On Prince Phillip’s “Filipino nurse” comment

Prince Phillip told a Filipino nurse “The Philippines must be half empty – you’re all here running the NHS”.

The man has a history of ethnic jokes in questionable taste. But this one has a nugget of truth in it. For years, UK governments have let other, poorer nations pay to train their own nationals to be doctors, nurses or midwives, and then, when they’re ready to help their own populations we recruit them to work in the NHS here.

And what about the health care needs of the people of the Phillipines, India, Bangladesh and other major sources of health-care professionals? Not our problem.

What is our problem is that the same governments posture and prattle about curbing immigration, giving British jobs to British people, and generally promote anti-immigration feeling which they know can become racial tension.

The NHS is a vote-winner. So is sounding off about immigrants. See how it works?

5 Responses to “ On Prince Phillip’s “Filipino nurse” comment ”

Comment by Charlie

It’s almost an Alf Garnett remark.

The UK is hardly big enough to skew the market but the US both though importing healthcare professionals and also though outsourcing the care of its sick and needy has led to 2 class medical systems in some countries. Though I suspect this might be dwarfed by the import of labour mainly from South Asia into the Gulf states and the attendant problems.

Over time, I suspect that demographics will even things out: genetic destiny overpowering the manifest kind. Remittances even from such underpaid workers are far more beneficial to developing nations than aid and also help redress some of the more egregious imbalances caused by the trade system.

Comment by Bruce

“The UK is hardly big enough to skew the market”

I’d imagine the cost of training 16,000 nurses, who then leave, is quite sizeable to a developing nation.

(I agree it’s Garnett-esque, though)

Comment by chaals

(The following is what makes me upset about badly-delivered but well-marketed “aid” – which isn’t all like this, although far too much of it is).

Actually, it turns out that poor countries struggle to train doctors, nurses, pilots and engineers, and generally produce far fewer graduates per capita than rich countries can turn out. So a medium-sized country like the UK (or Spain, or even Australia) with some money to offer can easily “asset strip” a population much larger than its own. And the UK isn’t the only country selectively taking the best, most expensive, and hardest to replace workers while minimising the number of people who can come in to do a normal job and send remittances home.

The real problem is that aid money is often used like this – the countries who can afford to make themselves feel good often do useful things like teaching people to fish (well, actually no. They teach people to use modern tools that are purchased with a subscription-based business model, or to prescribe modern medicines bought from companies who pay taxes to the countries giving the aid, not the countries getting it). And the benefits of that aid are that it is still cheaper to help train ten Poorlandistan doctors, and then convince 7 of the 8 good ones to come to my country, than to train people locally. After all, it makes more sense to have Poorlandistan invest dollar-for-dollar alongside the foreign aid, so they have a real commitment to the project, right?

And bingo, thanks Poorlandistan for our feelgood news, plus the subsidising of our countries medical (or engineering, or software, or…) needs. And while we realise you have a lot of farmers who would do very well if they didn’t have to sell their lean meat against the cows we subsidise to keep you out, and a lot of farm labourers who could help harvest our wine grapes at a much lower price, to the benefit of both economies, we’re not going to let that happen because we’re already helping you enough… to help us…

This isn’t just about the third world, actually. New Zealand decided it could not afford to train more F18 pilots, who usually ended up in the RAF if they wanted action and in the RAAF if they wanted a quiet life close to home.

(And yes, The DofE is often an easy way to learn things that his peers think but are too politic to say. Although it seems he is not actually 100% bigoted buffoon – so I hope he isn’t).

Comment by Justin

The flip side is that the ability to move to a foreign country drastically raises the returns to education. So you have two competing forces: on the one hand, some of your best educated young people are leaving, which is a net negative (assuming that they don’t help their home country via remittances), but on the other hand, you have more people pursuing education in the first place, and not all of them will migrate. Moreover, there will be more investment in educational institutions in the home country.

Which force dominates? There’s no way to know, without empirical study, and there’s been a lot of study of this phenomenon. I’m not sufficiently well informed to say what the results are, though I believe they’re more optimistic than you’re being.

Comment by Charlie

Bruce, sure the cost of training is not insignificant. However, the subsequent remittances are likely to more than cover them – don’t have any hard figures to back up that claim though. More of a problem is that the nurses are elsewhere and, therefore, not able to provide care in the country that trained them. Depending on the ratios this can be key in preventing development.

It’s arguable that the net outflow of professionals from India has over time allowed the country to benefit from the subsequent inflows of investment and expertise. This is probably truer for medicine than for IT but still debatable. The purse strings are still too tightly held by those with a invested interest in maintaining a slope.