Health

Up to 70% of GPs in parts of England qualified OUTSIDE of Britain, NHS figures show

Two thirds of GPs serving some parts of England originally trained outside the UK, official figures show amid calls for the country to become more ‘self-sufficient’.

Nationally, one in five GPs across England originally qualified overseas, but there is massive variance in how these family doctors are distributed across the country.

MailOnline analysis of NHS data from September this year found that in areas like Thurrock in Essex, 67 per cent of GPs serving patients originally trained abroad.

Other Clinical Commissioning Groups where foreign trained GPs made up at least half the area’s doctors included, North Lincolnshire (54.9 per cent), Southend in Essex (54.4 per cent), Cannock Chase in Staffordshire (52.5 per cent), Stoke on Trent (51.9 per cent), and Castle Point and Rochford (50 per cent). 

Most of England’s overseas trained GPs got their original qualification in India, accounting for one in three of this group of doctors, NHS data shows. Pakistan and Nigeria both made up around 10 per cent, respectively. 

The latest data follows Health Secretary Sajid Javid’s admission that the Government would fail in its objective to recruit 6,000 more GPs in England by 2024.

There have been calls for the Government to loosen Brexit rules and allow more foreign doctors to come to the UK to plug the workforce crisis but others have said ministers need to do more to nurture UK-born students. Although, campaigners accept that the country needs as many GP as it can get.

Tensions between Britain’s GPs and the Government are currently running hot due to an ongoing row about face-to-face appointments, which are 20 per cent lower than pre-pandemic.

Mr Javid has threatened to name-and-shame individual surgeries which don’t see more patients in person while doctors are contemplating strike action, claiming they are overwhelmed with a backlog of care caused by the Covid pandemic.

This map shows the percentage of GPs in each Clinical Commissioning Group in England which originally trained overseas. The nationwide total of foreign trained GPs is 20 per cent, but there is massive regional variance. Some areas have recorded more than half of their GPs as having got their original qualification from a non-British nation

Here are the top 15 countries where overseas trained GPs got their original qualification. India accounts for the vast majority of these overseas trained GPs, accounting for one in three, followed by Pakistan and Nigeria. Ireland and Germany are biggest EU contributors to overseas trained GPs in England

Here are the top 15 countries where overseas trained GPs got their original qualification. India accounts for the vast majority of these overseas trained GPs, accounting for one in three, followed by Pakistan and Nigeria. Ireland and Germany are biggest EU contributors to overseas trained GPs in England

In terms of EU nations, Ireland and Germany were the biggest contributors of GPs to the UK, with both countries each accounting for almost 4 per cent of overseas trained medics.

The proportion of GPs trained from overseas has not shifted significantly since 2006, when 21 per cent of doctors reporting they qualified abroad.  

British Medical Association (BMA) GP committee executive team member, Dr Krishna Kasaraneni, said overseas trained doctors made a huge contribution to England’s health.

‘Amid a historic workforce crisis caused by a failure to support and retain family doctors, our international colleagues make an invaluable contribution to patient care,’ he said. 

Dr Kasaraneni said working as a GP in the UK remained a goal for many doctors around the world, to both develop their skills, or to make a new home here in Britain and contribute to their community. 

Places in England with the MOST overseas trained GPs 

  1. Thurrock in Essex: 67 per cent
  2. North Lincolnshire: 54.9 per cent
  3. Southend in Essex: 54.4 per cent
  4. Cannock Chase in Staffordshire: 52.5 per cent
  5. Stoke on Trent in Staffordshire: 51.9 per cent
  6.  Castle Point and Rochford: 50 per cent
  7.  Doncaster: 47.7 per cent
  8.  North East Essex: 46.6 per cent
  9.  Basildon and Brentwood: 44.8 per cent
  10.  Blackburn with Darwen: 43.8 per cent

 

Places in England with the LEAST overseas trained GPs 

  1. Northumberland: 3.7 per cent
  2. Vale of York: 4 per cent
  3. Devon: 5.6 per cent 
  4. North Tyneside: 6.2 per cent
  5. Sheffield: 6.7 per cent 
  6. Gloucestershire: 6.8 per cent
  7. Bristol, North Somerset and South Glos: 7 per cent 
  8. Cornwall and the Isles of Scilly: 7.6 per cent
  9. Leeds: 9.1 per cent 
  10. North Yorkshire: 9.6 per cent

 

‘Despite current pressures, the system of NHS general practice is highly-regarded around the world, and many people will come here to train and practice, and then many will return to their home country to offer their newly acquired skills and expertise to patients there,’ he said. 

‘Of course, many stay, make a home here and offer a life of service to the NHS, their practice and local patients.’

The doctors’ union also highlighted that while many doctors may have got their original qualification outside of Britain, most would have undergone additional study in the UK to become GPs. 

Royal College of GPs (RCGP) chair Professor Martin Marshall said any GP working in the UK had to meet high standards, regardless of where they trained. 

‘All GPs working in the UK must meet rigorous standards, set by the General Medical Council,’ he said.

