Almost half of the recent 16,000 staff expansion of the United Kingdom’s National Health Service came from the recruitment of health professionals trained outside the UK and Europe, according to a report in this week's issue of The Lancet. English-speaking countries in sub-Saharan Africa are most severely affected.
John Eastwood (St George's Hospital Medical School, 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 (compared to less than 5% in France or Germany).
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. These include ring-fenced funds to attract people to work in the health care systems of African countries, more money for medical education in those countries, housing for health care staff, and strict limits on how long citizens of those countries can spend undergoing medical training in 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."
Eastwood JB et al. Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. The Lancet 365: 1893-1900, 2005.