Re: Gentleness matters in healthcare and role of the kindness of strangers

Agreement: I AgreeBody:

Dear Editor

People who remember what the delivery of healthcare was like in the post war years may also recall that the post war years were characterised by the "double whammy" of manpower shortages and austerity. Given the fact that "UK Government debt peaked at around 270 percent" shortly after the end of the Second World War[1], the 1948 launch of the NHS was, quite literally "on a wing and a prayer". That fledgling project could only come to fruition if immigrants from the Commonwealth rallied to the ranks of the NHS workforce both in primary care and in secondary care.

What better testimony to their contribution than the written account by Julian Simpson in his book "Migrant architects of the NHS: South Asian doctors and the reinvention of British General Practice (1940s-1980s)"[2]. In that book he even recalls that "by1960, 40 percent of junior doctor posts were filled by doctors from overseas.....while large numbers of British trained doctors were emigrating"[2]. A parallel contribution was the one made by immigrant members of the nursing workforce, memorably commemorated in Andrew Seaton 's book in the Jacket image of student nurses from Sierra Leone, and Lagos holding a newborn baby during a midwifery course in London,1948[2]. In subsequent years, when long term care of mentally and physically frail elderly patients was outsourced to nursing homes, immigrant care workers played a crucial role in helping those nursing homes to accept patients newly discharged from NHS hospitals, thereby relieving pressure on scarce NHS hospital beds and mitigating the risk of deployment of corridor care.

In view of the foregoing it seems inappropriate to deny foreign medical graduates opportunities for career progression in the NHS sector that their forbears nurtured in the formative years of the NHS. It also seems inappropriate to deny immigrant nurses and care workers the reward of timely naturalisation as UK citizens. Although both strategies might be justified by short term expediency, in the long run each of those strategies leaves us ill prepared for the vagaries of the economic cycle, let alone the relentless progression of the demographic shift attributable to the falling birth rate and the increase in the proportion of frail elderly people in the UK population. Any healthcare policy or economic strategy which fails to take due account of both the vagaries of the economic cycle and the relentless progression of the demographic shift can only be a recipe for disaster, let alone leaving us ill prepared for the next pandemic.

References
[1] Office of Budget Responsibility. Post World War II debt reduction. Fiscal Sustainability Report July 2013 page 124
[2] Simpson J. Migrant architects of the NHS. Manchester University Press. First Published 2018
[3] Seaton A. Our NHS: A History of Britain's Best Loved Institution. Yale University Press, New Haven, London. First Published 2013

No competing Interests: YesThe following competing Interests: Electronic Publication Date: Saturday, September 19, 2026 - 07:13AI use: No, I have not used AIHighwire Comment Subject:

Gentleness matters in healthcare

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Re: Gentleness matters in healthcare and role of the kindness of strangers

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Gentleness matters in healthcare

Check this box if you would like your letter to appear anonymously:: Last Name: JolobeFirst name and middle initial: Oscar MEmail:

oscarjolobe@yahoo.co.uk

Address: ManchesterOccupation: retired geriatricianAffiliation: British Medical AssociationBMJ: Additional Article Info: Rapid response