Workforce planners have been warned not to get 'hooked' on eastern European labour because the supply of foreign workers is likely to dwindle.

City University professor of health services research and policy Roland Petchey stressed the importance of building a home-grown NHS workforce at an HSJ conference last week.

He told delegates that the UK was becoming less attractive to doctors and nurses from newer EU countries such as Poland, where pay and conditions are improving.

"We should be careful about being hooked on Eastern European doctors as a solution to our workforce problems," he said.

He told HSJ: "There has been a tendency for workforce planners to focus on the here and now. There hasn't been quite as much strategic thinking about where the future workforce is going."

In 2004-05, less than 10 per cent of nurses coming to the UK from Europe were from Eastern European accession states. By 2006-07 this had risen to 60 per cent, with Poland providing as many nurses as the whole of Western Europe.

The proportion of doctors practising in the UK from Eastern Europe has gone up from 1 per cent in 2004 to 3.5 per cent in 2007.

But many Eastern European states face a shortage of health professionals. For example, Poland only has 2.3 GPs and 4.9 nurses per 1,000 people, compared with an EU average of 3.6 GPs and 8.2 nurses.

"The Polish government is well aware of these problems and is determined to take steps to redress the balance of appropriate pay rates and terms and conditions," Professor Petchey said.

The 1986 accession of Spain and Portugal had led to a "short-term spike" in NHS recruitment which petered out after two years, he said. It was likely to take around four years for the same to happen to East European workers.

The demand for home-grown staff will be further increased by the need to replace ageing workers: in 2006, 28 per cent of GPs were 50-59 years old and nearly one in 10 was over 60. The number of nurses aged over 40 jumped from 46 per cent in 1995 to 64 per cent in 2007.

Professor Petchey said the problem will be further compounded by a falling supply from non-European countries.

An ethical code of conduct was signed by the Department of Health in 2004 to stop the recruitment of doctors from developing nations such as the Philippines, and the effects of this are starting to be felt.

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