Britain's health service is more dependent on internationally trained medical staff than almost any other Western nation, according to a stark new international report.
Fresh data from the Organisation for Economic Co-operation and Development (OECD) shows that 38.3 per cent of the UK's entire medical workforce came from abroad in 2023. For doctors alone, the General Medical Council (GMC) estimates this figure has since risen to 42 per cent.
A Stark International Comparison
This level of reliance on foreign talent is more than double the average across 28 developed and developing countries, which stands at around a fifth (19.6%). The contrast with major European neighbours is particularly sharp.
In Germany, only 15% of doctors are foreign-trained, in France the figure is 11%, and in Italy it is a mere 1%. Norway, at 44%, is a rare example of a country with a higher proportion than the UK. The report also notes that in most Western nations, the share of foreign nurses is lower than that of doctors; in the UK, it was 23% in 2023.
Training Bottlenecks and Policy Shifts
The high proportion of international staff has ignited a debate about training and recruitment policy within the NHS. Earlier this year, it was revealed that one in five NHS staff, or approximately 311,000 people, hold a non-British nationality.
While foreign doctors and nurses are widely acknowledged as essential for safe staffing levels, UK medical graduates are facing fierce competition for specialist training places. There are typically four junior doctors applying for every available specialist training post, which are now open to international competition.
A significant policy change occurred in 2019 under Boris Johnson's government, when doctors were added to the UK's Shortage Occupation List. This meant NHS trusts were no longer legally required to prioritise British graduates for training roles and could recruit directly from overseas.
Calls for Systemic Reform
The issue has been highlighted by senior figures. Britain's Chief Medical Officer, Professor Chris Whitty, recently co-authored a report warning of problems with the current training system and emphasising the need to find the 'right balance' between British and foreign staff.
The report's authors stated: 'We cannot shy away from addressing this issue, while supporting the excellent international graduates in the NHS providing patient care.'
Stuart Andrew, the Conservative shadow health secretary, described the growing reliance as a 'wake-up call', arguing that as more are recruited from abroad, UK-trained doctors are left fighting for fewer spots. He called for reforms to both recruit internationally and prioritise domestic talent.
Echoing this, Gareth Lyon of the Policy Exchange think tank said, 'The UK needs to train more doctors and to establish more medical schools to train them.' The debate continues as resident doctors have cited a lack of training places alongside pay as a key reason for recent strike action.
