Far from Draining the System, Immigrants Keep the NHS Afloat
I went to A&E in mid-April 2017 with severe abdominal pain. Once they ruled out appendicitis, the male doctors all said that the problem must be food poisoning. I told them that I had lived in rural Senegal, I know what dysentery feels like. This was not food poisoning. But they sent me home anyways, with the casual suggestion that I make an appointment with my GP if I was still concerned. There is a story to tell here regarding male physicians and female bodies, but that is not the point of this article.
I had to wait for that GP appointment for seven weeks, then waited another three weeks for an ultrasound, waited another month for a follow-up, and waited another month to discuss the results. At that final appointment, I was told to wait six months for a surgery to remove the culprit of that pain — a cyst larger than a tennis ball on my left ovary.
If you’re keeping track, six months is about 24 weeks — six weeks longer than the promised 18-week threshold for surgeries. And what I needed done was not a knee replacement or a bunion fixed — the cyst was so heavy that my ovary was threatening to collapse in on itself. It needed to be completed in a timely manner. I argued for them to move up the surgery, which they did to a “mere” 12 week wait. After the procedure, the surgeon told me that I most likely would have lost my ovary had the original date been used. She was surprised my ovary had held up as long as it had, and it was a longer surgery than intended because the cyst was larger than it had been in the final ultrasound. If I hadn’t fought the wait times, I would be missing an organ — a reproductive organ — right now.
This is what cuts to the NHS have done. In fact, the NHS is in the midst of the largest sustained fall in spending since 1951, and it currently has a deficit of 2.45 billion pounds. As GP Kailash Chand wrote for the Guardian, “A government elected to fix near-bankrupted banks has replaced that by bankrupting our hospitals.”
With these cuts, nurses and doctors have taken pay cuts — doctors have seen their pay fall by eight percent since 2010, and prospective nursing students no longer receive stipends for training, replaced instead with a loan scheme. Not surprisingly, as of 2016, nine percent of NHS positions are vacant, as opposed to 2.7% open vacancies in the overall British economy. Broken down, between 2013–2015, there was a 50% increase in nursing vacancies and a 60% increase in doctor vacancies. In addition, more than half of all doctors express interest in changing careers due to these conditions.
As such, the NHS must look elsewhere for talent. Currently, 12.5% of NHS staff are foreign born — 26% of all doctors — with about half coming from other European Union countries. Since the Brexit referendum, the total percentage of new NHS staff has dropped from 11% EU citizen to less than 8%. EU nursing applications have plummeted by 96%, and in a 2017 survey, nearly 20% of all EU doctors were making plans to leave the country, with both uncertainty over the future and increased discrimination amongst the British public being the top two cited reasons for this exodus. In that same year, University Hospital Southampton trust saw a 40% increase in EU staff leaving, Guy’s and St Thomas’s trust saw an increase of 30%, and Liverpool’s Walton Centre trust saw an increase of 28%.
Meanwhile, the current government make it extremely difficult for non-EU workers of any vocation to immigrate to the UK, including those who do not qualify for the minimum £30,000 salary that is typically required of non-EU workers. In addition, only 20,700 non-EU immigrants are issued work visas every year — a number which is spread across every industry.
Bear this in mind the next time a politician claims that skilled immigrants are still welcome in the UK. It is purely campaign rhetoric used to make the electorate believe that it is acceptable to discriminate against low-skilled foreigners. Highly-skilled immigrants are also not allowed to come to the country. The lack of rhetoric against them is simply a reflection of the fact that highly-skilled British voters are less likely to be against immigration, and thus politicians don’t feel the need to attack their foreign counterparts. In addition, at face value, it does not come across as xenophobic when politicians claim that low-skilled workers depress British wages — despite the many studies that prove immigration is good for local economies — but it would be more difficult for them to get away with claiming that highly-skilled immigrants are also bad for Britain. Instead they make bold statements regarding the former while quietly also ensuring the latter are unable to come, as the government attempt to get immigration numbers down. They will never manage to get the numbers into the promised tens of thousands, but they are trying their best to do it all the same. In the meantime, hundreds of thousands of migrants lives are being thrown around in order to achieve this goal.
These anti-immigration values have their consequences. Between November 2017 and April 2018, only 34% of doctor applications for a visa were successful, and only 31% of junior doctors’ applications being approved. . Currently, only 1,500 doctors can come annually, and only on two-year visas that are often not re-upped — so they are allowed to come just long enough to establish lives before they are forced to abandon them.
To put it in plainest terms, the NHS in England alone is short nearly 10,000 doctors, of which it would have if not for the draconian immigration policies against non-EU immigrants. The government is aware of these shortages, and yet actively blocked requests by various departments to lift the number cap. The government has recently announced that they will raise the number allowed to come annually from 1,500 to 3,000, and they may be allowed to stay for three years instead of two (making the transition back to their “home” country even more difficult). And, unsurprisingly given the level of disdain towards immigrants at present within the UK, the allowance of more doctors to come was presented to ministers as, basically, “this is an exchange program, so we won’t include them in the numbers. The public doesn’t have to know about them.”
Yes. You read that right. The government is so convinced that the British public hates immigrants that it was only persuaded to allow more doctors to come by pretending they’re not actually there. Which then leads to a slew of questions, first and foremost being: why are international students kept in the immigration numbers when the vast — vast — majority of them leave upon completely their degree, especially considering that it is the post-2010 government that changed the rules in order to force the few students who do want to stay to leave. If the criteria is both length of stay and appeasing an unhappy public, surely it would make sense to remove students from the numbers as well.
Meanwhile, as this situation has unfolded over the past nine years, the government — and unfortunately sometimes Labour and Liberal Democrat leaders as well — have claimed that immigrants are the reason for the multitude of issues faced by the NHS. This despite the fact that immigrants — EU and non — pay more into the system than does the British public, thus subsidizing the NHS for the native population. And yet, non-EU immigrants recently saw their NHS fee doubled. At the announcement, Immigration Minister Caroline Nokes used the commonly used catch-phrase “the NHS is a national, not international, health service” (even though, in reality, so-called “health tourism” accounts for just 0.3% of the NHS budget). Non-EU immigrants already pay taxes, pay national insurance, and contribute to the economy with their purchasing power. They are part of that national health service. And yet, a family of four must now pay an extra £8,000 every five years for the simple crime of having been born somewhere else.
Of the 14 doctors, nurses, and surgeons who directly worked with me between the initial trip to A&E and the surgery itself, only five were British, four of whom clearly had immigrant parents. The NHS desperately needs immigrants, both for their taxes and their skills.
The rest of the world is watching. Skilled immigrants are no longer going to want to live in the country that previously inspired a happy imagined future of scones, gardens, and gentle rain. Nobody wants to be treated like this, and when they have other options they will take them. The British economy — and the NHS especially — cannot afford to lose immigrants. Yet the government continues to dig a hole that is already impressively deep, and doubles down whenever questioned on it.
