All entries for Thursday 14 April 2005

April 14, 2005

Immigration and the National Health Service

It’s widely accepted that non-natives currently contribute extensively to the NHS. Shortages of nurses and doctors have resulted in overseas recruitment drives, draining skilled labour from poorer regions. The NHS is better off as a result, and the new workers welcome the opportunity to establish a presence in a country which offers great opportunity; opportunity based on merit, rather than caste, wealth, or political influence.

Taking on workers from abroad carried costs too. Qualifications must be confirmed, extra training may be required and productivity is hampered initially as workers adjust to a new language and culture. Domestic recruitment may therefore be preferred in the first instance. Obviously it depends on the sector in question; a programmer who deals strictly with code will adapt faster than a worker who must face customers/patients regularly. A civitas document on immigration quotes an International Labour Organisation document criticising the NHS for not responding in the customary way (though wage increases) to shortages in staff.

As more migrants are targeted on a particular field which is failing in its bid to attract native workers, wages will increasingly fall short of competitive offerings, causing an acceleration of native flight towards non-targetted fields. This curious cycle is sometimes seen as a “native worker shortage”, though the term seems particularly ill suited to describe a problem of employers which is ultimately self inflicted. What may in fact begin as a simple temporary “sport shortage” of trained native workers, can in fact be made considerably more permanent by the attempting a quick fix from migrant labour. Any program which imports migrants into a sector whose employers are complaining of insufficient trained natives, can be expected to exacerbate (rather than alleviate) its native shortage. Rather than raising incentives to entice new workers to seek training to fill the empty slots, visas are likely to be used to avoid the needed market response.

The ILO readily accepts the contribution of all NHS workers, but criticises the Labour government for saying foreign recruitment and mass immigration is strictly necessary for the jobs to be done. (That’s not to say native workers are automatically preferable to others, or that the UK takes accepts ‘too many’ foreign workers on aggregate). What’s really needed is a system which rewards doctors and nurses for the work they do and generates incentives to join the system. With such incentives in place, there’d be no end of UK citizens willing to become a nurse, doctor, GP or dentist. However, this is impossible when NHS wages are not responsive to external pressures.


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