Credit: Tribambuka. See Credits for more

The National Health Service was created in the aftermath of the Second World War, amid efforts to rebuild a better society. For the first time, healthcare was available to everyone regardless of their ability to pay. An unprecedented number of healthcare workers were needed to realise this grand vision.

Much of the healthcare system prior to the NHS was already reliant on healthcare workers from overseas – in particular from Ireland and Central and Eastern Europe. Among them were Jewish refugees from Nazism.

Medical migrants :
A brief history

Explore a timeline of migrants who have made contributions to healthcare in Britain across the ages, long before the birth of the NHS.

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Fleeing the Nazis

Sir Ludwig Guttmann

Escaped Nazism, revolutionised spinal injury treatment and created what are now known as the Paralympic Games.

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Lotte Fuchs

Sent by her family to Manchester aged 17, Lotte found a sponsor to get her brother a visa and saved his life. She became an NHS nurse after the war, then a psychiatric social worker.

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Recruitment begins

After the Second World War, there were nowhere near enough medical professionals in the UK to staff the new health service. At the same time, thousands of British-trained doctors left the country, seeking new lives and careers in Australia, South Africa the US and elsewhere.

As a result, Britain began to actively recruit nurses, doctors and healthcare workers from across its current and former colonies in the Caribbean and South Asian subcontinent in particular.


This film was made to promote Britain’s new National Health Service to overseas audiences – and to encourage applications to the nursing profession. As an Indian-born Jewish woman, the film’s director, Sarah Erulkar, was unusual in the world of postwar British documentary filmmaking. Extracts from The District Nurse (1952) Courtesy: BFI

Legacies of Empire

The development of the British healthcare system is closely linked to the impact and legacy of Empire. Many who came to work in the NHS in its early decades had grown up educated in British systems and had long-standing links with the UK. The 1948 British Nationality Act allowed people from Britain’s former colonies to settle and work in the UK, easing the way for thousands of medical migrants.

Guyana was British Guiana at the time. The colony was modelled after Britain. So of course I knew about Britain before I went there.

Leila Phillips
Arrived in 1951 from Guyana (formerly British Guiana)

At the time of the founding of the NHS, medicine in Asia, Africa, the Caribbean and elsewhere had been shaped by imperial history. Dozens of medical colleges and schools were set up by the British in India starting in the 1830s. Similar institutions were created across the British Empire over the next century.

This led to many healthcare workers coming to train and practice in Britain well before the creation of the NHS. Even after countries gained their independence, these legacies continued.

Conversely, in the two decades after the Second World War, close to 4,000 British-trained doctors left the country, creating a need for recruitment from abroad. This wave of emigration was also linked to Empire, as Commonwealth countries including Australia, Canada and New Zealand were popular destinations due to British qualifications being easily transferable.

Our education was all in English. Our medical college was based on the British standard. All our teachers had gone to Britain to get their postgraduate qualifications. If you had an MRCP or FRCS, you were held in great esteem. So all of us wanted to come to Britain.

Dr Nayyar Naqvi OBE
Arrived from Pakistan in 1968

Making the decision

Ultimately there were many personal reasons why people chose to come to Britain: to expand horizons, have new experiences or create better opportunities for themselves and their children. Some didn’t make the choice, instead following family or spouses to the UK.

I was going to be a nun nurse, because my mother wanted me to be one. But I went dancing in the holidays and enjoyed it so much I no longer wanted to be a nun, so I went nursing instead. I applied to a hospital in Enniscorthy, but because my mother would have to give me £25 a month for my keep, I applied to England instead.

Arrived from Ireland in the 1960s

Looking further afield

By the late 1980s, the NHS again faced serious problems in retaining and recruiting staff as it struggled to meet increased demand for healthcare from a growing population. In particular, nursing’s popularity as a career choice had declined, with tens of thousands of nurses leaving the NHS every year.

Changes to immigration laws had made it harder to recruit workers from some areas, while Britain’s EU membership resulted in a growing number of European healthcare workers moving to Britain to work in the NHS. Recent decades have seen the NHS recruit from a much wider range of countries than in the early years of the service.

NHS migrants : Mapped

Explore our interactive map showing the nationalities of NHS workers from across the world.


© Junaid Masood

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