Recruiting NHS staff from other countries saves the British taxpayer the very substantial costs of training them.

However, the proportional financial cost to poorer source countries is much greater than our saving. John Holme (Letters, 21 March) mentions Malawi as one source for NHS staff: six years ago a study published in the BMJ estimated the loss of returns to Malawi just for doctors then working in rich, predominantly white countries, at $2.16m. Of those countries, it was the UK that benefited most, with a net transfer of wealth from nine sub-Saharan countries struggling with HIV/Aids of $2.7bn.

Getting poorer countries to pay for our medical training appears to be a deliberate UK policy rather than just the mighty free market, given the cuts in training places and funding.

Rather than selfishly celebrate this neocolonial asset-stripping, we should insist that countries of origin should be fully compensated for the loss. And that the UK should pay its own way in future.

Peter McKenna

Liverpool