The number of GPs applying to the GMC for certificates that enable them to work abroad shows no sign of abating, Pulse has learnt, with many escaping to Australia for the shorter working hours and higher wage.
The number of doctors applying to the GMC for Certificates of Good Standing (CGSs), a document which enables them to register with an overseas regulatory body or employer, has remained at a constant of more than 4,700 per year for the past two years, according to new figures obtained by Pulse.
GP leaders have said it is ‘alarming’ that taxpayers’ money is being invested in training graduates to become GPs, only for them to leave the NHS and have warned that the numbers could be higher, with many coming to train in the UK and returning to their country of origin to practice.
Last year Pulse reported that the number of CGS applications had risen by over 12% since 2008. The latest GMC figures show that the numbers are still increasing, although at a slower rate, with a a total of 4,741 UK-trained doctors obtained CGSs in 2013 – up from 4,726 in 2012.
Pulse has also found that a further 2,485 doctors have received CGSs in the first six months of 2014 alone, compared with 2,479 for the same period in 2013.
Figures from overseas medical regulators also indicate that the level of migration of British doctors to other countries has remained constant. Australia is one of the most popular destinations for UK doctors, with 729 granted the certificates of Advanced Standing that allow them to practice in Australia in 2013, and 945 in 2012.
The Australian Medical Council has awarded certificates of Advanced Standing to over 5,500 UK doctors since 2006, 40% of whom have gone on to complete the 12-month supervised performance assessments needed for general registration.
New Zealand is also an increasingly popular destination for UK-trained doctors, with 469 doctors added to the New Zealand medical register in 2013 and 511 in 2012, according to the Medical Council of New Zealand. Specialist medical recruitment consultants have told Pulse that other sought-after destinations include Canada, the USA and the UAE.
Guy Hazel, managing director of the Austmedic recruitment agency, told Pulse that there are fewer GP vacancies available in Australia compared to three years ago, particulary in the cities where UK GPs want to work. However the interest is still there and he sees a spike in ‘serious’ enquiries every year in August as MRCGP trainees receive their CCTs.
He said: ‘Most GP trainees who apply this August will be practicing in Australia by February next year. Most of them graduate and then spend three or four month locuming before moving over. But it’s not just newly-qualified GPs – I’m helping a 40-year-old GP partner from Northern Ireland to move over this week. I see a lot of partners looking to move because they’re attracted to the lifestyle.
‘GPs might work a 65 hour week in the UK. In Australia, they’ll work 40 and probably earn more. Once they’ve settled and gotten to grips with the Australian system, which takes about three months, a UK-trained GP could easily be earning $260,000-300,000 (£143,000-165,000)’
Paul Brooks, the managing director of the EU Health Staff agency told Pulse that many of the 100 or so UK doctors he has helped emigrate in the last year have sought to escape the ‘overwhelming bureacracy, paperwork and rationing of healthcare’ they associate with the NHS.
‘Two years ago, we’d have found a job for any GP that applied. Now there aren’t as many jobs, and not everyone will get one – but the interest has stayed pretty much the same.’
Pulse reported last year that Australia has seen a ‘sharp increase’ in the number of overseas GPs entering the country since 2006. Mr Brooks added: ‘Money clearly plays a part in it as well. Most GPs aren’t earning the figures they Daily Mail thinks they are, and they can earn quite well in both Australia and Canada.’
GPC negotiator Dr Beth McCarron-Nash said that the ‘deterioration’ of primary care in the UK was likely to prompt GPs, especially those who are newly-qualified, to consider careers abroad.
She said: ‘Trainees want their work/life balance to be healthy. They see the excessive demands and workloads placed on general practice here, and decide that this isn’t what they want long term.’
She added: ‘It’s very alarming for taxpayers to know that all that money has been invested in young doctors who are considering not working in the NHS. We need to ensure that the best and the brightest remain here.’
Dr Krishna Kasaraneni, chair of the GPC’s training committee, said that GPs of all ages and levels of experience are being lost to the healthcare systems of foreign countries. He concedes that the true number of GPs emigrating may be much higher, as the CGS figures do not include doctors from other countries who train in the UK and then return to their countries of origin to practice.
He said: ‘It’s not that one particular age group, gender or location are feeling hard-done by – it’s the fact that general practice is getting more and more stressful. It’s about self-preservation. I don’t blame any of my colleagues for wanting to leave. The workload in general practice is getting more and more every day without the resources to try and cope with it.
‘UK GPs are a great resource for any health system, but if we don’t respect them, we will lose them. It’s already happening.’
In the absence of any official data, the number of CGSs issued each year is the most reliable indicator of how many doctors are considering moving abroad. However, not all doctors who hold a CGS leave the country, and many of those who do remain on or return to the medical register.
The RCGP is proposing allowing GPs to have their annual appraisal whilst in another country,possibly via Skype, in a bid to remove barriers for GPs wanting to return to practise in the UK.
Number of doctors issued with Certificates of Good Standing (CGS)