"10,000 EU Nationals Quit the NHS"

Another attempt to deliberately scare and mislead. And totally out of context.

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So, Vince Cable said this to millions of viewers on the BBC a week ago:

Cable also put a more detailed version of the same claim on the Lib Dem website and followed up by calling it an "exodus" on Twitter. The claims are largely sourced to The Guardian, though the story was also independently covered by Pulse, a GP website.

To be precise, the claim is that in the year between 30 June 2016 (1 week after the Brexit vote) until 30 June 2017, 9,832 (rounded up to 10,000) EU Nationals quit the NHS, with a big part of the reason being the vote for Brexit.

As usual (at least for The Guardian), this is taken dramatically out of context, for what can only be the purpose of scaring both the public and NHS workers.

Here is a short 3 min YouTube video putting these claims into their proper context. If you don't want to watch the video, you can also read a summary below.

Okay, why is "10,000 quit the NHS" because of Brexit misleading?

The short reason is that 13,013 EU Nationals also joined the NHS in that same period. That's a net increase of +3,182 EU staff. Tell anyone that, and the claim looks very different. But lets look at the full context:


Missing context:

Some obvious questions come to mind:

  • How many EU Nationals joined the NHS over the same period?
  • Are there more or less EU nationals since the Brexit vote?
  • How many EU Nationals normally leave the NHS per year?
  • What about non-EU Foreign Nationals from the rest of the World?
  • What are overall staff numbers in the NHS? 

All of these questions are ignored - likely deliberately. What is the evidence for deliberately?

Of course I can only infer it - but both Mr Cable, the Lib Dems and The Guardian try to give their stories the imprimatur of plausibility, by claiming the data is sourced to NHS DigitalHowever: they do not link to the file or data source. 

When you track this down, you find that yes, it is true that 9,832 NHS EU workers left the NHS, but the exact same NHS Digital file also shows how many EU Nationals joined (13,013) and the total number of EU nationals - which are increasing.

It is hard to reconcile presenting only the "leaver" information on national television and in a major newspaper without including this context, once you see what that missing data says.


Full Fact did a half-way decent job of fact checking this claim in real-time (the only ones to even refer to NHS data in detail that I have seen), but in my view they missed the most important points - that the number of EU staff continue to increase, and also that joiners also outnumbered leavers for the exact period in question (this is not immediately obvious in the data so this is understandable). But, there was also no attempt to put the figures into context with other foreign nationals. The issue isn't is this one cherry-picked data point correct, it is what does it say about the NHS and EU nationals overall, if anything.


The Facts:

Total EU Staff

  • 30 June 2016 - 58,382 (5.04% of NHS workforce)
  • 30 June 2017 - 61,563 (5.22% of NHS workforce)

There are 3,182 more EU Nationals in the NHS since the Brexit vote (already the subject of a detailed KingdomComment.com post - 'There are more EU Nationals working in the NHS than ever before. Really'.).


Normal EU attrition / leaver rates

  • The EU leaver rate is always higher than for any other group (either UK/British nationals or Rest of World)
  • EU is usually between 12.19%-14.82% per year
  • This would be 7,500-9,100 leavers "normally" for 2016-2017 (given an end point of 61,563)
  • The rate was 15.97% since the Brexit vote, giving 9,832 leavers
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Yes, there are definitely higher leaving rates for EU Nationals since the Brexit vote. But it is arguable around 8,500 would have been "normal", anyway.

The NHS rate overall is also lower than it was for over two years between 2011-2013.


Non-EU Rest of World Foreign Nationals

Given the Lib Dem's / Guardian's "Little European" focus on the EU as synonymous with "foreign", it is not surprising they continue to ignore one of the biggest stories and trends in NHS recruitment since the Brexit referendum. This is the increasing recruitment and retention rates for the rest of the world (RoW).

This is incredibly important, since the NHS is much more reliant on RoW foreign nationals - e.g. the many Indian doctors, Filipino Nurses, and Australian ambulance staff - and much less reliant on EU staff than a typical UK organisation.

  • Rest of World foreign total staff numbers and % have been on the rise since 2015
  • They accelerated since the Brexit referendum and vote
  • The year after the Brexit vote had the best recruitment rates and the best retention rates in over 6 years for RoW staff
  • So, “foreign” staff are "more wanted” than ever before - not less. Sorry Vince.
  • As I've asked previously, it is plausible that people are racist towards Lithuanians but not Nigerians
Screen Shot 2017-09-28 at 15.47.17.png

There was a +3,417 net increase in NHS staff from non-EU countries, since the Brexit vote.


Overall NHS Staff numbers

  • Now at 1.18 million staff
  • Since Dec 2013, +73,676 staff, or 6.72% growth
  • Rising twice as fast as UK population growth, which was only 2.5% in the same period
Screen Shot 2017-09-28 at 15.52.29.png

+21,421 net increase in all staff - since the Brexit vote.


Summary

I hope this has shown that this story was yet another in the long line of overblown, out of context claims being made about the NHS and EU Nationals, largely for political purposes:

+3,182 net increase in EU NHS staff since the Brexit vote.

EU Nationals as % of NHS are also higher since the Brexit vote. In fact, the highest ever.

EU leavers rate is the highest in 6 years (15.97%), but still similar in scale to previous years (~8,500 leavers would be  "normal" anyway)

Lower leaving rate overall for NHS post-Brexit compared to two years of 2011-2013.

Best recruitment and retention for Rest of the World staff in 6 years.

NHS staffing growing twice as fast as UK population growth - +21,421 just since Brexit vote.

Vince Cable/Guardian are misleading millions of viewers and readers, and scaring NHS staff


Bonus: NHS Media Hysteria Survival Guide

Here are some questions to ask when reading the latest scare story. If the story satisfies these criteria, and it is still scary - it is time to get worried!

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