Pay, policy and pressure - Why Indian doctors are quitting the UK

New Delhi: Among the shared history, food, and architecture, India and the United Kingdom are also connected through a deeply immersed force of healthcare professionals. But what was once considered a deliberate choice of destination — a place to build a home away from home — no longer remains the same for Indians, especially for the medical professionals facing the impact of recent policy changes in the UK.

Speaking to PTI, senior doctors of Indian origin working in the UK's National Health Service (NHS) said many Indian health professionals are choosing to leave the UK — not out of dissatisfaction with clinical work, but because financial and immigration pressures have made the UK a less viable long-term option.

The doctors interviewed for this report spoke in their personal capacity and did not represent the views of the NHS or their employer.

Indian government data presented during the Winter Session of Parliament showed that Health and Care Worker visas issued to Indian nationals fell by about 67 per cent, with a sharper decline of nearly 79 per cent among nursing professionals.

Rajay Narain, a senior NHS cardiologist with more than 20 years of experience, told PTI many Indian health professionals are choosing to leave the UK as countries such as Australia, Canada and parts of the Middle East are offering significantly higher pay and clearer long-term pathways.

"Many graduates are leaving the UK as salaries there are lower compared with those offered in some European countries. Recent data indicate that Indian-origin healthcare professionals are increasingly choosing to work abroad, attracted by better pay, higher standards of living, and comparatively lower taxes," Dr Narain said.

As a professional working with the NHS for two decades, Dr Narain recalled how it was once regarded as one of the leading healthcare systems globally.

"Over time, however, it has faced numerous challenges, including long waiting lists for patients requiring procedures," he said, adding that many no longer see long-term career prospects in the UK, and several British-Indian professionals are even returning to India in search of improved opportunities.

The NHS was established in the UK in 1948, following the Second World War, as part of major social reforms. India's contribution was significant, rooted in the historical links from the British Empire era when medical training in the subcontinent was modelled on British standards, and Indian medical degrees were recognised by the UK's GMC until 1975.

One of the main factors behind Indian-origin healthcare professionals leaving the UK is that successive governments, regardless of political affiliation, have committed to reducing net migration, said Radiologist Sanjay Gandhi, who is a part of the NHS in the South-West UK.

"However, as controlling illegal immigration has proven difficult, legal migrants, including those working in the NHS, often face the impact of these policies. Another factor is the growing competition from locally trained doctors. Although the number of medical graduates has risen, training positions have not increased proportionately, leaving many qualified doctors struggling to secure jobs," Gandhi told PTI.

Professor Gandhi works as a consultant radiologist at one of the largest teaching hospitals in the NHS. In his 35-year medical career, he has taught at prestigious universities in the UK, India and the USA.

Speaking about the challenges faced by medical professionals of Indian origin in the UK, Gandhi further stated that the General Medical Council (GMC) has been directed to limit the number of PLAB (Professional and Linguistic Assessments Board) tests, which are costly, and even for those who pass, job security is limited.

International medical graduates from India and other countries are required to pass the PLAB tests in order to work in the UK and register with the GMC.

"However, securing a position in the UK has always been challenging," he added.

According to the UK government data (2024), Asian or Asian British staff make up 13 per cent of the NHS workforce, and account for 16 per cent of the full-time and 8 per cent of the part-time workforce.

Highlighting the long-term implications, Gandhi said the number of Indian professionals in the UK is expected to decline, noting that he knows of at least half a dozen doctors who have moved to Australia or New Zealand in the past three years alone.

When asked whether low pay and the cost of living are the main issues, he said both are a concern, adding that high taxation makes the situation worse.

An NHS consultant in the highest pay band pays the additional rate of income tax at 45 per cent, along with 2 per cent National Insurance (Class 1) contributions. They also contribute around 12.5 per cent (for those earning GBP 65,191 and above) pensionable pay to the NHS pension scheme.

Referring to the challenges faced by trainee and qualified doctors in the UK, the senior NHS radiologist said they are struggling to secure positions- not only paid roles, but even clinical attachments.

"Pathways for overseas healthcare professionals have largely reduced, while resident doctor posts now attract hundreds of applications within hours, making positions harder to secure even for UK graduates," NHS Pulmonologist Manish Gautam told PTI.

He said that after the Covid-19 pandemic, the NHS has been under significant financial pressure, with much of its pandemic and post-pandemic spending going to agency and bank staff to cover workforce shortages.

Highlighting the intense pressure on NHS trusts to deliver savings and improve productivity, Gautam said this has driven a shift away from temporary staffing towards building a more sustainable substantive workforce, a transition that will take time.

"Although UK healthcare experience remains highly valued, opportunities are constrained by financial realities," he added.