Professor John Robertson OBA

The Guardian above has another of its ‘UK’ pieces with not a word on Scotland in it. There is, of course, no peer-reviewed research on this topic but, the MSM often tell us that they just report what is happening out there. So, comparing media reporting on this issue in Scotland and England’s media will give us a reasonable comparison. Given the background independence factor we can be very sure that if the Scottish media had any accounts of health workers leaving Scotland because of an anti-migrant rhetoric here, we’d know all about it. So:

In the light of the anti-migrant rhetoric coming from the UK Labour Government, the Conservatives and Reform UK in England and the contrasting pro-migration rhetoric of the Scottish Government compare the evidence of foreign medics apparently shunning NHS England and NHS Scotland

Overview of Political Rhetoric Context

The UK Labour Government, Conservatives, and Reform UK have emphasized stricter immigration controls, with rhetoric often framing migration as a burden on public services like the NHS. For instance, Labour’s health secretary has criticized the NHS’s “overreliance” on foreign staff, while Conservatives and Reform UK push for reduced net migration. In contrast, the Scottish Government, led by the SNP, advocates for a more open migration policy, arguing that international workers are essential to Scotland’s health and care sectors, and calling for devolved powers to tailor migration to Scotland’s needs.Evidence of Foreign Medics Shunning NHS EnglandMultiple reports from 2025 indicate a notable exodus and reluctance among internationally qualified doctors and nurses to join or remain in NHS England, directly linked to anti-migrant rhetoric and rising racism. Key findings include:

• A 26% increase in overseas-trained doctors leaving the UK workforce in 2024 (from 3,869 to 4,880), with the General Medical Council (GMC) warning that hardening anti-immigrant sentiment is making the UK “less welcoming” and could exacerbate staff shortages. bmj.com +3
• Medical bodies like the BMA and royal colleges highlight that hostility toward migrants is deterring recruitment, with foreign medics perceiving England as an “unwelcoming, racist” environment. ukfactcheck.com +2
• Workforce data shows non-UK nationals comprising about 18-22% of NHS England staff (around 325,000 out of 1.5 million as of mid-2025), but trends indicate slowing international joiners and higher leavers amid policy changes like visa cuts. nationalguardian.org.uk +2
• Discussions on X echo this, with users noting Brexit’s role and racism driving away staff, potentially leading to NHS collapse without them.

This evidence suggests the rhetoric from English political parties is contributing to a tangible decline in international medic retention and attraction.

Evidence of Foreign Medics Shunning NHS Scotland

In contrast, there is limited direct evidence of foreign medics actively shunning NHS Scotland. Available data and reports point to stable or slight growth in the workforce, with a pro-migration stance potentially mitigating UK-wide deterrents:

• NHS Scotland’s workforce stood at around 188,000 headcount (161,000 whole-time equivalent) as of March 2025, showing a 0.6% annual increase, with nursing staff numbers rising and vacancies decreasing. turasdata.nes.nhs.scot +2
• International staff make up an estimated 26% of Scotland’s health and care workforce, and regional efforts like NHS Highland’s recruitment of 21 overseas nurses in 2024 indicate ongoing attraction despite UK visa restrictions. nhshighland.scot.nhs.uk +1
• Scottish leaders, including former First Minister Humza Yousaf and Health Secretary Neil Gray, emphasize the vital role of overseas workers and criticize UK-wide anti-migration policies (e.g., an 88% cut in health visas by Labour), advocating for independence to enable a Scotland-specific system.
• Some positive internal migration trends exist, such as junior doctors from Wales moving to Scotland for better pay, but this is UK-domestic rather than international. @msm_monitor

While UK immigration policies affect Scotland (as a reserved matter), there’s no comparable spike in departures or warnings of shunning tied to rhetoric. Instead, the Scottish Government’s welcoming approach appears to support retention, though hard comparative data on international joiner rates is sparse.

Direct Comparison

Aspect	NHS England	NHS Scotland
Workforce Size (2025)	~1.5 million headcount; 18-22% non-UK	~188,000 headcount; ~26% international in health/care
International Leavers Trend	26% rise in overseas doctors leaving (2024 data); recruitment slowing due to rhetoric	No reported rise; slight overall workforce growth (0.1-0.6%)
Joiners Trend	Declining interest amid hostility; overreliance criticized but departures outpacing arrivals	Ongoing recruitment (e.g., 21 nurses in one board); pro-migration push for more
Impact of Rhetoric	Directly blamed for “hostile environment” and exodus	Mitigated by pro-migration stance; criticism focused on UK policies, not local rhetoric
Key Challenges	Racism, visa cuts, Brexit effects leading to shortages	UK-wide visa restrictions; calls for devolved control to boost intake

In summary, evidence strongly supports foreign medics shunning NHS England amid anti-migrant rhetoric from major English parties, with quantifiable increases in leavers. For NHS Scotland, the pro-migration rhetoric from the Scottish Government correlates with more stable trends and active recruitment efforts, though both systems are constrained by UK immigration rules. If Scotland gains more autonomy, this contrast could widen.