Quarter of all nurses come from overseas

ONE IN four new nurses in Britain is now recruited from overseas while the number of those entering the profession has fallen to its lowest level since records began, the regulatory body warned yesterday.

Nurses' leaders said the Government faced the worst crisis in nurse shortages in 25 years as nurses "voted with their feet" to shun the profession because of increasing workloads and erosion of pay.

Worryingly, the statistics from the United Kingdom Central Council of Nursing, Midwifery and Health Visiting (UKCC) show that young people are increasingly turning away from nursing - for the first time more than half of those on the register are aged 40 or over - which exacerbates future shortages.

The UKCC figures follow a "horrific" fall in nursing recruits revealed last week by the English National Board for Nursing, Midwifery and Health Visiting. It said that in the past four years the number of nurses in training had dropped by more than 8,000 - a decline of 15 per cent.

The ENB said the decline put in jeopardy the Health Secretary's promise in last month's Comprehensive Spending Review to give the NHS an extra 15,000 trained nurses and 6,000 training places over the next three years. In response, Frank Dobson said he would be recommending nurses' pay should rise to combat the recruitment crisis.

The UKCC figures show that the number of nurses on the register has fallen by 30 per cent over 10 years. It is particularly acute in midwifery where almost half work part time with only 32,803 practising in total.

Initial entrants to the register stand at 16,382 compared with 17,984 the previous year and 22,164 in 1990/1. But more than a quarter of this number is now made up of numbers of nurses from overseas.

While Australia remains the largest single overseas source, numbers of nurses coming from Finland were sharply up. Other countries which supplied many nurses included New Zealand, Canada, Sweden, Germany and Ireland.

"The rise in admissions to the register of overseas nurses reflects the increasing pressure under which hospitals and trusts are working as they are forced to look abroad to fill nursing vacancies," said Christine Hancock, general secretary of the Royal College of Nursing. "This is a fire-fighting measure, not a long-term solution."

Fewer than one in seven nurses registered is aged under 30 and the percentage of those in their 30s is falling for the third year running. A quarter of registered nurses will therefore be eligible for retirement by 2000.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said the figures were even worse for midwives, with one in six midwives aged over 50 compared with only one in 12.5 under 30. "With the current figures it will be practically impossible to provide one midwife to one woman in labour which is the least that every woman deserves," she said.

Particularly worrying was the trend for midwives to work part time while the birth rate had not gone down. "This supports evidence from the heads of midwifery that the workload of individual midwives is increasing almost to breaking point," she said. "It is hardly surprising that given these tensions, together with the continued erosion of midwives' pay, the midwives are voting with their feet."

A spokeswoman for the Community Practitioners and Health Visitors Association said she was "not in the least surprised" by the UKCC findings after the way health visitors had been treated.

"Nurses are still being treated like children by the NHS. They do not have a proper voice," she said. "They will tell you it is not that it is unattractive but that it is unbearable to be a nurse."

"This is a double whammy for the Government," added Ms Hancock. "Not only are people turning their back on entering the profession but the average age of existing nurses is rising ... This double dose of bad news has serious implications for nurse shortages which has a direct impact on patient care."

"The figures are low today because there was insufficient investment in nursing three years ago," said a spokesman from the Department of Health. "It takes three years to train a nurse and the impact of increased investment in nurse training in recent years is not reflected in the latest UKCC statistics."

The Government said that in 2001 and 2002 there will be 18,700 training places, an increase of 73 per cent. It claimed that, under the last government, nurse training places had dropped to 10,849 in 1994 and 1995.