Political questions to which the answer is no

Should the NHS pay poorer countries for taking their health workers?

Because people are not slaves of the country they happen to have been born in, not property for which compensation is payable.

23 thoughts on “Political questions to which the answer is no”

  1. What a truly bizarre idea.

    Where to begin? Obviously you are correct, Tim. But I’d add:

    * Why should healthcare be treated differently than any other industry? If we’re going to pay Pakistan for poaching their doctors, shouldn’t we also bung Bulgaria for nicking their brickies?

    * Do we not already give billions a year that we can’t afford to “developing countries”?

    * The International Development minister is a Tory – when asked to sign off on a review, why didn’t he say “no, fuck off. We already spend enough taxpayer money”?

    * Will we get out the begging bowl to Australia and Canada for employing British migrants?

  2. You are forgetting that none of the normal rules of common sense and logic apply when we are talking about our glorious NHS.

  3. bloke (not) in spain

    Being the NHS is an arm of the State, the proposition’s entirely rational.
    Are we not repeatedly told spending on education is an investment in the UK’s future? So some other country’s spending on education must be investment in that country’s future. So nicking their health workers is clearly theft.

    Problem you get if you persist in regarding government spending as investment. Like “investing in the NHS.

  4. It is somewhat of a joke that the NHS actively restricts the places available to natives whilst recruiting doctors and nurses from developing countries that need doctors and nurses so badly that we bung them billions via another department and call it aid.

  5. What they going to do with the money? Give it to sick people instead of treating them? Bribe diseases to stop being contagious?

    If we recognise that it is immoral to use our economic clout to take doctors and nurses away from poor countries that desperately need doctors and nurses, then surely the correct response is to stop bloody doing it.

    > It is somewhat of a joke that the NHS actively restricts the places available to natives

    God, yeah. I looked into becoming a maths teacher at one point. I have a degree in maths and Northern Ireland had a shortage of maths teachers. But there were no grants available for getting the qualification, because they had a surplus of applicants for the few available places on the courses. It apparently hadn’t occurred to anyone in government that, if you have a shortage of maths teachers, you might want to increase the number of places on training courses that produce maths teachers. Instead, because the courses were oversubscribed, they thought they had a surplus.

    Needless to say, grants and full scholarships were available to become teachers in various other subjects of which there were no shortage of teachers. Because those courses were undersubscribed.


  6. ‘Because people are not slaves of the country they happen to have been born in, not property for which compensation is payable.’

    Depends where you were born:

    ‘Cuba Forecasts $8.2 Billion From Doctors Abroad This Year’


    Looks like they’re really getting the hang of this surplus value thing over there. Contract your doctors out for USD $4,300 a month, give them USD 400 to live on abroad and USD 600 in Cuba for when (or if) they return.

  7. If the answer is yes, then the next question is “How much?”.

    Where does one even begin to calculate such a figure? The total amount that the country has spent on each doctor or nurse’s education?

    On an unrelated note, if a Brit wants to study medicine, but isn’t accepted on a course in the UK, can he or she travel to India or Zimbabwe and enrol on a medical course there? Are the entry criteria less strict, and/or the fees lower? I presume from the fact of overseas doctors in the UK that such degrees are automatically valid in the UK.

  8. I would suggest when encountering such ideas – ask if we are going to buy Africans in bulk, do we get a discount?

    This works very well on CiF type people.

  9. Its nothing to do with the people being slaves or not, they are free to work where they like. Its who paid for their education thats might be a bit miffed. Folk in poor countries are paying taxes so some people can become doctors there, but aren’t getting the benefit from those doctoring skills because the NHS has swooped in and hoovered them up. Thus people in rich countries are being subsidised by people in poor countries, by not having to pay for their doctors education, which hardly seems fair.

    Of course its all a consequence of education being State funded – if it was all privately paid for then no-one could complain.

