Overseas doctors: coming to Britain.

Abstract

Without doctors who qualified overseas the National Health Service would not have been able to grow as fast as it has done nor would it be able to do the work it does today. In 1978 there were about 66 000 doctors working in the NHS and of those about 18 000?about one-third of hospital doctors and one fifth of general practitioners?had qualified overseas.1 2 Ever since the 1950s they have been coming to Britain in large numbers, as many British doctors were emigrating and British universities could not produce medical graduates quickly enough for the rapidly expanding NHS. The relationship between the NHS and overseas doctors was tacitly assumed to be one of mutual benefit: overseas doctors did essential work and in return received a good training. No comprehensive study of overseas doctors in Britain was made, however, until 1977. The results of that study?carried out by David Smith for the Policy Studies Institute?were reported last year,2 and they will be discussed at a conference in London this week. That study, looming medical unemployment, and the worries of overseas doctors who want to remain in Britain and yet who do not have career posts have thrust overseas doctors' problems to the fore. There are two main problems, and they are quite different. Firstly, how can Britain contribute in the future to the training of overseas doctors ? Secondly, what will happen to the overseas doctors who want to stay in Britain and yet who do not have career posts ? An emotional debate on these questions is already beginning in the medical press, while the Commons Social Services Committee, the General Medical Council, and the British Medical Association are all looking at various aspects of the problem. Furthermore, the Central Manpower Committee, which has since 1972 advised the Health Departments on staffing in the hospital grades, has to take into account the impact of overseas doctors on NHS manpower planning. These three articles aim at supplying information for the debate and discussing suggested proposals for change. One thing that emerges from studying overseas doctors' problems is that they are in many ways the problems of the whole profession. As a vulnerable group, they have always experienced the worst aspects of manpower, training, and career problems. But their problems today are likely to be those of other groups?particu? larly women doctors?tomorrow.