The expansion of the NHS has relied too much on the recruitment of overseas and temporary staff who may quit at short notice, the Royal College of Nursing has warned.
The RCN said its annual survey of the NHS labour market had found that the nursing and midwifery workforce in England had grown by 16 per cent to 292,000 over the past four years, exceeding government targets.
But this was largely achieved by recruiting foreign nurses – notably from the Philippines, India and South Africa – and increasing the use of casual staff, the figures revealed.
The number of temporary nursing staff on NHS hospitals’ books went up by 36 per cent over the same period and the bill for using agency nurses had almost tripled since Labour came to office, reaching £628m in 2002-03.
The college warned that the inflow from abroad may turn into an exodus of both UK and overseas staff, as the US steps up a drive to recruit more than a million nurses by 2012.
If the NHS did not offer more flexible shift patterns to lure agency staff into signing up for permanent jobs, the service could find itself without the staff required to keep wards open, it said.
The US wants to recruit a million by 2012, including 623,000 to fill new posts. Canada expects to need an extra 78,000 nurses by 2011, and Australia forecasts a shortage of 40,000.
The health minister, John Hutton, dismissed the survey as alarmist. “It is nonsense to suggest that there is a crisis in recruitment and retention in A&E departments,” he told the Guardian.