

Doctors who have trained outside the EU are required to pass a language test before they practice in the UK. They must also have gained their medical qualifications in a university ‘approved’ by the General Medical Council. But the watchdog has only blacklisted eight institutions from the thousands around the world including one in Liberia, one in the Cook Islands in the South Pacific, and one in Belize. Doctors who qualify within the EU are exempt from such checks due to strict ‘freedom of movement’ rules and they are allowed on the register automatically. There is widespread concern that European doctors are being allowed to work in Britain even if they can barely speak English or have rusty medical skills.

The flaw was tragically exposed in 2008 when a German GP, Dr Daniel Ubani, killed pensioner David Gray by giving him a huge dose of morphine on his first shift as an out-of-hours GP. Roger Goss, of Patient Concern, said: ‘One of the main complaints we hear from patients is the language problems. ‘Often these doctors speak better English than patients but they cannot understand regional dialects and due to their intonation, patients cannot understand them. There are also problems with doctors getting to grips with all the NHS’s policy and guidelines. They are thrown in at the deep end, and they just don’t know what they are doing.’

The Government plans to appoint senior consultants and GPs to supervise EU doctors and ensure they are up to scratch – on the language and medical skills. The system is due to come into force next year but doctors say they will not have time to carry out the checks and warn that locums – who do not have a permanent workplace – will slip through the net.

Gail Beer, of the think-tank 2020 health, said the health service needed to ‘tighten up considerably’ on foreign medics. She added: ‘Where you’ve got night locums, it’s very difficult to get them up to speed and often they are employed when there are less senior staff around.’

GMC figures show that there were 252,553 doctors who trained oversees on the register last year, a rise of 3 per cent from 2011. India provides the most doctors, with 25,336, while 8,998 are from Pakistan, 5,695 from South Africa, 4,010 from Ireland and 3,936 from Nigeria – where medical training has been heavily criticised. Another 727 are from Libya – where there are few computers and students learn from blackboards – 383 from Ghana and 123 from Colombia.

The General Medical Council has only blocked eight institutions from supplying doctors to the UK. Foreign doctors are four times more likely to be struck off or suspended than those with British training.

Some experts pointed out that the NHS depends on overseas doctors particularly in unpopular specialisms such as A&E and care of the elderly which struggle to recruit staff. A spokesman for the British Medical Association said: ‘Overseas doctors have for many years made a valuable and important contribution to the NHS, especially in key services where there has been a historic shortage of UK-trained doctors. ‘This includes consultant posts in emergency care, haematology [blood disorders] and old age psychiatry. Without the support of these doctors many NHS services would struggle to provide effective care to their patients.’