Why the future of the NHS is a global question

Today, as the UK Global Health Summit opens across seven locations in London, the APPG on Global Health and Security is publishing a report that contains a number worth sitting with. 

 £14 billion.  

That is the conservative estimate of what the UK has saved in training costs by recruiting doctors, nurses and midwives trained overseas. Around £1.1 billion in the most recent year alone. 

That is not a criticism of international recruitment. It is not a criticism of the NHS, nor of the extraordinary professionals who have built careers and lives here.  

It is simply a fact.  

And it is a fact that comes with a question attached: if the UK benefits this substantially from health workers trained elsewhere, what responsibility does that create? 

The new APPG inquiry report, An Honest Account of the Benefits and Costs of International Health Worker Recruitment, is the APPG’s attempt to answer that question honestly. Global Health Partnerships and the Center for Global Development supported the inquiry, and I am proud of what it has produced. 

The report’s central finding is blunt.  

International recruitment is not a short-term fix or a marginal feature of the NHS. It is structural. One in three NHS doctors was trained overseas.  

In 2023/24, nearly half of new nursing joiners were internationally educated. This is the workforce the NHS depends on – and it comes, in significant part, from countries with health systems that are already understaffed, under-resourced, and under pressure. 

When experienced clinicians leave those systems, the effect is not abstract. It is felt in hospitals, maternity wards, and rural clinics. It affects the capacity to train the next generation. It has consequences for patients who never made it to the UK. 

None of this is simple.  

Health workers have every right to build lives and careers where they choose. But rights and responsibilities can coexist. The report’s call is not to stop recruitment – it is to match the benefits the UK receives with proportionate investment in the systems it draws from. 

That is the case for co-investment. And it is a case this report makes with evidence, rigour, and – as the title promises – honesty. 

At Global Health Partnerships, we see every day what genuine partnership looks like: long-term relationships between UK institutions and overseas health systems, built on reciprocity rather than extraction, that strengthen both sides.  

The NHS does not exist in isolation from the rest of the world.  

Its workforce is shaped by global dynamics. So are its choices. 

This report asks the UK to make a better one. Not to turn away from international recruitment, but to approach it with open eyes and with a willingness to invest in the global health workforce in proportion to what it gains from it. 

The case is not only compelling.  

Given the pressures facing health systems everywhere, it is urgent.