There is a well-worn line that “without migration, the NHS would collapse.” It’s something that has stuck in the public’s imagination, with one poll showing that Brits believe 42% of NHS workers are migrants. The truth, though, is less than half of that figure: under 20% of NHS staff are foreign nationals.

But that number excludes migrants who have become UK citizens since arriving. So while the public may be mistaken on paper, their instincts aren’t entirely off.

The NHS’s reliance on foreign workers is now at a record high. Non-UK nationals made up just 11.9% of the workforce in 2009 and 13% in 2016 — figures that have since climbed steadily. The NHS Workforce Plan warns that this leaves the system “overexposed to future global shocks and fluctuations in international workforce supply”. Yet the trend shows no sign of slowing.

Last week, the Telegraph revealed that the Government has frozen funding for nursing degrees. Education Secretary Bridget Phillipson has halted increases to the grants universities receive to offset the higher costs of delivering medical training.

This affects a range of programmes, including nursing, midwifery, and courses for so-called “allied health professionals” such as paramedics, radiographers, and occupational therapists. In a letter to the Office for Students, Phillipson confirmed that per-student funding will remain at last year’s level, which amounts to a real-terms cut.

Such a cut will likely result in universities offering a larger proportion of their nursing training places to foreign students to offset these increased costs. Typical BSc Nursing international fees range from £15,000 to £35,000 per year. But domestic students pay around £9,250.

Nursing is now set to follow the same path as medical placements, which are increasingly squeezing out British students. After the Government scrapped the Resident Labour Market Test, medical vacancies no longer had to be advertised to UK citizens first. What’s more, employers were no longer required to prove that no suitable UK candidate was available before offering the role to a foreign national.

That has led to a huge increase in the rise of applications to specialty training, driven almost entirely by non-UK doctors joining the workforce. In 2024, applications for NHS training jobs outstripped the number of posts available by 73%. As a result, reports of final-year medical students being left in the dark as to where they will be working have become as regular as the NHS winter crisis stories, with many contemplating finding a new career before they even start.

As the population ages, demand for medical staff is only set to rise. The BMA estimates that the UK will need 11,000 more medical school places by 2030 to meet future workforce needs. Yet the NHS continues to rely heavily on overseas recruitment — a strategy its own workforce plan warns leaves the system vulnerable to global labour shocks.

This dependency isn’t just risky: it may be undermining care. Medical training standards vary widely, and many foreign-trained doctors fall short of what British medical practice requires. Despite major increases in the number of doctors and nurses, productivity has barely improved. Foreign-trained doctors are 2.5 times more likely to be referred to the General Medical Council for fitness-to-practise concerns. A GMC-commissioned study, for example, found that half of foreign doctors would not meet UK standards — and passed only because the exams were too easy.

We will naturally need more nurses as well as doctors; but without serious investment in training and education, the NHS’s dependence on foreign-trained staff will only deepen.

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Tom Jones writes at The Potemkin Village Idiot.

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