Half of doctors who graduate in Wales leave to practise somewhere else, a new study has revealed. The 2022 workforce report by the General Medical Council (GMC) found that most UK medical students remain in the nation where they graduated with the exception of Wales where 46% relocate to England due to greater availability of foundation posts.
Meanwhile an additional 4% move from Wales to Scotland, Northern Ireland, or abroad to work upon graduation. And while England retained more than 92% of newly-qualified GPs and specialists after four years 77% of those who qualified in Wales stayed here.
The report found that between 2017 and 2021 the only UK nation that had an overall increase in the number of doctors leaving the workforce was Wales (3%) – it fell between 5% and 13% in other parts of the UK. Doctors also had to look after more patients in Wales than in England and Scotland according to the report – for every doctor in Wales there were 271.4 patients compared to 242.9 in both England and Scotland.
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However on a positive note the report stated that the number of doctors located in Wales increased by 15% between 2017 and 2021 – the second-most behind England (16%). Wales had 11,615 licensed doctors in 2021 – up from 11,046 in 2020 and 10,105 in 2017.
Dr Olwen Williams, vice president for Wales for the Royal College of Physicians, said: "Staffing shortages are the biggest challenge we face right now. No amount of financial investment in the NHS can make up for the fact that we simply don't have enough doctors, nurses, or social care staff to keep up with patient demand. We're flying blind without proper workforce data and we still don't have a detailed workforce plan that sets out exactly how we're going to improve the situation. We need to recruit, retain, redesig,n and retrain – the four ‘R's of building a resilient workforce."
BMA Cymru Wales chair Dr Iona Collins said medical students who train in Wales are "lured" to work in England because they can earn more money by performing the same job. She said: "Our members in Wales have highlighted the stark gaps in the NHS workforce for years. Despite our warnings and repeated calls for a proper workforce we are still waiting to see the necessary data collection and a long-term plan. We are not witnessing any positive action which is improving our workforce crisis in the NHS.
"What should be of most concern to the Welsh Government and NHS employers is the impact this has on patients. The fact that people in England and Scotland have quicker access to a doctor is shameful and Welsh patients deserve better. The chronic shortages in our NHS workforce are contributing to delayed surgeries and increasing waiting lists, resulting in prolonged ill health for patients across Wales. We are suffering.
"With fewer doctors per patient in Wales it is no wonder that doctors here are burned out, demoralised, and leaving the profession. Our members have regularly told us about the despair they feel when treating patients without appropriate staff numbers and facilities that are unfit for purpose. As a result morale is at an all-time low – especially when they know they have a greater workload than their UK colleagues and yet continue to be paid less than their counterparts elsewhere.
"This is a deepening healthcare crisis which requires a robust NHS workforce plan. We need to rectify the recruitment and retention of doctors in Wales. Medical students who train in Wales are lured to work in England and elsewhere after they qualify as doctors instead of remaining in Wales. This makes perfect sense when they can earn more money by performing the same job along with more doctors in England delivering healthcare per head of population.
"We are going to continue haemorrhaging staff out of NHS Wales so long as our NHS continues to undervalue its staff and so long as the system continues to expect its staff to work above and beyond to compensate for the system's failings. We are not heroes and we are burning out."
Overall the GMC report identified that the UK medical workforce headcount is growing thanks to large increases in international medical graduates (IMGs). Of the doctors who joined the workforce in 2021 half (50%) were IMGs and 39%were UK graduates. It also found that specialty and associate specialist (SAS) and locally-employed (LE) doctors have grown at almost six times the rate of general practitioners (GPs) in the last five years.
More than half of GPs (54%) across the UK reported working beyond their rostered hours and feeling unable to cope with their workload, which was the largest proportion of all registered groups. Meanwhile the workforce is increasingly female and is moving closer to parity with men.
Commenting on the number of Welsh graduates leaving the country, Welsh Conservative shadow health minister Russell George MS said: "There cannot be a strong and safe NHS in Wales if doctors who graduate here do not want to continue their training and practise here. We must ask why doctors would rather be in England for training and why the Labour Government has failed to create the conditions that retain the wealth of talented medicine graduates that go to university here.
"But should we be surprised if students do not want to stay in NHS Wales when waits in A&E departments, treatment waiting lists, and ambulance delays are shorter elsewhere in the UK? Patients and staff are getting a raw deal from this failing Labour Government so we should expect people to seek a better deal elsewhere."
Welsh Liberal Democrat Leader Jane Dodds MS said: "The figures outlined by the General Medical Council for Wales are pretty dire – 46% of medical graduates in Wales leaving for England is a huge amount of talent being lost. We must make sure Wales is an attractive destination not just to study medicine at university level but also for students wanting to go on to specialise in specific areas of medicine and carry out more advanced training once qualified. Our NHS is already suffering from stretched resources and low morale among staff – the last thing we need is talented staff leaving the country for better opportunities elsewhere."
In response a Welsh Government spokesman said: "We are making a record investment – more than £260m – in education and training programmes with plans to deliver an additional 12,000 clinical staff by 2024-25. There has been an increase in the number of GPs working in practices across Wales. Our marketing campaigns and financial incentives for GP training, with up to £20,000 for trainees in north Wales and parts of west Wales, have helped achieve this.”
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