The NHS is facing criticism over its growing dependence on healthcare workers from World Health Organization (WHO) “red list” countries—nations struggling with severe medical staff shortages.
Health Secretary Wes Streeting has called the situation “immoral”, blaming years of underinvestment in UK medical training for forcing the NHS to recruit from countries that desperately need their own doctors and nurses.
NHS Turning to Overseas Staff to Fill the Gaps
Since Brexit, the NHS has increasingly turned to Nigeria, Ghana, Zimbabwe, and other red-list nations to fill staffing shortages. New figures from the Nuffield Trust show that since 2021:
- 32,935 healthcare workers from red-list countries have joined the NHS.
- One in 11 medics in England now comes from these nations.
- 46% of all nurses hired since 2021 were trained outside the UK or EU.
Since 2018, the number of nurses coming from Nigeria has surged by 46%, from Ghana by 21%, and from Zimbabwe by 16%.
Streeting: ‘The NHS is Pinching Doctors from Needy Countries’
Streeting has made it clear that relying on overseas recruitment is not a long-term solution. He criticised past governments for failing to train enough homegrown medics, leaving the NHS in the “immoral position” of hiring from struggling nations.
“The NHS has been left in the immoral position of pinching doctors and nurses from countries which desperately need them, because we haven’t trained enough medics at home.”
At the same time, he pointed out, British students with top grades are being rejected from medical school, despite a clear need for more NHS staff.
Is the NHS Breaking WHO Guidelines?
The WHO has warned against actively recruiting from 55 red-list countries where healthcare staff shortages are most severe. The UK government officially supports this policy—but the figures suggest the NHS is heavily dependent on red-list recruitment.
Between March 2023 and November 2024 alone:
- The number of red-list nurses in England rose by 36% to 21,500.
- The number of red-list doctors increased by 24% to 13,675.
- The number of support staff from red-list nations jumped by 74% to 21,600.
A Global Race for Healthcare Workers
With ageing populations and staff shortages worldwide, wealthier nations are competing for medical professionals. Countries like the UK, US, Australia, and Saudi Arabia now account for 70% of global health worker migration.
While NHS leaders insist they are not actively recruiting from red-list countries, experts say the trend is unsustainable.
Sebastian Rees from the IPPR think tank warned:
“While the NHS benefits hugely from the experience and skills of overseas staff, its over-reliance on red-list recruitment is both unethical and unsustainable.”
However, Jim Campbell, the WHO’s workforce director, argued that many overseas workers apply directly to the NHS for better opportunities, rather than being actively poached.
“This raises ethical questions. But many graduates are seeking career opportunities in the NHS that wouldn’t be available to them at home.”
The Future of NHS Staffing
Streeting has pledged to reduce NHS reliance on overseas workers by expanding medical training in the UK. Officials are now reviewing the NHS long-term workforce plan, originally launched by the previous Conservative government in 2023.
But with a global shortage of healthcare workers and rising demand, can the NHS realistically move away from overseas recruitment any time soon?
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