The British government-run National Health Services (NHS) has been arguably among the world’s best run public healthcare systems.
Still seen as a model for health system planners and managers, it is however finding itself in the spotlight again this month over under-staffing reports.
A few months ago it was the nationwide strike by junior doctors lamenting terms. Previously some patients complained of lengthy queues for specialist services.
Data from a report posted on the BBC website cites a 2015 survey intimating a staffing shortage across the NHS.
The most affected, with a deficit of about 19,000, were nurses, followed by junior doctors at 5,000 and 200 or so specialists.
To address this, an NHS campaign is ongoing to recruit medics from elsewhere. Kenya has traditionally been one of the sources of such labour. A colleague recently passed their interview and will be relocating to practice there.
Is this good or bad?
The obvious repercussions of such actions are of course felt by “younger” health systems. Certainly, the NHS pays better than local employers and can thus lure young medics.
While there is a greater need for doctors and nurses locally, it appears we lack the capacity to absorb even the few we are producing. Perhaps for lack of funds or misplaced priorities.
The recent impasse where counties refused to hire post-internship doctors is an example. It is ridiculous that a nation with only 9,000 or so doctors can afford to haemorrhage its staff for lack of better pay.
Sad, but the reality is that the highest bidder gets the services. For this reason, the NHS recruitment is perhaps a boon for local unemployed nurses and doctors. Why fight for employment if someone else is ready to take you?
However, the root of the problem is that the UK — like most countries — is not churning out doctors as quickly as needed.
It is obvious that increasing personnel also means increasing the funds to train and pay them. The only way to do this is to tax more or “steal” from other budgeted areas, but will politicians and citizens allow this?
An alternative is to create a “holistic doctors’ marketplace”. The problem really is lack of funds to train and pay medics across most health systems. A cost-efficient, high volume graduates’ turnover scenario addresses this.
But would a formal global marketplace where systems with higher training costs fund those with lower costs then “draw” them out on qualifying work?
Thus, if the NHS takes 100,000 pounds to train a doctor and Kenya can do the same at 50,000 would they fund the Kenyan government to train on their behalf?
In return the UK can draw as many doctors and nurses as it pays for to be trained.
Of course this is naïve economics, it is cheaper for the NHS to let others train for it and only “harvest” the skilled and experienced crop.
These new foreign recruits may also earn less, thus cutting on training and wages. Perhaps such a system — under the WHO policy of rich health systems not destabilising poorer ones — could work.
Ironically though for the NHS and other health systems, while those already in employment are demanding better pay, more are being employed.
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