We benefit from health workers trained abroad – so we should invest in their health systems too
3 min read
As a public health doctor, I have spent much of my career thinking about what helps people and health services thrive.
One truth comes up again and again: health does not begin or end at the hospital door. The same is true of the NHS.
Walk through any hospital in Britain and you can see it for yourself: a doctor trained overseas leading the ward round, a nurse from another part of the world calming a frightened patient, a midwife who began her career thousands of miles away helping deliver a baby safely.
International health workers are not a footnote in the NHS story. They are part of its foundations. That is why Britain needs to think much more honestly about the global health arrangements on which we now rely.
Covid-19 exposed the cracks. So have aid cuts, climate shocks and rising geopolitical instability. Yet the organisations and funding behind global health remain too fragmented, too donor-led and too poorly joined-up for the pressures they now face. That matters to all of us.
It shapes whether outbreaks are spotted early, whether health services can withstand shocks and whether countries are supported to build long-term resilience rather than lurch from one short-term fix to the next.
That is why the APPG on Global Health and Security has called for a reset: a simpler, fairer and more accountable global health architecture. That means a stronger but more focused World Health Organization, clearer roles for major global health bodies, stronger regional leadership and funding that backs long-term health system resilience rather than piecemeal programmes.
The timing matters. This month, the World Health Assembly and the FCDO’s Global Partnerships Conference will put the future of global health co-operation firmly in the spotlight. The UK should use both moments to push for reform. And it should start by applying those principles to itself.
The NHS has saved more than £14bn in training costs by employing doctors, nurses and midwives educated abroad rather than funding that education here
Our recent APPG inquiry into international health worker recruitment found that more than one in three NHS doctors and around a quarter of nurses and midwives trained overseas. It also found that the NHS has saved more than £14bn in training costs by employing doctors, nurses and midwives educated abroad rather than funding that education here.
Those figures tell a story not just of NHS dependence but of contribution by other countries whose investment in training health workers has helped keep our health service going. That should prompt a serious question: what does Britain owe in return? The answer cannot be nothing.
Our inquiry does not argue against international recruitment. The NHS depends on internationally trained staff and will continue to do so. But dependence without responsibility is not a serious policy.
That is why the APPG has proposed a principle of co-investment. If Britain continues to benefit from internationally trained health workers, it should invest in the health systems it recruits from – in training, retention and long-term workforce and system strengthening.
This is not charity. It is fairness. And it is exactly the kind of thinking that should shape the wider reset now needed in global health: less extraction, more reciprocity; less short-termism, more partnership.
A stronger NHS and a fairer global health order are not competing goals. They are part of the same argument. If Britain wants to lead credibly in the next phase of global health reform, it must be willing to back a model that is fairer abroad and more honest at home.
Dr Beccy Cooper is Labour MP for Worthing West
