Pandemic, wave of retirements hardening of immigration rules resulting from Brexit: the British public health service (NHS) is threatened by a serious shortage of staff, whose survival depends on foreign caregivers.

With no less than 211 nationalities in its services in England, the NHS - whose free access is the pride of the British - is indeed one of the most cosmopolitan employers in the world.

This is why the inability to travel during the pandemic created a serious shortage of caregivers, believes Faizan Rana, operations manager at a London hospital.

In total, 3,700 fewer foreign caregivers than in 2019/2020 arrived in the UK between March 2020 and 2021. But the UK has been attracting less for several years: according to the official register, there are 8,000 fewer European nurses in 2021 than in 2016, the year of the referendum on the country's exit from the European Union.

And more than half of those leaving the UK have indeed cited Brexit as the reason for their decision, reports a 2020 Nursing and Midwifery Council survey.

A shortage of more than 100,000 nurses

By 2029, the explosive cocktail created by Brexit, tougher immigration rules and the pandemic could end in a chronic shortage characterized by the shortage of 108,000 nurses, says think-tank Health Foundation. This would represent a loss of more than a third of its current workforce, which stands at around 300,000 nurses. Bringing in foreign caregivers has long been "a quick fix" for the UK, which has suffered 40 years of "recurring crises," said Mark Dayan, analyst at the Nuffield Trust health think tank.

The contribution of immigrants to the healthcare system has a tradition that dates back to the post World War II era, when doctors from British colonies were sent to areas of the UK in need of caregivers.

But a large part of them retired in the 2000s, creating a shortage in the north of England - where immigrants are overrepresented among healthcare workers -, further accentuated by the "enormous demand" generated. by post-Brexit departures.

Other countries now more attractive

Brexit has also made the arrival of new caregivers more complex, with the establishment of a points-based immigration system, in which applicants must meet salary levels and proficiency in English, and have an offer for qualified employment. Although a special visa regime exists for health workers, Australia, Canada, New Zealand and the Middle East could be privileged, due to their more generous visas.

According to Mark Dayan, this reform will particularly affect social professions - closely linked to the NHS but where very poorly paid staff are not considered qualified - even though the sector has already suffered particularly with the end of the "safety valve". security ”constituted by the free movement of persons within the EU.

The British government announced this month to allocate an additional 36 billion pounds (42 billion euros) to the NHS over three years.

But injecting funds will not be enough to solve the staff shortage, says analyst Mark Dayan, who instead advocates better planning and training of the workforce.

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