As the Soviet Union showed, by the time medicine is fully nationalized, careers in medicine have been reduced to the lowest status level, somewhere around street cleaning. Learning medicine and practicing medicine (including nursing, pharmacy, technical jobs, etc.), is incredibly time-consuming and, in a society that still has the gloss of being capitalist, costly. The jobs themselves are incredibly tough, both physically and emotionally. Aside from the undoubted pleasure many find in helping sick people, the real remuneration for all the time and energy involved in working in medicine is money. Government, of course, takes that incentive away. And, absent the incentive, that’s how you end up with this:
An NHS hospital has staff from a staggering 70 countries on its payroll.
The huge number of overseas nurses, cleaners and porters has forced health chiefs to send them on ten-week English courses because many do not understand basic medical phrases.
Among the terms some workers from countries such as Burma, the Philippines and Poland can’t follow are ‘nil by mouth’, ‘doing the rounds’ and ‘bleeping a doctor’.
They highlight the language problems throughout the Health Service, which critics say are putting patients’ lives at risk.
The lessons follow several ‘near-disaster’ cases, including one where a meal was delivered to a patient because a member of staff did not understand that ‘nil by mouth’ meant the man could not eat or drink.
Although all doctors from outside the EU must pass an English language test set by the General Medical Council before they can practise, the same rules do not apply for other hospital workers.
Instead, they are usually assessed on their grasp of the language at interview.
The problem has become so acute at Oxford Radcliffe Hospitals that foreign workers are being encouraged to attend ten-week, taxpayer-funded ‘English For Speakers Of Other Languages’ courses, which are run by a nearby college.
Research has found that up to a quarter of nurses - more than 60,000 - working in London are foreign, with the largest number coming from the Philippines.
Read more here.
While the above report makes clear that the language problem in the NHS involves nurses, not doctors (who must be minimally competent in England), reading the British papers makes it clear that foreign educated doctors carry their own problems. Training isn’t standardized, many of them commute from overseas and are perpetually jet lagged, and practice values are different. In a country that makes being a physician worthwhile — which is what America has done for so long — you get the best and the brightest. Once practicing medicine or being a nurse is about as high status (and high paying) as being a clerk in a government office, you’re going to see the best and the brightest gravitate elsewhere.