The NHS is synonymous with Britain, yet almost 15% of its workforce are originally from outside of the UK. It has always been so. In 1949, during its first full year of operating, the NHS launched amass recruitment加勒比海的卫生工作者。到1962年，已经从国外招募了10,000多名医学生。典型的英国人可能是NHS，但它是由海外卫生工作者所做的贡献深刻地塑造的，我们不知道。

When the government temporarily imposed visa restrictions on the recruitment of doctors from India last month everyone, from The Daily Mail to The Guardian, rushed to defend the right of the NHS to recruit from overseas.

这是有问题的，原因有两个。

首先，人们对海外招募卫生工作者对原籍国的影响一直很少。拿India例如，每1000人只有0.7名医生，比世界卫生组织（WHO）全球建议平均每1000人平均2.5位医生。这个国家真的有能力向NHS出口600名医生吗？

Secondly, the NHS is operating in an increasingly competitive world. Competing with others for health workers has worked for us in the past, but will it in the future, and at a time when we are exiting from the EU? It seems unlikely.

We must shift the compass from competition to collaboration and the NHS can play a pivotal role in this.

但是，不仅是英国和印度面临短缺。到2030年，世卫组织估计短缺将达到1800万。德国慈善机构警告说，需要超过100,000名额外的医护人员来满足老年人口的需求，中国至少有20万名儿科医生，161,000名全科医生，40,000名精神科医生，这一名单可能会继续下去。

那么什么是替代方案？

我们必须将指南针从竞争转移到合作，而NHS可以在此中发挥关键作用，与海外卫生系统建立新的联系，成为以慈善和商业方式运作的全球力量。

We should continue to attract health workers to the UK, for training and education purposes, with a view to them returning home to up-skill health workers in growing numbers. However, we must also respect the right of health workers that decide to migrate to the UK, who play a vital role in a global NHS that is open to learning from the world. In this way we can derive mutual benefits whilst respecting the spirit of international recruitment codes.

Some of the foundation stones for this global NHS are in place.

我自己的慈善机构，Tropical Health and Education Trust (THET)，自2011年以来一直与130个NHS信托合作。通过国际发展部（DFID）的资助，他们为31个国家 /地区的84,000多名卫生工作者进行了培训。令人着迷的，也许是出乎意料的是，有2,000名员工为这份培训文件提供了无数的例子，这些例子是返回家园的新思维，这给NHS带来了好处。

These initiatives lay the foundations for a global NHS, responsibly engaged with partners overseas, working in our mutual interests whilst respecting the spirit of international recruitment codes.

In April, the Department of Health and Social Care announced a全球护理合作伙伴关系with Jamaica. This will see Jamaican nurses work in the NHS for 3 years to gain specialist skills – which they will then take back to the Jamaican health system. All in the hope that up-skilling nurses will not only strengthen the respective health systems and plug workforce gaps in the short term, but will build a workforce ready to receive new recruits when and if the time comes.

在其他地方，商业纽带越来越多。国王学院医院（King's College Hospital）以价值2亿美元的交易扩大了对沙特阿拉伯的服务。作为Rt Hon Alistair Burt, Minister of State for the Middle East at the Foreign and Commonwealth Office and Minister of State at the Department for International Development, noted; ‘The UK public and private healthcare system is considered among the top in the world. We are extremely excited to expand British healthcare internationally’.

These initiatives lay the foundations for a global NHS, responsibly engaged with partners overseas, working in our mutual interests whilst respecting the spirit of international recruitment codes. This is why, on its 70^th周年纪念日，THET呼吁政府在其宪法中赋予NHS的全球性质，该条款将以全球范围内的NHS方式以在家中受益，同时还增强了其他国家建立强大的卫生系统的能力。当然，这是表达以适合当今方式塑造NHS的原则和价值观的正确方法。

Our annual global health conference will explore this theme along with others at Imperial College London, 27^th- 28^thSeptember 2018:www.thetconference.org