The NHS lacks staff, but so do the countries it has recruited from

I share Dr Richard Turner’s despair (Letters, 21 November). He asks how much the NHS needs to restore order, but things are even worse than this. Even if there were a large injection of cash this would not help, since the prime need is for staff and the staff are simply not there; the cash would be waiting for them and unable to help.

This was highlighted by last week’s joint review by the King’s Fund, the Health Foundation and the Nuffield Trust, which showed that the current workforce shortage of 100,000 will be 250,000 by 2030, or even as high as 350,000.

Multiple causes have contributed to this crisis; the main factor is failure by successive governments to fund sufficient training places for doctors and nurses, but the problem has been compounded by tuition fees, the withdrawal of nursing bursaries and the unprecedented rate at which staff are taking early retirement; if staff are not valued they will not stay. Immigration policies and the effect of Brexit have added to the problem.

The extraordinary fact is that workforce shortage, not inadequate funding, is now the largest threat to the future of the NHS. It surprises me that this has not been more widely discussed. Perhaps Brexit dominating the news has obscured wider recognition. The government could reverse these trends if it had the will, but it clearly finds it easier to spout irrelevant statistics than face these serious issues.

Richard Spicer

Edington, Wiltshire

• Frank Arnold (Letters, 21 November) correctly points out that many NHS staff have been trained overseas “at no expense to the UK”. Many of those countries are the least able to afford both to pay for our training costs and to lose the healthcare workers they have invested so heavily in. A 2011 study in the British Medical Journal estimated that the nine sub-Saharan countries struggling most with HIV/Aids transferred $2.7bn to the UK in this form – to plug gaps in the NHS engineered by cuts in training and funding.

Rather than make it all about the benefit to ourselves, surely the most immediate response should be to demand that those countries be compensated in full?

Peter McKenna

Liverpool

• May I add a postscript to Dr Frank Arnold’s statement that “More than 20% of nurses and doctors in the NHS have been trained at no expense to the NHS before migrating here”, and that is that non-white consultants are paid nearly £5,000 less a year than their white colleagues; nurses, £2,700 less.

They make up a third of the medical workforce, and where would we be without them? They face unacceptable barriers and discrimination, which is inexcusable.

Veronica Edwards

Malvern, Worcestershire

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