  10. At first blush, the notion that a brain drain should be compensated by a money flow seems only fair.

    In practice, it’s a clusterfuck. Paul Collier (Exodus, pp 150 – 153) fisks the idea and finds it morally indefensible, economically illogical and practically and politically impossible.

  11. Andrew M

    The GMC will accept many overseas qualifications, but doctors then have to pass the PLAB. Not hard as I understand it.

    The issue with training is somewhat more complicated than people seem to imagine. About eight years ago the UK began to have a massive glut of doctors who started training under the first and second Blair governments. At the time there was a dreadful shortage of trainee doctors, but since it takes 7 years to become a doctor the NHS had to hire lots of foreigners. When the people finished qualifying, there was a shortage of places for early career doctors. I know quite a few who had to go overseas to finish their training. (Should we ask Australia for compensation?)

    The bulk of the problem is that there is not very much joined up thinking about what is needed and appropriate planning – not helped by the way that Labour and more recently the coalition have engaged in reorganisation after reorganisation and altered priorities at absurd short time horizons.

  12. “Because people are not slaves of the country they happen to have been born in…”

    Someone had better tell Ritchie. He seems to think the opposite, which is a bit bizarre for a dual national…

  13. Bloke no Longer in Austria

    There was (is) a scandal in Austria about this sort of thing. Austrian students were being shoe-horned out of studying medicine in Innsbruck and Salzburg by German students, who were prepared to pay for their studies. There are no tuition fees in Austria, so whereas the Austrian students not only didn’t have to, but couldn’t pay, the Germans could bung a small amount and jump the queue.

    Both Germany and Austria use a lot of Polish and Czech doctors, should these eastern european lands be compensated too ? Do the African/Indian medical students get their tuition for free ?

  14. I listened to something on this subject a few months ago. It was about doctors from Malawi (IIRC, but some African country). The argument was that we are benefiting from the training provided by the poor country.

    It turned out that they didn’t have enough hospitals for all the doctors an nurses and those hospitals they had they couldn’t afford to run above a very basic healthcare service.

    The real benefit is the remittances being sent home and having a cadre of up to date doctors who could come home in the event that they ever generated the wealth to be able to afford to build, and, more importantly, run a decent health care system. The time take to train and get experienced doctors is far longer than it takes to build a hospital so the training of doctors is an investment.

    You could say we’re doing them a favour by taking their “exports” and paying them enough to be able to send remittances. If they were building luxury cars that nobody in their country could afford we wouldn’t feel guilty about buying those, well at least on this side of a Guardian column we wouldn’t I hope.

  15. It is quite possible thjat poor nation doctors only trained as doctors because there was a good furture for them in the UK.
    Oddly back in the 60s and maybe even now Australia was only training doctors in limited numbers because they got about 200 a year from the UK.

  16. I was told when I visited Cape Verde that its largest single element of national income was remittances from those who have gone abroad (principally to the USA) to work. This was partly due to the mess that the previous marxist government had made of the economy.
    The NHS should pay the staff it recruits enough to support the families they leave behind (elderly parents, youinger siblings, whatever).

  17. You would think the Left would be pushing this idea far more strongly, as they are after all the Believers in the Fixed Pie of Wealth.

  18. If some organisation had paid all my training expenses then it might be within its rights to ask me to compensate it in some way, perhaps working for it post – qualification; perhaps repaying it if I then left that organisation. It is after all a benefit it has provided to me, one that will probably yield further financial benefit to me down the years. So it seems fair I should repay in some way. I would fully expect this to be written into my training contract. If my new employer, however, compensates my old employer then that would effectively be extra remuneration from my new employment. I can’t see how that is right and proper.

    P.S. I really would recommend reading Ritchie’s blog from about 30 November. Colin Hines is not merely talking about recently trained doctors, he is indeed seeking to restrict workers to moving only where and when the State allows. Howard Reed throws a hiss fit at me, buy seemingly fails to notice that I have simply repeated a premise of Hines ‘ article; Ritchie comes across as the proverbial rabbit in headlights. I found it very very funny.

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