Oscar Gish

Emigrating British physicians.

Abstract The volume and reasons for medical emigration from Britain are reviewed. The effect of emigration upon the availability of medical manpower in the country is discussed. And the relationship of medical immigration to medical emigration is developed.

Overseas-born doctor migration 1962–66

In March 1968 the (then) Ministry of Health2 published a study of medical migration into and out of Great Britain (England, Scotland, and Wales) which covered the years 1962 to 1964, with an addendum for the year 196465 (Ash and Mitchell, 1968). Detailed description of the methodology employed is contained within that study. The basic data were drawn from an index containing, among other things not relevant here, the names, country of birth, country of qualification, age, and occupation of all provisionally or fully registered civilian doctors known to be in Great Britain at 30 September of each year. Thus, doctors in the armed forces and 1,000 to 1,500 temporarily registered overseasborn practitioners are not included in the index. Each year, as of 30 September, the index is brought up to date and all doctors who have left or entered Great Britain are recorded according to the country they had come from or the one to which they had gone. Certain short-term movements such as holidays, visits, and movements into or out of Britain within any one 30 September to 30 September period are excluded. Foreign-born graduates of British medical schools do not appear as part of inflows to the index but do appear as part of the stock of foreign doctors in the country, as well as in outflow data should they leave Britain. I n reckoning the period of time such doctors have been in Britain no account is taken of the years spent before qualifying as a doctor, or, more strictly, since entering the index. In spite of numerous difficulties, the Ministry has been able to improve its methods for tracing the movements of those entering, leaving, or remaining in the index. At times, however, it is not possible to ascertain that a doctor has left Britain until a year or two after the fact;

5. Health planning in developing countries

Summary Planning for health care in less developed countries must differ from that in more highly developed countries because of the greater scarcity of manpower and facilities, the differences in population structure, and the different disease patterns. Because poor countries usually do not have more than 10s. per head per annum to spend for health care, it would be unrealistic to plan for hospital‐based medical care delivery systems. It is equally inappropriate to attempt to make the medical doctor responsible for the care of each and every patient. The training of medical doctors must reflect the economic, demographic and health patterns of low‐income countries. Health problems in these countries are aspects of poverty rather than of the tropics. Future reduction of morbidity and mortality is more likely to be accomplished through an improved system for the distribution of heath services rather than from further advances in medical science as such.