Leading voices from Scotland’s healthcare professions are questioning whether a commitment to recruit doctors into NHS Scotland from abroad is practical or ethical.

In the NHS Recovery Plan published last month, ministers commit to spending £11m on new national and international recruitment campaigns as well as the establishment of a national workforce centre.

The plan was criticised for a lack of focus on staff retention, while several organisations pointed out that plans around growing the workforce by training more people in Scotland will only make a difference in the longer term.

With this in mind, some professional bodies welcomed the commitment to recruit from outside Scotland to fill the gap.

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said:

“We must redouble efforts to attract doctors from outside Scotland, within the UK and internationally, to train and work in the country, and we must also ensure that those who already work here continue to wish to do so.”

But Professor Elder’s counterpart at the Royal College of Surgeons of Edinburgh, Professor Michael Griffin, suggested that bringing in clinicians from abroad might damage healthcare in the countries they are coming from:

“Recruiting internationally at this point of the pandemic, when many other countries are still experiencing extreme pressures as a result of covid, may prove challenging and could essentially result in stripping vital healthcare workers from countries where their expertise is in high demand.”

The President of the Royal College of Physicians and Surgeons of Glasgow, Professor Jackie Taylor, in an interview with healthandcare.scot said bringing people from abroad permanently to fill workforce gaps in Scotland may not be ethical – or practical:

“The shortages are global ones. They are not just Scottish or UK or European. There is a global shortage within healthcare.

“So, fundamentally, I think it will be very difficult to recruit internationally individuals to come and work in the UK, practically speaking.

“There is also clearly an ethical issue about recruiting staff from countries where the need may be far greater than ours.

“I think we would have to be extraordinary careful about ethical recruitment.”

On the day the Recovery Plan was published, the doctors’ trade union, BMA Scotland, made its concerns about overseas recruitment clear.

The organisation’s Chair Dr Lewis Morrison said:

“The plan puts significant emphasis on recruitment from overseas to build capacity, but there is a risk of overreliance on that, and other countries need their own doctors too.

“Expecting doctors from other healthcare systems to come here and “hit the ground running” isn’t practical or fair to them. Many will need time and support to orientate to a new country and new healthcare system, not be thrown into the melee from day one.”

Professor Taylor says one solution already exists in the Medical Training Initiative, a scheme supported by the Royal Colleges to allow doctors to enter the UK from overseas for up to two years to broaden their skills and experience working within the NHS, before returning to their own countries.

“That is a very ethical way of training,” Professor Taylor told us.

“I think that is something that we could expand and, actually, even pre-covid, we were asking the UK government for an increase in the number of people who were allowed to come here because we see this as a win-win.”

The Scottish government’s NHS Recovery Plan acknowledges the importance of training new people and developing the skills of existing staff.

Professor Taylor is concerned about ‘training capacity’. She says healthcare professionals need the time and resources to devote to be trainers as well as continuing to meet their frontline clinical commitments:

“None of this can happen unless clinicians have time to train other people.

“It’s not just about putting an extra seat in the lecture theatre.

“And this does create a tension: we will all want to be doing as much clinical work as we can because we want to be looking after patients and want to be reducing the backlogs that we have. But, at the same time, we need time for professional duties – we need to go and examine those candidates. If there are no exams, then there are no qualified people for tomorrow.

“Training within Scotland, training within the UK, is of an incredibly high standard – but that is because of the time that clinicians dedicate to doing it and we need time to do this well so we can maintain the quality of the trainees that we have and the quality of the consultants we have in the future.”

 

Read More: Ministers drop “unrealistic” NHS restart target; ‘Many worrying gaps’ in NHS recovery plan; Insight: Recovery is about workforce and well-being; NHS staffing: time to “positively disrupt education”.

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