Golden Jubilee 6

Immigrants make huge contribution to the NHS in United Kingdom.

Symptoms of a rare form of vasculitis called Wegener’s Granumolatosis

wilson brian 3I have had more contact with the NHS over the past year than desirable though there is nothing like first-hand experience to provide insights, writes Brian Wilson.

Having suffered from apparently random ailments and felt generally rotten for a few months, I was referred to hospital in Stornoway. There, I experienced a stroke of good fortune (and excellent care).

A Manchester-based consultant who had never previously been there took one look at my case-notes and deduced the ailments were not so random. They were symptoms of a rare form of vasculitis called Wegener’s Granumolatosis.

I later learned how fortunate I was to get that diagnosis early since, because the condition is so rare, that does not always happen. So thank you, Dr Ali Salem Ramadan Ajaj, and our NHS without borders.

I was air ambulanced to Raigmore and another lucky break in the person of a Polish consultant with a specialist interest not just in vasculitis, which is pretty rare itself, but my sub-species. These damned immigrants!

Amidst political sniping about Brexit and pernicious claims about demands made on the NHS by immigration, an historical truth tends to get lost.  The NHS has, to a significant extent, been built on immigration since its inception. This is nothing recent.

From early days, there were Jewish doctors who had fled the Nazis.  There were nurses and auxiliaries brought from Commonwealth countries to meet post-war labour shortages. There were the Irish and in Scotland there was internal migration with the islands providing a disproportionate recruitment base for nurses.

I do not believe Brexit is going to disturb that history to any significant extent.  Seven per cent of the NHS workforce in Scotland are of non-UK nationality. In England (I can’t find the same breakdown for Scotland) there are five times as many Indians as Romanians; four times as many Filipinos as Spaniards. Only 5.5 per cent come from EU countries.

There is no reason to believe, when Brexit dust settles, a shutter will come down on people – consultants or auxiliaries –  the NHS requires. However, there is another side to this coin.  Would it really be a bad thing if the NHS was less dependent on staff from other countries?

I hope nobody will pretend to be stupid enough to claim that is an “anti-immigrant” question. Nothing could be further from the truth. However, there are reasons it needs to be asked.

The first involves an inescapable whiff of post-colonialism in an assumed reliance on poorer countries sending us doctors and nurses to maintain the NHS.  Eventually, these countries become more prosperous – as we are seeing in Eastern Europe – and less likely to export their brightest and best.

Then there is a legitimate question about over-reliance on immigrant labour leading to a failure to educate and train enough of our own people to work in the NHS, at all levels.  The question has to be faced up to honestly: “Why are there no longer enough young Scots opting for careers in the NHS?”

In Scotland, Nicola Sturgeon, when Health Secretary, actually cut the number of nursing and midwifery training places in case we ended up with “oversupply and graduate unemployment”. Fat chance. The numbers are only now getting back to 2011 levels.

When the alarming tally of NHS staff vacancies in Scotland was published recently, the response from Jeanne Freeman was: “We are doing all we can to try and mitigate the appalling impact that a no deal Brexit poses to recruitment to our health and care services”.  Really? Is that all?

Few who have had the kind of contact with the NHS that I have over the past year fail to appreciate the value of the institution, the dedication of staff or strains they are under from myriad factors – mainly that medical science keeps people alive a lot longer than in 1948.

Unless and until society reconciles itself to the fact it is going to have to pay a lot more for the service it demands in time of need, current political debates will prove marginal to these challenges. Blaming Brexit is light years removed from these realities.


My limited knowledge of the BBC programme “Call the Midwife” suggested that, in among the child-births, it reflected social attitudes and conditions in the East End of London in the 1960s.

However, when the Christmas Special took it to Lewis and Harris,  I would have bet a few bob on such sensitivities and insights being replaced with the usual rag-bag of clichés and stereotypes. And I would have won my bet.

Hard, Presbyterian religion, of course, had to be at the centre of events. As one implausible scenario followed another, we found the boatman – with an even more implausible accent – refusing to take the heroic team to a lighthouse on the Sabbath, although the lives of woman and unborn baby were at stake.

This would never have happened, as a moment’s research into the doctrine of “necessity and mercy” could have confirmed. Even allowing for dramatic licence and the passage of half a century, it is disrespectful and insulting to tell the world otherwise.

OK, it was entertainment rather than documentary. But if they were going to alight upon the Hebrides at all, there might have been some acknowledgement that these islands provided a kernel of the future NHS when, in 1912 – not 1964 –  the Dewar Report delivered such a devastating indictment of medical conditions that the system of District Nursing was created.

There might even have been parallels to draw. Whether in Poplar or Possil, Lewis or Lewisham, it was poverty and poor housing which dictated low life expectancy.

But hurrah, it all ended with a ceilidh and the scenery was wonderful. “Super telly”  – so who needs historical accuracy or respect for people and beliefs?

One comment

  1. “Poverty and poor housing” didn’t dictate low life expectancy. Who caused the deprivation and created the conditions the working class had to experience and were forced to live under? See the Glasgow Centre for Population Health for more. Long Live Stalin!

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