I’ve had cause recently to use several NHS services — GP appointments, hospital visits, the lot. And one thing really struck me. Many of the doctors and nurses who looked after me were from overseas. I want to be absolutely clear: this isn’t a criticism. In fact, it’s the opposite.

The care I received was exceptional — kind, professional, and delivered with real dedication.

Noticing this simply made me curious. Why does the NHS rely so heavily on international staff?

It’s a genuine question, not a judgement. And the answer, as it turns out, has nothing to do with culture or attitude — and everything to do with how the NHS has been shaped over time.

The NHS Has Always Been a Global Workforce

From its earliest days, the NHS has welcomed staff from around the world. In the 1950s and 60s, the service actively recruited from the Caribbean, India, Pakistan, the Philippines and Africa because it didn’t have enough home‑grown staff to meet demand.

That tradition has continued. The NHS is one of the most diverse workforces in the country — and that diversity is one of its strengths.

Training Enough British Staff Takes Time — and We Haven’t Always Kept Up

Becoming a doctor takes the best part of a decade. Training a nurse takes years too. Even when governments increase training places, the impact is slow.

There have also been bumps along the way — like the removal of the nursing bursary in 2017, which caused a sharp drop in applications. Many never returned.

So the NHS ends up with gaps, and international recruitment fills them.

The Work Is Hard, The Pressures Are High, and The Pay Doesn’t Always Match the Responsibility

This is the part that often gets misunderstood:

It’s not that British people think the work is beneath them. It’s that the job has become incredibly demanding. Long shifts, high pressure, emotional strain, and pay that doesn’t always reflect the responsibility — it’s a tough sell for many young people choosing a career.

Meanwhile, for clinicians from overseas, the NHS can offer:

• better pay than at home
• internationally recognised training
• a clear career structure
• and the chance to work in a respected public health system

So the NHS becomes an attractive place to build a career.

The NHS Would Not Function Without International Staff — And That’s Something to Celebrate

This is the heart of it. The NHS depends on international staff, and the service is richer for it. They bring skills, experience, compassion and commitment — and my own recent care is proof of that.

The diversity of the NHS isn’t a problem to be solved. It’s a strength to be valued.

So What’s the Real Issue?

It’s not about who’s doing the work. It’s about whether we’re training and supporting enough people at home to keep the NHS sustainable in the long term.

That’s a workforce planning issue, not a cultural one and unless tackled we are storing issues for the future.

My Take

I’m grateful for every single member of staff who looked after me — wherever they were born. But my recent experiences have reminded me how much the NHS relies on people who have chosen to come here and care for us.

That’s something to appreciate, not question.

But it’s also a reminder that we need to think seriously about how we train, support and retain the next generation of NHS staff — both British and international.

Because if there’s one thing the NHS proves every day, it’s that compassion doesn’t have a nationality.