Sam Bidwell Profile picture
Aug 10, 2024 15 tweets 5 min read Read on X
When we talk about immigration, we're often told that we need immigration because our public services, like the NHS, are reliant on it.

A short 🧵 on why this is nonsense - and why we shouldn't let the NHS be a thought-terminating cliché when discussing migration: Image
Let's start with a basic point - most migrants don't come to the UK to work in the NHS.

In fact, according to analysis from @BernoulliDefect, just 2.6% of the 1.22 million migrants who came to the UK in 2023 did so using the Health and Social Care Visa route. Image
It's not even fair to say that immigrants are *disproportionately* likely to work in the NHS - thanks again to @BernoulliDefect.

Clearly then, it's possible to cut immigration - even radically so - without impacting the NHS' access to an overseas labour pool... Image
But maybe it's still fair to say that the system is 'dependent' on migration? After all, we don't have enough people training to be doctors and nurses here in the UK - it's simply inevitable that we have to prop up our system with foreign-trained practitioners, right? Image
Nope - this is entirely a self-imposed problem.

In partnership with the British Medical Association, the Government caps the number of training places at UK medical schools - currently it's 7,500, though there are indications that this might be increased over time to 15,000. Image
When the cap was temporarily lifted in 2020/21, demand for medical training places shot up - before the cap was reimposed in 2022.

The obstacle to a self-sustaining NHS workforce is the UK Government's reticence to make a long-term investment in the UK's domestic workforce. Image
This decision stems back to 2008, when the BMA voted to cap the number of medical places and ban the opening of new medical schools - for fear of "overproducing" doctors and "devaluing the profession".

This is racketeering and protectionism, plain and simple. Image
Between 2010 and 2021, 348,000 UK-based applicants were refused a place on a nursing course.

The House of Lords found that, in 2016 alone, 770 straight-A students were rejected from all medical courses to which they applied.

Failing to train our own workforce is a choice. Image
And, of course, there are second-order impacts of migration on public services as well. Like the rest of us, migrants use the NHS - between 2010 and 2020, there were 7 million new GP registrations by migrants.

That's BEFORE the 2022/23 spike in overall migration. Image
"But what if we rejected those applicants because they weren't good enough? We don't want low-quality medical practitioners."

As @93vintagejones notes, foreign-trained doctors are 2.5x more likely to be referred to the GMC as unfit to practice than British-trained doctors. Image
We've known for years that foreign-trained doctors are more likely to fall below expected standards than British-trained ones.

We're substituting a high-quality domestic workforce for a low-quality international one, thanks to BMA protectionism and government incompetence. Image
"But training takes time! We won't be able to fill those gaps immediately."

First, successful management of public services requires a long-term perspective.

Second, that may be the case - so create a special, time-limited visa route for practitioners from certain countries. Image
Plenty of countries have schemes that enable high-quality migrants to come to the country for a fixed period of time, under particular conditions.

A policy of using migrant doctors to fill short-term gaps doesn't require us to open the borders in perpetuity - obviously.
"But even if you opened those training places, you wouldn't fill them with British people."

Once again, we know that this isn't true - when the cap was temporarily removed, applications increased.

And if that doesn't work, there's a case for increasing public sector pay. Image
However we choose to address the NHS workforce, the key takeaway is that we shouldn't allow this to be a thought-terminating cliché.

Most migrants don't contribute to the NHS.

Our "reliance" on migration is entirely self-imposed.

We can choose to do things differently.

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More from @sam_bidwell

Apr 23
Happy St. George's Day 🏴󠁧󠁢󠁥󠁮󠁧󠁿

England is a special place - great food, great art, great music, great people.

But culture isn't about what people eat and wear. It's about norms, habits, and methods of social organisation.

A 🧵 on the systems and norms which make England unique Image
But first, how did we get here?

England, unsurprisingly, was founded by the English.

The English are a nation native to England, who speak the English language and share a common history and culture. Image
The English largely descend from two main historical population groups.

