The role of overseas healthcare professionals in Britain has come under renewed scrutiny after a parliamentary report highlighted the scale of NHS international recruitment, warning that government plans to significantly reduce reliance on foreign-trained staff may be unrealistic.
A new inquiry by the All-Party Parliamentary Group (APPG) on Global Health and Security found that the National Health Service has saved more than £14 billion by employing doctors, nurses and midwives trained abroad.
However, MPs involved in the report warned that the NHS remains deeply dependent on NHS international recruitment, and reducing overseas hiring to around 10% of the workforce by 2035 may be an overly ambitious target.
The findings have sparked debate about the future of workforce planning in Britain’s healthcare system and the ethical implications of recruiting medical staff from countries already facing shortages.
NHS workforce heavily reliant on overseas professionals
According to the report, a significant proportion of the NHS workforce has been trained outside the United Kingdom.
Currently, 36% of doctors and 24% of nurses and midwives working in the UK received their medical training overseas.
This reliance reflects decades of international recruitment used to fill gaps in the healthcare workforce.
Andrew Mitchell, a former UK development minister who chaired the inquiry, said the NHS has not operated with such a low proportion of international staff for many years.
“The NHS has not operated at that level for decades,” Mitchell said.
He added that while increasing domestic training is essential, the global nature of healthcare means countries cannot treat medical workforces purely as national resources.
Overseas recruitment saved billions in training costs
The APPG report highlights the financial impact of NHS international recruitment, which has helped reduce the cost of training healthcare professionals in the UK.
Analysis presented to the inquiry estimated that training a doctor domestically costs around £120,000, including subsidised university education and clinical training.
Training a nurse is estimated to cost approximately £23,000.
By employing healthcare professionals trained overseas, the NHS has avoided billions of pounds in training costs.
Researchers from Global Health Partnerships (GHP) and the Center for Global Development calculated that the NHS has saved more than £14 billion through international recruitment.
Visa numbers for healthcare workers falling
Despite the NHS’s reliance on overseas workers, the number of visas granted to international healthcare professionals has declined sharply in recent years.
Government policy aims to reduce dependence on foreign recruitment by expanding domestic training and retaining UK-trained staff.
However, the APPG inquiry concluded that NHS international recruitment will remain necessary for the foreseeable future.
Mitchell said the government should recognise the reality of global workforce mobility.
“In a shrinking world, pretending health workforces are purely national assets is no longer credible,” he said.
Ethical concerns over global healthcare workforce
The inquiry also raised ethical concerns about the impact of recruiting medical staff from lower-income countries.
Many of the nations supplying healthcare workers to the NHS face significant shortages in their own health systems.
The report argues that Britain has a responsibility to help strengthen healthcare systems in countries where it recruits staff.
“If we benefit from health workers trained overseas, we also have a duty to help strengthen the systems they come from,” Mitchell said.
Global shortage of healthcare workers forecast
The concerns highlighted in the report reflect broader global workforce trends.
The World Health Organization (WHO) predicts a worldwide shortage of 11 million healthcare workers by 2030.
Currently, a large share of the global healthcare workforce is concentrated in wealthier countries.
Almost a quarter of the world’s doctors, nurses and midwives are employed in just 10 high-income nations, including the UK.
In contrast, many developing countries struggle to maintain sufficient numbers of trained medical professionals.
Differences in doctor availability worldwide
The disparity in medical staffing levels between countries is significant.
In the UK, there are about 30 doctors for every 10,000 people.
However, the figure is much lower in many countries that supply healthcare workers to the NHS.
India has about nine doctors per 10,000 people, the Philippines about six, and Ghana just one doctor per 10,000 people.
Healthcare leaders warn that large-scale international recruitment can worsen these disparities.
Evidence from countries losing healthcare staff
Representatives from several African countries gave evidence during the inquiry, describing the impact of medical staff leaving for work abroad.
Officials from Kenya and Uganda told MPs their healthcare systems are losing experienced doctors, nurses and educators.
They warned that the migration of healthcare professionals can affect patient care and limit training opportunities for future medical workers.
The loss of senior staff can also weaken medical education systems.
Call for partnership approach to recruitment
The APPG report recommends a new model for NHS international recruitment based on partnerships rather than one-way recruitment.
It suggests that recruitment agreements should include investment in training, workforce development and healthcare infrastructure in partner countries.
Current agreements between the UK and recruitment countries mainly focus on managing migration rather than strengthening healthcare systems.
The report argues that a partnership approach could balance Britain’s workforce needs with global health responsibilities.
Aid cuts raise additional concerns
The issue of global healthcare cooperation has also been affected by recent policy changes.
Last week it emerged that the UK government had cancelled a health development programme supporting training for healthcare workers in six African countries.
The project had provided assistance with workforce development and healthcare training.
The cancellation forms part of wider cuts to international aid spending as resources are redirected toward defence.
Critics warn that such decisions could further weaken global health systems.
International staff described as vital to NHS
Dr Beccy Cooper, chair of the APPG on Global Health and Security, emphasised the importance of international workers to the NHS.
She said overseas healthcare professionals have long been part of the health service’s identity.
“International health workers are part of the NHS’s DNA,” Cooper said.
She argued that both domestic training and ethical international recruitment are necessary to maintain a stable workforce.
According to Cooper, inconsistent workforce planning risks damaging both the NHS and global healthcare systems.
Government defends focus on domestic workforce
The Department of Health and Social Care acknowledged the contribution made by overseas staff but said the government is committed to expanding the domestic workforce.
A spokesperson said international recruitment will continue but should not undermine healthcare systems in other countries.
“The NHS benefits hugely from its international staff,” the spokesperson said.
However, the government also aims to increase the number of British-trained healthcare professionals.
Officials say new policies will prioritise UK medical graduates for available positions and improve pay for newly qualified nurses.
Workforce shortages across NHS
The debate surrounding NHS international recruitment reflects broader staffing challenges within Britain’s healthcare system.
The NHS has faced persistent workforce shortages in recent years, with demand for healthcare services continuing to rise.
An ageing population, increased demand for treatment and the impact of the COVID-19 pandemic have placed additional pressure on healthcare providers.
International recruitment has helped fill staffing gaps, but policymakers are increasingly seeking long-term solutions that balance domestic training with ethical global workforce practices.
As the NHS continues to evolve, the question of how to maintain a stable workforce while supporting global health systems is likely to remain a central issue for healthcare policy.