Global Health and Diaspora: Enable, Engage, Empower

True to its ethos of working in partnership to support health workers across the world, THET embarked on an inquiry centering on the very important and topical issue of NHS staff with heritage from low- and middle-income countries (LMICs), whom we respectfully refer to as diaspora NHS staff within this report. The intention was to highlight an area that has not been systematically explored before – the contribution diaspora NHS staff make to the advancement of health in the UK and global health, and to Health Partnerships between the UK and LMICs in particular.

During my time as a Trustee, THET managed more than £30million of UK Government funds to support UK health professionals link with colleagues overseas through Health Partnerships – the heart of THET’s work. More recently, THET has engaged in policy discourse which emphasises the interdependence of health systems. Themes explored have included the growing competition for health workers in an increasingly mobile world; opportunities to encourage bi-directional learning inherent when healthcare workers come together from very different perspectives; the scope for innovation that these encounters can spark, as well as the thornier issue of unconscious biases that we all grapple with. These topics inform and are informed by the contribution made by diaspora NHS staff, the central theme of this current report, and represent a growing body of thinking that THET is producing on how to optimise the Health Partnership model.

From a personal perspective, I was delighted to be invited, as an outgoing THET Trustee, to chair the steering group of eminent members who brought an enormous wealth of knowledge, lived experience and wisdom to bear on this inquiry. It was a double delight, not only because of my long links with THET, but also because I embody the experience of diaspora that this report seeks to capture. I am following in the footsteps of what the report terms ‘the success of post-war recruitment campaigns in the UK encouraging Jamaican nurses to move to or train in the UK’.

Experts in our Midst explores the broader current context and promotes the marginalised voices of diaspora NHS staff within the wider, often hostile, environment. We know that diaspora NHS staff have always played a valuable role in Health Partnerships. What we did not know was the scale of their engagement, the challenges faced, nor how best to amplify their voices to demonstrate the impact diaspora can have on global health projects.

Within the report there is an acknowledgement of a worsening social and economic climate for members of diasporas, increased racism and scapegoating of diaspora and migrant communities, attacks in the media and of course the disproportionately harsh impact of Covid-19. It is important to acknowledge that although the report does not claim to have all the answers, it does at least begin to address head on these issues with practical approaches that may help us to better understand the value and impact such health workers can increasingly have, both in their workplaces in the UK but also through their interactions with countries of heritage.

The report attempts to do so in order to influence the behaviour of THET and our work within the wider Health Partnership community. But more widely, the report makes a contribution to the discussions around the value diaspora staff add to global health activity, and indeed to the NHS, through the sharing of expertise and learning born of their understanding of different health systems. The recommendations, therefore, are designed to help shift the dial, in a modest way, to combat the unconscious bias and racism that shapes attitudes to information exchange and bi-directional learning between the UK and LMICs.

I am firmly of the view that it is vital that THET’s inquiries influence practice and are followed through, rather than being of passing interest. I therefore look forward to the reception and implementation of the recommendations contained within this vitally important report, a report that pushes the boundaries and challenges complacency.