UK doctors to get priority for jobs to make NHS ‘self-sufficient'

Times

8 hours ago

British doctors will be given priority for NHS jobs under plans to make the health service 'self-sufficient' in staff.
A ten-year plan, due to be published this week, will commit to hiring no more than one in ten NHS recruits from overseas, promising reform to a system in which two thirds of new doctors come from abroad.
Doctors will also be instructed to prioritise returning to work as a key goal of treatment, as ministers seek to curb a rising benefits bill. Work coaches will be stationed in GP surgeries and local NHS chiefs will be given targets to help the sick return to work.
Sir Keir Starmer will set out a plan designed to get the NHS back on track and make the best use of a £30 billion budget boost in the spending review. The Times has seen an internal government briefing on the plan, which is yet to be finalised as wrangling continues over key questions such as whether to introduce a minimum unit pricing for alcohol and restrict advertising.
At the heart of the plan is an attempt to create a 'neighbourhood health service' through beefed-up local care teams, alongside a 'choice charter' that promises patients greater say over where and how they are treated.
As doctors and nurses again consider strike action over pay, the NHS has been described as a 'bad employer' that leaves staff unhappy and demoralised.
The plan promises to 'prioritise UK medical graduates' for junior doctor posts to reduce the risk of British-trained doctors losing out on consultant-track jobs. A recent increase in medical school numbers has begun to reverse Britain's long-running failure to train enough doctors, but career opportunities in the NHS have not kept up. There are expected to be about five applicants for every specialist training place this year as expansion of medical jobs has been constrained to control costs.
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The plan criticises an expansion of training 'without a commensurate expansion in postgraduate training places, compounded by the 2020 decision to open competition for postgraduate medical training to international trainees on equal terms'.
Saying this is an 'unacceptable way to treat doctors', the plan pledges to prioritise 'UK medical graduates and other doctors who have worked in the NHS for a significant period for foundation and specialty training' in order to avoid British doctors being shut out of consultant-track jobs.
It comes as ministers end the overseas recruitment of care workers and tighten immigration rules to make all jobs below degree level ineligible for skilled worker visas. Hospitals and other clinics will be given 'new duties' to employ staff from their local areas, in an effort to use the NHS budget to tackle poverty and boost employment around the country.
However, ministers are preparing to reconsider previous promises to increase doctor and nurse numbers. The plan criticises 'an inexorable rise in staff numbers based only on demographic changes and in the absence of any reforms to the model of care'. This is expected to put more emphasis on training GPs rather than hospital doctors.
Promising 'a more realistic' workforce strategy later this year, the plan commits the NHS to 'a self-sufficient workforce by 2035', saying that less than 10 per cent of new recruits should be from overseas. This is down from about a quarter currently, rising to two thirds of new doctors who qualified abroad in 2022-23.
Labour MPs criticised Jeremy Hunt when the Conservative health secretary set out the 'self-sufficiency' aim in 2016. Diane Abbott, then the shadow health secretary, called it 'nonsense' and an attack on foreign-born NHS staff.
However, Wes Streeting, the health secretary, acknowledged it was 'completely bonkers' for taxpayers to fund training for doctors who cannot get jobs. He has told staff he wants to 'prioritise UK-trained students for jobs in the NHS' and 'make sure that if you go through your medical training here in the UK, that you're able to work in the UK'.
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The British Medical Association has attacked the 'scandal' of British-trained doctors facing unemployment and a spokesman said ministers must 'implement this much-needed reform at pace'.
He said: 'Doctors are facing severe underemployment as we speak, and waiting until 2035 to give them a fair shot at a training place will lead to more leaving the profession in the meantime. By next year we need to have a system that prioritises UK grads while making sure those international colleagues already here don't lose out.'
Mark Dayan, of the Nuffield Trust think tank, said: 'For this plan to work there will need to be better alignment between NHS workforce planning and funding that we've seen in much of NHS history. We also need to get better at retention. Otherwise, the risk is filling a leaky bucket with more UK-trained staff who then drop out after a few years.'
Talks about performance-related pay for frontline staff have also begun, although unions remain sceptical.
In an attempt to move care out of hospital, the plan will promise 'neighbourhood health centres in every community', where GP-led teams offer checks and appointments previously available only in specialist centres. Routine follow-up appointments will be scrapped and far more outpatient appointments will be held in local clinics. The most frail patients will be identified for preventative care by specialist teams aiming to keep them out of hospital.
At the same time, hospitals are promised more autonomy. All are due to become self-governing foundation trusts and some will take over healthcare entirely in some areas, as ministers pledge to stop meddling. An expansion of hospital league tables 'ranking providers against key quality indicators' is also planned.
Senior NHS bosses are sceptical about tensions between these goals and have asked where the money for more local clinics will come from when infrastructure spending is held flat.