APPG publishes new inquiry report on international health worker recruitment

16 March 2026

The All-Party Parliamentary Group on Global Health & Security has today published An honest account of the benefits and costs of international health worker recruitment, a new cross-party parliamentary inquiry report examining the UK’s reliance on internationally trained health workers and the case for fairer, more sustainable co-investment in source countries.

The report argues that international recruitment is not a short-term fix for the NHS, but a structural feature of the health system. It finds that the UK has benefited significantly from internationally trained doctors and nurses, while the costs for countries with fragile and understaffed health systems can be substantial. The report concludes that the UK must move “from reliance to responsibility” by combining more honest workforce planning with stronger, enforceable partnerships and proportionate co-investment

Who led the inquiry

The report is a publication of the All-Party Parliamentary Group on Global Health & Security.  The inquiry Chair is Rt Hon. Sir Andrew Mitchell MP, alongside Dr Beccy Cooper MP, Chair of the APPG on Global Health and Security, Monica Harding MP, Rt Hon. The Baroness Prashar CBE and Lord Nigel Crisp KCB. 

The report was prepared and supported by Global Health Partnerships (formerly THET), and the Center for Global Development.

Please note this is not an official publication of the House of Commons or the House of Lords. It has not been approved by either House or its committees. All-Party Parliamentary Groups are informal groups of Members of both Houses with a common interest in particular issues. The views expressed in this report are those of the group.  

How evidence was gathered

The inquiry was established in June 2025 to examine the benefits and costs of international health workforce recruitment and to develop practical recommendations for a fairer, more sustainable and transparent approach to workforce mobility. 

It took evidence across three hearings: two online evidence sessions held on 4 November and 18 November 2025, and a hybrid evidence session on 9 December 2025. The inquiry also drew on roundtable discussions in Kenya and Uganda, as well as written submissions received through a public call for evidence. Contributors included health workers, international governments, researchers, global institutions and policy experts. 

Headline findings

The report finds that the NHS is deeply dependent on internationally educated staff. It says one in three doctors were trained overseas, around one in four registrants on the UK nursing register were internationally educated in 2025 and nearly half of new nursing joiners in 2023/24 were internationally educated. It describes international recruitment as “not a marginal feature of the system - it is structural.”

It also finds that this reliance has brought major benefits to the UK. Based on a conservative estimate, the report says the UK has saved approximately £14 billion in training costs across NHS doctors nurses and midwives, with around £1.1 billion saved in the most recent year alone.

At the same time, the report warns that poorly governed recruitment can impose real costs on source countries, particularly those with fragile health systems, through the loss of experienced health workers, educators and specialists, with knock-on effects on training capacity, service delivery and patient outcomes.

Recommendations

The report calls on the UK to:

• Restore development spending to a level that reflects and reinforces the UK’s long-standing leadership in global health while ensuring stable and predictable co-investment is proportionate to the benefits gained.
• Invest in a robust future for the NHS by directing reliable, predictable long-term co-investment aligned with partner country priorities for the training, employment and retention of health workers, especially in countries with fragile or severely understaffed health systems.
• Give source countries predictability by setting out clear, long‑term workforce plans that include realistic expectations for international recruitment and retention, avoiding sudden rises and falls.
• Ensure that UK support increases when UK recruitment increases, so that countries most affected by UK recruitment also benefit from additional investment in their health workforce.
• Establish co‑investment mechanisms - time‑limited, evidence-based global training and skills pathways that address locally identified priorities e.g. the UK Medical Training Initiative and Global Skills Partnerships), supported by ethical and transparent government-to-government agreements that strengthen health systems and workforce development.
• Integrate, protect and retain internationally recruited staff by ensuring fair employment conditions, high quality induction and pastoral support, recognition of their skills and strong safeguards against exploitation, enabling them to build stable, rewarding careers within the NHS.
• Underpin voluntary guidance by establishing binding, mutually beneficial government to government agreements that set out shared expectations, clearly defined responsibilities - including worker protections and mechanisms for accountability.

Download the report using the link at the bottom of this page.