UK faces imminent NHS staffing crisis, says new IEA research

27 Oct 2020 10:31 AM

When we emerge from the Covid-19 pandemic shortages of doctors could be thrust to the centre of the political debate, says new research from the Institute of Economic Affairs, authored by Mark Tovey. While population growth and ageing have increased demand, demographic factors could mean a staffing crisis is on the horizon.

• Shortages of PPE and ventilators have overshadowed shortages of doctors during this pandemic, but that could change when normality resumes;
• The UK ranks 27th out of 36 OECD countries for number of physicians, and around 30 per cent of doctors on GP and specialist registers are over 55 years old;
• The UK relies more heavily on foreign-trained physicians than comparable countries – but within a decade it could become increasingly difficult to meet demand this way;
• There could be a deficit of 400,000 doctors by 2030 between 32 OECD countries. At the same time, rapid economic development in Asia is likely to reduce the ‘push factors’ that have made dependence on foreign-trained doctors possible;
• A perfect storm could be forming around the NHS, as the fallout from the pandemic threatens to increase the demand for health services at the same time as reducing the resources available to fund it. Efficiency savings are arguably more urgent than ever;
• A new paper from the Institute of Economic Affairs suggests a range of cost-effective solutions to plug doctor shortages once this crisis has passed.

Around 30 per cent of doctors on the GP and specialist registers are over 55 years old. The majority (57 per cent) of doctors in training are women, which could lead to a drop in the average hours worked. And the UK relies more heavily on foreign-trained physicians than comparable countries: over a third (37 per cent) of doctors in the UK qualified abroad, compared with 25 per cent in Canada and the US, 12 per cent in Germany and 11 per cent in France.

While importing doctors from abroad will be essential in the short term, within a decade, the report argues, it will be increasingly difficult to meet demand in this way. There will be a shortage of 400,000 doctors by 2030, spread across 32 OECD countries. The international market for doctors could, in turn, become fiercely competitive.

At the same time, rapid economic development in Asia is likely to reduce the ‘push factors’ that have made dependence on foreign-trained doctors possible. For example, India’s burgeoning private healthcare sector is providing more high-quality jobs than ever. Meanwhile, home grown talent is moving overseas: from 2013 to 2017, the UK lost on net 4,144 doctors to Australia, Canada, the USA and New Zealand.

These pre-existing trends could be exacerbated by the Covid-19 pandemic. In the medium to long term, the increased public debt burden and economic contraction may reduce the resources available to the health service.

However, there are options to blur job boundaries and tackle pressing shortages, such as addressing where professional protectionism is blocking non-medics from upskilling and lightening doctors’ workloads in key shortage areas.

For instance, more extended-nursing posts could be opened up for direct entry to graduates with degrees in biological science subjects. Accessible, fast-track training pathways to PAs, clinical psychologists and biomedical scientists could be introduced to take on tasks traditionally considered to be within the physician’s protected sphere. Prescribing rights could be extended through the removal of legislative barriers. And we could create incentives to plug speciality gaps through pay differentials.

Mark Tovey, author of “Is there a doctor in the house? Averting a post-pandemic staffing crisis in the NHS” , said:

“Currently, the law prevents many dedicated health professionals from stepping up and lightening doctors’ workloads, simply because they do not have the correct job title. At the same time, thousands of biology graduates are ending up on the scrapheap of unemployment, when they could be fast-tracked into frontline clinical roles. 

“It’s high time the NHS kicked out the jobsworths and upskilled its brightest and best, to bring down cancer waiting times, tackle the crisis in mental health and abate the looming global doctor shortage.”

Notes to editors

For media enquiries please contact Emma Revell, Head of Public Affairs, on 07931 698246 or erevell@iea.org.uk

Mark Tovey is available for further comment.

“Is there a doctor in the house? Averting a post-pandemic staffing crisis in the NHS” can be found here.

The mission of the Institute of Economic Affairs is to improve understanding of the fundamental institutions of a free society by analysing and expounding the role of markets in solving economic and social problems. The IEA is a registered educational charity and independent of all political parties.