Jeremy Hunt is to pledge that the NHS in England will be “self sufficient” regarding doctor numbers after Britain leaves the European Union, as he sets out a package of measures aimed at reducing its reliance on foreign-trained medics.
The health secretary will use his speech to the Conservative party conference on Tuesday to promise that medical schools in the UK will be allowed to offer up to 1,500 extra training places every year, and released figures that said that one in four NHS doctors have been trained abroad.
Hunt will stress that foreign-trained doctors do a “fantastic job”, and say that “we want EU nationals who are already here to be able to stay post-Brexit” – but he will also ask: “Is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”
He wants NHS England to reach the target in 2025. “Of course it will take a number of years before those doctors qualify, but by the end of the next parliament we will make the NHS self- sufficient in doctors,” Hunt is to add.
Remain campaigners warned in the run-up to the referendum that the NHS, which relies heavily on foreign staff, would be hit if EU workers could no longer travel freely to work in the UK. Data from the General Medical Council records that 30,472 doctors come from the EU and other countries in the European Economic Area, while 71,139 were trained elsewhere in the world outside the UK.
Hunt hopes that by boosting the number of places now, he will have a pipeline of British-trained doctors ready in time. There is rapidly accumulating evidence that doctor shortages are causing serious problems, including the part-closure of A&E units at hospitals in Chorley, Lancashire and Grantham in Lincolnshire.
The move represents a partial U-turn by Hunt, as until now he has repeatedly responded to evidence of understaffing by pointing out that the NHS in England has more doctors now than when the coalition took office in 2010. Currently half of those people applying for medical school are rejected, because of the limits on the number of places.
Before individual medical schools are allowed to lift the cap on training places, they will have to show the government they are taking steps to attract students from deprived economic backgrounds.
Trainee doctors will have to work in the NHS for four years before they can accept overseas postings in an attempt to avoid a rapid exodus of people trained in the UK. Many young doctors head to Australia and elsewhere overseas, and increasing numbers say they want to go abroad as the protracted junior doctors dispute has dragged on.
Medical organisations welcomed what the British Medical Association said was Hunt’s belated recognition that the NHS is under-doctored, especially in specialities such as A&E, paediatrics, anaesthesia and psychiatry. But they warned that the health service would not benefit from the extra medics for another decade and that others were were needed to tackle doctor shortages.
“While it is welcome that he has finally admitted the government has failed to train enough doctors to meet rising demand, this announcement falls far short of what is needed”, said Dr Mark Porter, the BMA’s chair. “We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors. This initiative will not stop the NHS from needing to recruit overseas staff.”
The Department of Health is expected to publish a consultation paper on the details of the plans later in the autumn.
Hunt was irritated last month when a report from the Royal College of Physicians, which represents hospital doctors, said that the NHS was “underfunded, under-doctored [and] overstretched.”
Welcoming Hunt’s plan, RCP president Prof Jane Dacre said: “The RCP has long argued that rota gaps and staff shortages are the greatest threat to patient safety and have significantly contributed to low morale among junior doctors. The NHS needs more doctors, and this dramatic increase in medical school places will help relieve many of the pressures faced by the NHS in the long-term, and support a more sustainable workforce.”
Dr Simon Clark, workforce officer for the Royal College of Paediatrics and Child Health, cautioned that “with 30% of doctors deciding to take a break from medicine in the UK for a period of time before they take up speciality training, government must address the retention, attrition and career hiatus that occurs.” Ministers would need to ensure that the extra doctors would be deployed in the areas of England which are facing the greatest shortages, he added.
Labour’s shadow health secretary, Diane Abbott, said: “It appears that Hunt has taken a chapter from the Hard Brexiter’s Myth book. The idea that we can be self-sufficient in medical staff is nonsense.”
“The true picture is that the NHS has never been in a more perilous state and the Tories are cutting the health budget by £22bn.
“The reality is that Hunt has lost the trust of the medical profession and is the least popular health minister in recent history. Morale among NHS staff is at rock bottom and Hunt has shown once again just how little regard he has for the hard-working people that keep our health service running.”
The first of the extra places, which could eventually increase the number of trainee doctors by up to a quarter, will start to become available from 2018-19.
The Department of Health, which subsidises medical students by funding their clinical placements in hospitals, will pay for the expansion from its existing budget.
It plans to offset part of the cost – expected to be £100m in total by 2021 – by forcing foreign medical students to pay for their own clinical placements.
That will increase fees for medical school for students from overseas – but Department for Health sources pointed out that the current £9,000 a year is far lower than the fees for other prestigious international medical schools.
Jeremy Hunt promises to end NHS reliance on overseas doctors after Brexit
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