1. Celtic Britons, the pre-Roman inhabitants of Britain

2. The West Germanic tribes, including the Angles, Saxons, and Jutes, who settled in southern Britain following the withdrawal of the Romans Image
Read 23 tweets
Apr 19
The Home Office has barred Renaud Camus, a controversial French philosopher, from entering the UK.

They claim that his presence is "not conducive to the public good".

But is that a consistent standard? Let's look at some of the people that they've allowed to come to the UK: Image
Syed Muzaffar Shah Qadri, who is banned from preaching in Pakistan, was allowed to travel to the UK in 2016.

Qadri has celebrated the murder of politicians in Pakistan, arguing that it is legitimate to kill people who oppose Pakistan's oppressive blasphemy laws. Image
Qadri was a key influence on Tanveer Ahmed, a Bradford taxi driver who was convicted of the murder of another Muslim man, who he deemed insufficiently pious.

During his visit, Qadri delivered sermons at several UK mosques, including venues in Leicester, Woking, and Bolton. Image
Read 16 tweets
Apr 15
Wales has quietly become a hotbed of historical revisionism, anti-white discrimination, and DEI 🏴󠁧󠁢󠁷󠁬󠁳󠁿

For decades, the Labour-led Welsh Government has pushed dangerous ideas about race, culture, and history onto an unwilling population.

A 🧵 on the disaster unfolding in Wales Image
But first, some context.

Since 1999, Wales has had its own parliament - the Senedd - with devolved responsibility for a number of issues.

Over time, the Senedd has received more powers from Westminster, allowing them to make decisions on things like healthcare and education. Image
But despite this transfer of powers, the UK press is relatively disinterested in Welsh affairs.

This has allowed successive Welsh Governments to pursue radical agendas, without the kind of scrutiny which similar policies might face if they emanated from Westminster. Image
Read 23 tweets
Apr 9
Riverway Law has launched a challenge against the UK's ban on Hamas.

They argue that the Islamic terror group should be legalised in the UK. This shouldn't come as a surprise, given some of the other cases that they've supported.

A 🧵 on some of Riverway Law's recent work Image
In January 2023, Riverway challenged the Home Office's decision to strip British citizenship from a British Pakistani man who travelled to Syria, in order to join Al-Qaeda.

They argued that this was 'arbitrary' and 'disproportionate'. Their challenge were unsuccessful. Image
In September 2021, Riverway challenged the Home Office's decision to bar an Afghan man from entering the UK on national security grounds - after he had spent months with the Taliban.

They argued that the man would be at risk if he stayed in Afghanistan. They were successful. Image
Read 12 tweets
Apr 6
Last July, four independent MPs were elected in heavily-Muslim seats.

They capitalised on Muslim frustration with the Labour Party's position on Gaza. Their campaigns focused primarily on winning Muslim votes.

But what have they been up to since the General Election? A short 🧵 Image
Adnan Hussain was elected in Blackburn - a seat held by the Labour Party since 1945.

The constituency is 47% Muslim.

Hussain won with a narrow majority of 132 seats - the Muslim vote was split between Hussain and a candidate representing George Galloway's Workers Party GB. Image
Hussain has spoken twenty-five times in Parliament since he was elected.

Eleven of his interventions have focused on Israel or Gaza.

He has campaigned for immediate recognition of a Palestinian state, and the immediate cessation of all arms sales to Israel. Image
Read 25 tweets
Mar 20
52% of British adults are now reliant on the state for their livelihood - and YOU could be paying for it.

That's according to @ASI's inaugural State Reliance Index, which tracks the number of Britons who rely, directly or indirectly, on the state.

A 🧵 on our findings Image
So what does the State Reliance Index consider?

We looked at adults (1) receiving benefits or state pension, (2) employed by the public sector, (3) in higher education, or (4) who work in the private sector, but in fields which only exist because of public sector regulation. Image
This was a conservative estimate.

We didn't even look at every area of the private sector which receives state subsidy - and nor did we include the charitable sector, which relies heavily on state support.

In other words, the true figure could be even more than 52%. Image
Read 12 tweets

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