The NHS must do more to reduce the waste of talent and opportunity that high unemployment of refugee healthcare professional represents, argues Maeve Keaney

The NHS must do more to reduce the waste of talent and opportunity that high unemployment of refugee healthcare professional represents, argues Maeve Keaney

On a conservative estimate, around 600 refugees who are healthcare professionals will be granted leave to remain in the UK each year for the foreseeable future.

Many of those granted leave are doctors, but there are also large numbers of nurses and midwives, dentists, pharmacists and allied health professionals. Along with academics, teachers and lawyers, they are highly exposed in conflicts around the world.

In rebuilding their lives, many of these people.will look to employment in the NHS as a major milestone. The degree to which the NHS engages is critical to the speed and quality of the adaptation process. Before competing in the job market, refugee healthcare professionals need to pass language and 'fitness to register' exams and undertake educationally supported placements in the NHS.

The support available across the UK varies considerably and the past two years has seen a wide range of initiatives close due to disinvestment. One of the ongoing initiatives is the Reache Centre, based in a purpose-built facility at Salford Royal foundation trust. The centre supports a wide range of refugee healthcare professionals and has helped more than 70 doctors back to work in the NHS in the past four years.

Moral duty

But given the increased supply of UK healthcare graduates, some are asking why the NHS should support the adaptation of refugee professionals.

First, we have a fundamental moral obligation to provide initial support and equality of opportunity to individuals we have decided to grant refuge. Healthcare professionals who arrive here as refugees need a very different approach to that we take towards other international healthcare professionals.

In both policy and practice, refugee healthcare professionals are very different. Refugees justifiably require public resources to rebuild their lives and enable them to make a full contribution to British society.

Also, refugees are among the most economically deprived and socially excluded groups in the population. Unemployment among refugees is estimated to be well above 30 per cent. Employment has a major role to play in improving health and social cohesion.

Social gains

By enabling refugee healthcare professionals to compete effectively in the job market, we increase the economic potential of individuals and their families. We improve the social capital of local refugee communities and at the same provide a diverse workforce. Successful refugee healthcare professionals provide leadership within their communities and raise aspirations.

While we currently have an oversupply of UK graduates, this will not last forever. We know there will always be a supply of refugee healthcare professionals and it would make sense to factor this into future plans. Furthermore, in the case of refugee doctors, many are content to work in less sought-after non-training posts to re-establish their careers. There is likely to be a demand for doctors to fill these posts even in the short term.

When making good use of scarce public resources, the following is instructive: it costs on average around£25,000 to train a refugee doctor to be fit for practice in the NHS and takes on average two and a half years. The cost of training a medical student is around£250,000 and takes five years.

As the largest employer in Europe, the NHS can and must do more to reduce the waste of talent and opportunity that high unemployment of refugee healthcare professional represents. The NHS has a commitment to corporate social responsibility and has a role in promoting community cohesion, assisting integration and supporting the health and well-being of deprived local communities.

Dr Maeve Keaney is director of Reache Northwest, a consultant microbiologist and director of infection, prevention and control at Salford Royal foundation trust. If you have any questions or queries, contact

For more about Reache and the support provided for refugee healthcare professionals, click here

You can.join the Reachout Network to stay in touch. The network was recently launched as a UK-wide resource by the Reache Centre with the support of NHS Networks.