The NHS is facing such a chronic shortage of British nurses that one in four had to be recruited from abroad last year, new figures from the Nursing and Midwifery Council reveal. The shortfall follows cuts in the numbers of training places in each year under the coalition government. As a result, fewer “home-grown” nurses are coming through the system.

The revelation comes when hospitals are under pressure to hire more nurses than ever before to care for the growing number of elderly patients and overall growth in the UK population.

During the leaders’ debates on Thursday evening, David Cameron defended his record on the NHS, claiming that there were “more nurses, more doctors, more people being treated”. He was accurate in claiming that more nurses are being recruited, but it will be embarrassing for the Conservatives that so many have had to be recruited from abroad. The Royal College of Nursing (RCN) has praised the skills of foreign nurses who come to the UK, but warns that continually recruiting from abroad is expensive – and unfair on thousands of young Britons who would be keen on a career in the health service but are not given the opportunities.

A recent RCN survey estimated that there are 54,000 homegrown applicants a year seeking training places. However, in 2010-2011 there were only 20,092 nurse training commissions in the UK. In each of the next four years under the coalition there were fewer places, a reduction of 8,000 British nurses coming into the system.

The new figures from the Nursing and Midwifery Council, which was set up in 2002 to maintain professional standards, show that, whereas in 2009-10 11% of nurses were recruited from abroad, in 2014-15 that proportion rose to 29%. Around 7,500 of those were recruited from the EU, particularly Spain, Italy and Portugal, with 665 from further afield, including the Philippines and other countries in the far east.

In a recent interview Pat Read, chief nurse at Luton and Dunstable University Hospital Foundation Trust, said it costs around £2,500 to actively recruit a nurse from the EU before wages were taken into account.

Examples of recruitment trips by hospital trusts include those by:

■ Aintree University Hospital Foundation Trust, which spent £46,000 on a trip to Madrid to recruit 20 nurses, only 11 of whom were still in the job after one year;

■ United Lincolnshire Hospitals Trust, which spent £100,000 on a trip to Athens, where it recruited 39 Greek nurses;

■ Colchester Hospital University Foundation Trust, which reportedly sent staff to a four-star Irish spa resort, but failed to recruit a single nurse.

At the same time government figures show that spending on agency staff by foundation trusts alone has risen by £540m since 2010 – from £855m to £1.396bn in 2013-14.

Dr Peter Carter, chief executive and general secretary of the RCN, said nurses from overseas had made an important contribution to the NHS. “However, the over-reliance on nurses from overseas demonstrates a complete lack of long-term planning. Instead of training the nurses we need to care for our sick and our old, we go from famine to feast every few years by trying to plug staffing gaps from abroad when care becomes unsafe. Then once things are under control, the NHS cuts back again and the cycle repeats. Proper workforce planning is the only way of meeting the extraordinary demands faced by care services in the coming years.”

Andy Burnham, the shadow health secretary, said: “Because there are not enough nurses coming out of training, hospitals are having to tour Europe looking for recruits. Labour will immediately increase the number of training places and is committed to 20,000 more nurses paid for with an extra £2.5bn each year.”