UK demand for overseas doctors severely affecting sub-Saharan Africa


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Almost half of the recent 16,000 staff expansion of the NHS came from the recruitment of health professionals trained outside the UK and Europe, states an article in this week's issue of THE LANCET.

John Eastwood (St George's, University of London, UK) and colleagues note that, while the serious consequences of 'brain-drain' are becoming increasingly recognised, the fact that the UK's demand for health professionals has affected the English-speaking countries of sub-Saharan Africa the most, has not been appreciated.

The health systems of developing countries have been badly damaged by the emigration of their doctors and nurses to developed countries. The UK has played a particularly prominent part in the process, with 31% of its practising doctors having trained outside the UK. The UK's chronic need to recruit doctors, nurses, and other health professionals from overseas is also increasing in comparison with other European countries of similar size. In France and Germany the proportion of practising doctors who are trained overseas is only around 5%. The authors believe that the UK, as a major beneficiary of health professionals from sub-Saharan Africa, has a responsibility to take the lead in tackling the problem. They suggest a number of practical steps to slow the migration of health professionals from developing countries. These include significant increases in the training of both doctors and nurses in the UK, and a range of practical measures to assist the African countries most severely affected by loss of health professionals to the UK.

Dr Eastwood comments: "The demand from UK employers for more staff to run their hospitals appears to be a significant cause of the drain of health professionals from English-speaking sub-Saharan Africa. We certainly need to train more doctors and nurses in the UK. Also, in 2005, there are special opportunities for the UK to take the lead in focusing the attention of the G8 on the wider problems of health professional migration from poor to rich countries. We suggest that one basic measure would be an agreement in consultation with WHO to establish a basis, in developed countries, for minimum annual numbers of health professionals in training. This would help to reduce developed country reliance on the investment in training made by developing countries." (Quote by e-mail; does not appear in published paper)

In an accompanying editorial The Lancet comments: "Every rich country can afford and should aim to train as many health-care workers as it needs. To poach and rely on highly skilled foreign workers from poor countries in the public sector is akin to the crime of theft."

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