EU Doctors Quit Britain as Brexit Looms
An exodus of medical specialists is putting new strains on the U.K.’s National Health System
BIRMINGHAM, England—Pioneering transplant surgeon Paolo Muiesan is returning to Italy after about 1,000 operations and 26 years in the U.K. The reason, he says, is Brexit.
“I’m disappointed that the European dream, of working and living in a borderless world, has failed,” he said.
The U.K.’s planned exit from the European Union in March next year is fueling an exodus of European workers from the U.K.—one of the outcomes sought by many of those who voted to leave in the 2016 referendum. Their departure highlights how Brexit is rippling through the U.K. economy, worsening labor shortages in critical industries where native Britons with the right skills are in short supply.
This squeeze is especially pronounced in health care, which is dominated by the National Health Service, the strained state-run system that is a pillar of British national life.
The effect has been felt acutely in some areas of specialist medicine. The number of surgeons who are, like Dr. Muiesan, citizens of another EU country is down 23% from its 2014 peak. The comparable number for obstetricians, in another example, has fallen 21%.
The Wall Street Journal obtained those figures through Freedom of Information requests from the U.K.’s General Medical Council, the body responsible for administering medical licenses in the country. They show the number of specialized doctors with non-U.K. EU citizenship has reached an eight-year low of 10,487 in 2018.
Around 10% of NHS doctors in 2017 were from elsewhere in the EU, according to the GMC. In some specialized roles, the percentage is higher. In ophthalmology, one in four doctors hails from elsewhere in the bloc; in surgery, it’s 18%.
Brexit is likely not the only factor encouraging doctors to return home. The GMC noted that economic improvements elsewhere in the EU may have tempted doctors to leave Britain, and an English-language test requirement introduced in 2014 may have discouraged some new entrants. But the declines across the board accelerated significantly in 2016, the year the U.K. voted to leave the EU.
The NHS has long drawn in highly skilled staff from Europe and beyond to fill expert posts in its 1.5 million-strong workforce. Widespread knowledge of English, the easy mutual recognition of qualifications, relatively good salaries and world-class research acted as magnets, doctors said. But now top doctors are quitting, threatening new strains in the creaking 70-year-old institution.
Dr. Muiesan’s unit has seen an outflow of at least five European doctors in recent years. Two of those, German nationals, said Brexit played a role in prompting them to return to their native Germany.
“It’s actually funny, the department is full of people from all over the world, and they are fantastic surgeons,” said Undine Gerlach, a transplant surgeon who worked at the same Birmingham hospital but is now working in Berlin.“That they could all leave, that would be such a loss.”
The agreement British Prime Minister Theresa May has forged with the EU protects the rights of EU citizens already in Britain. But the deal faces strong opposition in Parliament for other reasons, and she has made it plain that EU citizens who arrive after Brexit won’t get privileged treatment compared with other foreigners.
A survey released in November by the British Medical Association said almost four out of five European doctors weren’t reassured by Mrs. May’s commitment to protect their rights in the event of a no-deal Brexit.
That concern isn’t limited to doctors. There were 132,000 fewer EU citizens employed in Britain in the third quarter of this year than during the same period a year ago, the largest such drop recorded since comparable records began in 1997, according to official figures. Factors besides Brexit have been at play, including the eurozone’s economic recovery and a post-referendum fall in the pound.
For the National Health Service, the outflow of skilled workers is intensifying a chronic staffing crunch that medical professionals expect to get worse. The NHS had a personnel shortage just shy of 110,000 in the first six months of this year, 11,500 of which were doctor positions. If nothing changes, the number of NHS vacancies is expected to climb to 190,000 by 2027, according to Health Education England, a state agency that aims to ensure high-quality health care.
The U.K. Department of Health, which oversees the NHS, has countered the GMC findings with its own numbers showing an increase in European doctors, but Parliament has contested the accuracy of those figures in several reports and cautioned against making comparisons with them. The department said it is taking steps to boost foreign staff recruitment and retention. Doctors and nurses have been excluded from visa quotas for non-EU skilled workers, it noted, while 167,000 EU health workers have been given priority access to apply for permanent residency. The department said is also adding 1,500 training places for doctors.
Still, concerns persist not only over specialists leaving Britain, but also that new ones aren’t coming.
“What we’re worried about is trainees, because a sizable proportion of those comes from Europe. We just don’t have enough,” said Eveline Internullo, a consultant cardiothoracic surgeon at University Hospital Bristol, Dr. Internullo, an Italian who has lived in the U.K. since 2011, said her department received no applications from non-British Europeans for the last senior-trainee posting it had open in August.
Oncologist Alfredo Addeo, who moved to the U.K. in 2010, left earlier this year for Geneva, Switzerland, closer to his native Italy. He worked at the same hospital as Dr. Internullo.
Brexit, he said, played an important role in his decision to abandon what he called a “British dream.” When he arrived in the U.K., strapped for cash, he slept on an air mattress; when he left he was a consultant oncologist, one of the most prestigious positions in the NHS.
“The U.K. was for me the prototype of multiculturalism and integration,” he said. “When Brexit happened, it was just a slap in the face.”
That sense of hopes betrayed is echoed by other foreign physicians. “Europeans in the U.K. have been treated like bargaining chips,” said Dr. Muiesan, who was the first in Europe to introduce a new procedure allowing organs to be harvested quickly from the deceased, speeding up and increasing transplants.
Some doctors say even patients’ attitudes changed after the referendum. Anna Zampetti, a consultant dermatologist who returned to Rome in 2017, said a patient in one of her last appointments asked where she came from. “‘Oh, so you’re Italian, you’re not an English consultant,’ they told me. It was glacial. The perception was just that we weren’t welcome anymore,” she said.
Miguel Panades, a Spanish-born consultant oncologist, works at Boston and Lincoln Hospitals in Lincolnshire, an area of the English Midlands that has large numbers of eastern European agricultural workers and that voted for Brexit by the greatest majority in the country.
“The migrant harvesting potatoes and I are the same thing,” Dr. Panades said. “You can’t cherry-pick. At the time of the referendum, that wasn’t explained.”
