12.02.2026

What’s up, doc?

Doctors are leaving in droves. It is not just that Australia, New Zealand and Canada look more attractive. There is, says James Linney, the push factor too. Labour is proving to be little different from the Tories

The words ‘NHS’ and ‘crisis’ are these days the best of friends: inseparable, and almost never appearing in media news stories without each other. It is now taken for granted that the national health service is in perpetual crisis, in a way that would have seemed shocking a decade or two ago.

How did we get here? The way was paved by 14 years of Tory misgoverning and stealth privatisation and - sadly, but predictably - the current Labour government shows no intention of putting on the brakes or steering the NHS out of danger.

Here we will consider one major crisis, among several, currently facing the NHS - one that at first glance appears paradoxical: namely, a dire shortage of doctors, while simultaneously thousands of doctors are unable to secure training posts or jobs, many of them having to look outside the UK for work.

The NHS workforce crisis is not new - it has been glaringly obvious for a long time now. However, over the past two years the situation has sharply worsened. Despite clear warning signs, Labour appears uninterested in making any meaningful attempt to avert catastrophe.

When it comes to the number of doctors per 1,000 of the population, the UK has always ranked amongst the lowest in Europe and well below the global average, compared to other higher-income nations (3.2 doctors per 1,000¹).

Latest data

There has been an increase in the number of medics completing their university training in the UK each year, with around 9,500 places available annually as of 2023 - an increase of approximately 2,000 since 2013. And, according to the latest data (August 2025), the number of licensed doctors has been increasing steadily for over a decade. NHS secondary care now has over 47,000 more full-time employed doctors than in September 2015 - a 45% increase.² Yet the increase has failed to keep up with demand. Meanwhile, hospital trusts have been subjected to years of so-called ‘efficiency savings’, meaning they are now unable to afford to create the training posts needed to employ doctors who have completed their two foundation years.

By August 2025, more than 30,000 doctors were competing for just 10,000 speciality training places. Doctors finishing foundation years are increasingly struggling to progress onto training schemes. A recent British Medical Association survey found that 52% of the foundation year two (F2) doctors surveyed said they did not have employment secured.³

The situation in primary care is arguably even more serious. The number of full-time equivalent (FTE) fully qualified GPs (including locums) has fallen overall by 2.3% since 2015,⁴ while during the same period the average number of patients cared for by each general practitioner has risen by 15% and GP surgeries are now providing 22.8% more appointments each year compared to 2019.⁴

Older GP partners have been retiring without being replaced, while younger ones cannot afford the risk of buying into a practice, given the uncertainty around the future of primary care, as well as rising property costs. Many instead are choosing to work as salaried GPs or locums, competing for a diminishing number of available jobs, due to the fact that GP surgeries are under extreme financial pressure. The defunding of primary care that took place throughout the Tories’ 14 years in government has continued under Labour, despite their promise to “bring back the family doctor” by “shifting resources to primary care”.

So it is unsurprising that a large BMJ survey⁵ found that around one in three UK medical students plan to leave the NHS within two years of graduating, with the vast majority intending to take up medical posts abroad. Most plan to emigrate to Australia, New Zealand or Canada. The General Medical Council reported that 11,384 doctors intended to emigrate in 2025 - an increase of 44%, compared to 2019.⁶

Hardly a day goes by when I don’t receive an unsolicited email from a recruitment agency advertising jobs in Canada or Australia, promising golden hellos, better pay, a lower cost of living, improved work-life balance and more affordable housing. As I sit writing this (occasionally glancing out of my window at a typical UK winter’s day, oscillating between blustery wind, sleet and drizzle), it is hard not to be attracted by the prospect of warmer climates. Who would not want to pop down to a sun-drenched beach for a swim before work?

Of course, the reality is that the trend towards underfunding public hospitals and squeezing pay for medical workers is not unique to the UK: it is global - a reflection of the ongoing crisis of capitalism since the 2008 crash. Doctors leaving the UK for greener pastures may just find themselves on picket lines elsewhere: there have been recent strikes by doctors over pay and working conditions in both New Zealand in 2024⁷ and New South Wales in April 2025.

Motivation

But, besides pull, the current exodus of UK medics is being driven by push. Historically, NHS staff were motivated by the sense that their work was socially useful and genuinely beneficial. That satisfaction has been steadily eroded. Chronic understaffing, relentless workloads and falling real-terms pay have pushed nurses and doctors into industrial action - something medical professionals were traditionally extremely reluctant to take.

After two years of Starmer’s government, all that have been delivered are gimmicks and broken promises. Plans to ‘modernise’ the NHS, as laid out in its 10-year plan⁸, largely amount to putting all the eggs in the AI basket - a technology that is currently ill-suited for patient diagnosis and which will instead serve as cover for further privatisation, as well as granting big tech access to NHS data and patients for profit.

The so-called transformation of primary care boils down to forcing surgeries to allow patients to send an uncapped number of appointment requests to surgeries online, from 8am to 6:30pm. Health secretary Wes Streeting might claim they are improving access, but he is fully aware that it does nothing of the sort. The BMA, which is now in dispute with the government over the policy, has repeatedly pointed out that all it does is simply overwhelm GPs: doctors are now forced to spend their time triaging hundreds of requests daily - thus increasing clinical risk, while reducing the time available for face-to-face care. When leading GPs raised safety concerns, Streeting’s pathetic response was to accuse the BMA of “juvenile delinquency” and behaving like “moaning Minnies”.⁹

Similar attacks on resident doctors (formerly known as junior doctors) have been just as aggressive - arguably more so than anything seen under the Tories. Streeting described the planned five-day strike by resident doctors in December 2025 as “morally reprehensible” and warned it would cause “untold misery and disruption to patients” during a high-pressure winter period. Yet we know that medical professionals are historically reluctant to strike and have been driven to do so only because misery and disruption have become the norm for the NHS: it is no longer unusual for waits of over 12 hours for emergency care, with patients being held on trolleys for days.

The NHS has always been heavily reliant on non-UK-trained and non-UK-born workers - historically they have been actively recruited from less economically well off countries. Doctors who qualified outside the UK currently make up around 42% of the workforce.¹⁰ However, GMC data shows that increasing numbers of non-UK doctors are also choosing to leave: “Greater numbers of non-UK-qualified doctors left practice last year. 4,880 doctors who obtained their primary medical qualification outside the UK and had been working in the UK left in 2024 - a 26% increase on the previous year’s 3,869.”

This is a deeply worrying trend. As Dr Jeanette Dickson, chair of the Academy of Medical Royal Colleges, warned, without the contribution of overseas doctors and nurses the NHS “could quite easily fall over” and find itself without “a critical mass of people there to run the service safely”.¹¹

Brexit effectively turned off the tap of EU workers coming to work in the NHS. Meanwhile, Labour’s pandering to the right, along with its fear of Reform UK, is leading to an increasingly hostile environment for those not born in the UK, discouraging other non-EU medical professionals from moving here. One such example is the introduction of the Medical Training (Prioritisation) Bill in early 2026 in order to ‘prioritise’ graduates from UK medical schools for foundation and speciality training posts - echoing Gordon Brown’s desperate “British jobs for British workers” slogan back in 2007, when Labour were also pandering to the right to avoid general election defeat.

A Reform victory at the next general election, which is looking increasingly possible, would obviously multiply the problems for the NHS exponentially. Nigel Farage has declared that he intends to introduce an insurance-based healthcare system, as in the USA, so a Reform win could potentially mean the end of the NHS as we know it¹².