With reports indicating that countries such as Botswana, Kenya, Ghana and Zimbabwe will continue losing qualified health personnel to the UK, the question that has been popping up in peoples’ heads is whether these source countries will cope and address public health issues in their respective countries with a smaller and inexperienced health workforce. The NHS recently secured the services of sixty six Batswana nurses, with more expected in the following months and years. In central Africa, there is a steady flow of scores of nurses from Kenya taking up opportunities in the NHS. In Zimbabwe, the Health Service Board indicated that more than 900 nurses left the workforce with most reported to have migrated to UK. These are just a few examples among many others.
U.K’s recruitment drive, which other scholars have labelled as grossly insensible, comes at a time when the World Health Organisation (WHO) estimates that African countries already have the lowest doctor-to-population ratio in the world. Currently, Botswana’s doctor-to-population ratio does not meet WHO recommended threshold. A massive recruitment drive of nurses aggravates an already bad situation in Botswana and southern Africa as it leaves these countries with a very low number of health workers manning the system. The Lancet – a weekly peer-reviewed general medical journal – published an article which corroborated these findings highlighting that the reason developed countries such as U.K, Australia and the United States of America (USA) have the highest doctor-to-population ratio in the world is because of their nifty recruitment practises of medical graduates from developing countries in Africa.
UK’s recruitment presents major challenges on its own seeing that African countries bear over 24% of the global burden of disease. According to WHO: “Africa has access to only 3% of health workers and less than 1% of the world’s financial resources”.
In March, the NHS England reported that they were experiencing staffing shortage with over 39, 600 nursing posts unfilled as well as 8,150 unfilled doctor posts. The 39, 600 vacant nursing posts represent approximately 10% of the nursing workforce.
In the 2021 report entitled: “State of medical education and practice in the UK”, the General Medical Council (GMC) noted that while there was a decline in international medical graduates from outside the European Economic Area (EEA), “the number joining in 2021 was roughly the same as in 2019, which was the second-largest year covered by the data we hold.” GMC is a public body that maintains the official register of medical practitioners within the United Kingdom.
In 2021, two doctors wrote an open-access article in the South African Medical Journal (SAMJ) criticising the UK government and the NHS for what they said was an “unethical” recruitment drive of overseas medical personnel from developing countries. The letter which was written by Johannes Fagan: Professor and Chairman, Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa and Mahmood Bhutta: a Consultant and Honorary Clinical Professor, Department of ENT Surgery, Royal Sussex County Hospital, Brighton, UK noted that “when politicians and healthcare planners err by not training enough of their own healthcare personnel to care for their population, or do not create working conditions to retain staff, then they should pay the price, not patients and health systems in poorer-resourced countries.”
According to the WHO: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”. Although the WHO Global Code of Practice on the International Recruitment of Health Personnel which was adopted in 2010 is an ethical guide rather than an enforceable, it urges member states to practise moral recruitment practises. “An adequate and accessible health workforce is fundamental to an integrated and effective health system and for the provision of health services,” states the Code.
With countries such as Botswana and Zimbabwe already experiencing an overburdened health sector, should the UK be exploiting other countries’ weakness to get what they want?