‘This includes overseas GPs, who will need to demonstrate equivalent competence to practice in the UK.’

Professor Marshall said the UK needed to become ‘self-sufficient’ in terms of GPs.

‘It is important that work is done by Government to ensure the UK becomes self-sufficient in terms of the supply of GPs and the wider health workforce so that general practice has the capacity to meet the needs of patients and continued increase in demand for services,’ he said. 

‘It is also important to ensure that the UK does not take family doctors from countries that can ill-afford to lose them, especially in developing countries.’

However Professor Marshall said the Government was failing to meet its own objectives in this regard.

‘In 2012, the Government set a target that half of UK medical graduates should enter general practice, however this is yet to be met,’ he said.

‘While recruitment to GP training is looking promising, it takes a long time for a GP to qualify, and more GPs are leaving the profession every year than are coming up through the pipeline.’ 

Silver Voices, a group representing elderly Brits and which has been campaigning for more face-to-face appointments from doctors said the NHS needed all the GPs it could get.

Dennis Reed, head of the campaign group, said while historically some people had expressed concerns about overseas doctors this had faded away. 

‘There may have been some concern some years ago when people used to be concerned about that sort of thing but I don’t pick up any antipathy these days from older people towards overseas doctors,’ he said. 

Some four in ten appointments are still not being carried out face-to-face, figures showed. The above graph shows the proportion of appointments that have been face-to-face since September two years ago

Some four in ten appointments are still not being carried out face-to-face, figures showed. The above graph shows the proportion of appointments that have been face-to-face since September two years ago

‘I welcome the fact that overseas doctors are willing to work and contribute to our communities.

‘Every doctor whether they’re from overseas or not, provided they are good communicators…the more the better.’

But the Adam Smith Institute warned the statistics were a sign of successive failure to recruit enough GPs in England

Daniel Pryor, head of programmes at the thinktank, said: ‘These statistics demonstrate how successive governments have failed to meet GP training targets here in England.

‘They also highlight the vital role played by doctors trained overseas in propping up our ailing healthcare system as demand and patient numbers continue to ramp up.

‘Even if new NHS investment is properly targeted at recruitment and retention, it takes many years to train new GPs here. 

‘That’s why it’s essential that we continue to welcome overseas medics, who are required to meet rigorous training standards.’

Mr Pryor also dismissed concerns about the UK taking doctors from countries with poorer health systems than the UK’s.  

‘Concerns about brain drain on developing countries are exaggerated: foreign NHS doctors often enrich their families and communities back home with remittances and use the skills they learn in the UK in their country of birth,’ he said. 

The performance of England’s GPs has come under the microscope in recent months with the number of face-to-face appointments carried out in general practices still languishing at pandemic levels.

Figures show that around six in 10 GP appointments are in person now compared to more than 80 per cent before Covid. 

This week the feud escalated further with Sajid Javid stating patients are resorting to turning up to overwhelmed emergency departments because they can’t access a doctor in person.

Mr Javid made the comments to MPs from the Commons Health and Social Care Committee.

‘[A] significant portion of people are turning up for emergency care when they could have actually gone to their GP,; 

‘That is not the fault of those people at all. They have stayed away from the NHS when they were asked to, they now want to be seen and that is right.

‘But part of the reason I think people are turning up in A&E perhaps when they don’t need it is because they’re not able to get through to their primary care services in the usual way.’

Asked again if a lack of availability of GP appointments had led to increased pressure on A&E, he said: ‘I think that that general point is correct.’

It comes amid an explosive row about a lack of face-to-face consultation. Mr Javid has threatened to name and shame the worst-performing surgeries, while unions are considering industrial actions over what they deem to be unfair treatment.

During his session with MPs, Mr Javid also admitted the Government would not hit its target of recruiting 6,000 more GPs by 2024.

Asked if the Government was on track, Mr Javid said: ‘No, I don’t think we are….We’re not on track, I am looking at what more we can do, I want to see that increase but I’m not going to pretend we’re on track when clearly we are not”.

But Mr Javid has accepted that GPs were under ‘huge pressure’ due a backlog of people who never came forward during lockdowns.

He said: ‘I’m really proud of our GPs up and down the country… the last few months GPs have stepped up and as a nation we couldn’t be more proud of what they’ve done.

But in a subtle warning shot, he added: ‘It’s important patients can be seen as quickly as possible and where they have desire to be seen face-to-face, that choice should be respected.’  

Last month, Mr Javid revealed that performance data from individual surgeries would be published regularly, including the number of face-to-face appointments.

GPs warned that publishing ‘league tables’ was unfair and demoralising. Some unions warned it could trigger a wave of retirements.

Mr Javid today distanced himself from the so-called league tables, telling MPs: ‘I never planned on having league tables, that never came from my Department, or the NHS.’

But family doctors warn the move – announced in the NHS blueprint to improve patient access – would inevitably be used as a league table, even if wasn’t the Government’s intention.  

It comes after a top GP last week blamed Britons’ ‘Amazon Prime mentality’ for the increasing number of patients turning up at A&E with symptoms that could be managed by a GP.    


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