In praise of foreign medicine

June 18, 2008 at 3:19 pm | Posted in British Politics, NHS | 4 Comments

As it strides into its 60th year, Patrick Butler reminds us that the history of the NHS is also a history of post-war Britain, and that most of the myriad changes which have occurred in British society are reflected in our health service’s practices and practitioners. This is especially true when we consider the history of economic migration, and how recruiting doctors and nurses from overseas (Ireland in the 1940’s, the Caribbean in the 50’s, India & Pakistan in the 60’s) has sustained successive governments’ obligation to provide free healthcare for its citizens.

But we should also remember that these émigrés have historically provided healthcare for our poorest citizens, and were encouraged to come here to fill gaps in provision that effected working class towns and cities. A particularly enlightening stat from Butler’s piece is that in the Rhonnda Valley – an area that once boasted 20 collieries but is now blighted by poverty, crime and poor health – over 70% of the GPs are of south Asian origin.

Of course, they haven’t always been appreciated by their patients, nor are they universally appreciated now. All too often I’ve overheard stories about visiting a doctor in which his/her race or ethnicity is prioritised over their name or even the diagnosis they offered, and the NHS is forced to be constantly vigilant against racist attacks.

There are two types of racism at play here. One is the most obvious, non-negotiable, naked racism that makes bigots suffer a bilious reaction at the mere thought of interacting with someone who isn’t white. The other is a milder but arguably more widespread type of racism that views the skills, expertise and diagnoses of foreign doctors to be deficient to those of white, British doctors. Like steel that’s made from China rather than Sheffield, or receiving advice from a call centre in New Delhi rather than Dagenham, there’s a tendency to view with suspicion all those goods and services which don’t originate from this country, and this leads to viewing the advice of foreign healthcare workers with everything from suspicion to outright hostility. How ironic that for all this nation grumble’s about the state of the NHS, we still have a mindset that views all other countries’ healthcare systems as inferior!

If it weren’t for the Indian GP, the Phillipino midwife and the Jamaican nurse, many of the poorest members in our society would find an even greater struggle to receive the healthcare they need; as the NHS looks forward its next 60 years, we should remember that with gratitude.



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  1. If it weren’t for the Indian GP, the Phillipino midwife and the Jamaican nurse, many of the poorest members in our society would find an even greater struggle to receive the healthcare they need;

    This is appears incorrect to me / unproveable.
    Why do you think there is a connection ?

  2. Well, the NHS has historically welcomed doctors & nurses from overseas for two reasons: first, because they were more likely to work for less money, and second, to make up for staffing shortfalls. These two factors (a shortage both in funds and staff) have tended to be most acute in economically-deprived areas, and as a result these areas have tended to have predominantly foreign doctors/nurses. An example of this is the Rhonnda Valley, discussed above.

  3. Apols. Still does not seem to be correct correlation.

    The NHS provides healthcare uniformly across the country.
    The NHS has and does employ doctors and nurses who arrive from overseas.
    NHS pay scales will be standard on wider regional scales.
    NHS services available to all.
    NHS is centrally funded ~ does not vary according to local income levels

    Perhaps its just how one looks at it.
    And I suppose it does not make much difference either way.

  4. Now it’s my turn for an apology; It’s been quite a while since I wrote this, and since I was a bit rushed for time I offered a rather lazy & partially inaccurate response to your comment, without referring to the reading I’d done when writing the original post. I’ll try again and you can tell me whether you think it adds up.

    If we take the NHS’ recent history (say the last 10 years), I’m sure you’d agree that there has been a shortfall in doctors and nurses which the goverment tried to rectify by doctors (1) and nurses (2) from overseas. Indeed, a study four years ago essentially admitted that the NHS was being ‘propped up’ by foreign-trained doctors (3).

    So I’ve hopefully demonstrated that foreign workers are integral to the the NHS. Now, how does this relate to health care provision in economically-deprived areas of the country? Well, because in those areas, the need is greatest. Health problems tend to be much more widespread among the working class & the unemployed than in the professional classes, and accordingly there are more medical professionals in deprived areas than affluent areas (4). With a greater need for doctors in these areas matched with a greater availability, it increases the likelihood that someone is given care by a doctor of foreign birth.

    As a result, I believe this shows that whilst society in general is indebted to the work foreign medics do, those with the least are probably indebted to them the most.

    So am I any closer to convincing you?

    (4) (Page 6 of 13, Figure 3)

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