Why Indian Doctors Are Reconsidering the UK: Costs, Careers and Changing Policies

Indian doctors are increasingly leaving the UK as rising taxes, high living costs, tighter immigration rules and limited job security outweigh the NHS’s traditional appeal. Visa numbers have dropped sharply, while better pay and clearer career paths abroad attract talent. Policy pressures, workforce competition and reduced entry routes are further shrinking opportunities for overseas healthcare professionals.

For decades, the United Kingdom stood out as a natural destination for Indian doctors and nurses. The National Health Service (NHS) promised professional credibility, steady employment and global recognition. Today, however, that long-standing appeal is weakening. A growing number of Indian healthcare professionals are choosing to leave the UK, driven less by dissatisfaction with clinical work and more by mounting financial pressures, policy shifts and uncertain career prospects.

Senior doctors of Indian origin currently working within the NHS told PTI that the rising exodus is rooted in economic and structural challenges rather than disillusionment with medicine itself. Government data presented during the winter session of Parliament reinforces this trend. The number of Health and Care Worker visas issued to Indian nationals has fallen sharply—by nearly 67 percent—while visas granted to Indian nurses have declined by about 79 percent.

Financial strain at the forefront

Pay and taxation remain central concerns. NHS consultants in the top salary brackets face an additional 45 percent income tax, alongside 2 percent in National Insurance contributions. Those earning £65,191 or more also contribute roughly 12.5 percent of their pensionable income to the NHS pension scheme. These deductions significantly reduce take-home pay, particularly when combined with the UK’s high cost of living.

The burden is even heavier for junior doctors and trainees. According to radiologist Sanjay Gandhi, many newly qualified doctors struggle not only to secure permanent paid roles but even to find clinical attachments that allow them to gain experience. The gap between effort and reward has become increasingly difficult to justify.

Senior NHS cardiologist Rajay Narain, who has spent over two decades in the system, told PTI that salaries in the UK now lag behind those offered in parts of Europe and other regions. Better pay, improved living standards and relatively lower taxes elsewhere are drawing Indian-origin healthcare professionals away from Britain.

Looking beyond the UK

As pressures mount, Indian doctors are actively exploring global alternatives. Countries such as Australia, Canada and several Middle Eastern nations are emerging as preferred options, offering more competitive compensation and clearer long-term pathways. Narain noted that the NHS, once regarded as a benchmark for healthcare systems worldwide, has seen its reputation dented by growing waiting lists and limited opportunities for career advancement.

This shift has prompted not only outward migration to other Western countries but also a return to India for some British-Indians seeking renewed professional growth and stability.

Policy and workforce pressures

Government policy has also played a decisive role. Gandhi explained that successive UK governments have pledged to reduce net migration. As curbing illegal migration remains challenging, legal migrants—including NHS staff—often feel the impact of tighter controls.

Another challenge lies in increased competition from domestically trained doctors. While the number of UK medical graduates has risen, training posts and permanent positions have not kept pace. This imbalance has left many qualified doctors, including international graduates, struggling to secure employment.

Entry routes have also narrowed. Gandhi pointed out that the General Medical Council (GMC) has been directed to restrict the number of PLAB (Professional and Linguistic Assessments Board) exams, a mandatory requirement for international medical graduates seeking to practise in the UK. These exams are expensive, and even those who pass face no guarantee of employment.

Based on his own experience, Gandhi warned that the presence of Indian doctors within the NHS is likely to decline further. He said he personally knows several colleagues who have relocated to Australia or New Zealand over the past three years.

A historic bond under strain

The contribution of Indian doctors to the NHS runs deep. When the NHS was established in 1948, it relied heavily on doctors trained in India under a medical education system aligned with British standards. Indian medical degrees were recognised by the GMC until 1975, strengthening the flow of talent from India to the UK.

As of 2024, UK government figures show that Asian or Asian British staff make up 13 percent of the NHS workforce, accounting for 16 percent of full-time and 8 percent of part-time employees. Despite this significant presence, opportunities for overseas professionals are narrowing.

NHS pulmonologist Manish Gautam told PTI that resident doctor positions now attract hundreds of applications within hours, making jobs difficult to secure even for UK-trained graduates. He added that the financial strain on the NHS intensified after the COVID-19 pandemic, when heavy spending on agency and temporary staff became necessary to address workforce shortages.

Today, NHS trusts face pressure to reduce costs and improve productivity. This has triggered a shift away from temporary staffing towards building a permanent workforce—a transition Gautam said will take time to stabilise.

While experience in the UK healthcare system remains highly valued globally, financial constraints and policy realities are limiting opportunities. For many Indian doctors, the question is no longer whether the NHS offers prestige, but whether it offers a sustainable future.