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Do We Need More Doctors, or More Patients? - Continental Telegraph
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Do We Need More Doctors, or More Patients?

Gerry Robinson was a famous troubleshooter in the world of business – he said most businesses fail because they don’t even know what they are trying to achieve. 

Britain has this problem with its border policies.

We waffle about immigration, asylum policy and refugee camps, without ever actually discussing what we are trying to achieve.

And without having agreed these basic principles, it’s really hard to know if all our efforts are appropriate to our goals. If the Left and Right cannot even agree on what we are trying to achieve, we will keep shouting past each other on this subject – if we are not trying to achieve the same goals, it’s not likely we will agree on the tactics and strategies we should be pursuing.

The first question we must ask and satisfactorily answer is “Should we discriminate between refugees, unskilled migrants and skilled migrants?”

Because listening to the modern Left, you get the uneasy sense that if someone presented them with this cardinal question, they might well answer “NO – let them all in”

At that point we must realise that the argument about dental exams is a long way from being purposeful – to someone that believes all should be welcome, dental exams seem like pointlessly racist and deeply insulting bureaucratic nonsense.

We have to go back to that cardinal question, because until it is asked and answered, everything else is just noise.

Let’s begin.

Modern Britain needs skilled migrants – to take just one example, if our foreign-born nurses all returned home, the NHS would instantly collapse. There are simply too few native Brits training as nurses, and it takes too long for them to qualify. We need immigrant nurses to meet the demands we place on our healthcare systems.

Now we could argue about the pressure migrants place on it, and we could argue about whether nurses need to be degree-qualified to provide basic nursing care, and we could argue about whether the NHS should be privatised.

But for now, Britain needs skilled migrants.

Nurses, doctors, engineers, scientists, computer programmers – our society is very advanced and a big chunk of our economic strength is based on advanced services that need skilled people like these. And there aren’t enough native Brits skilled in these areas – our demand outpaces our supply of people. We need lots of computer programmers and only relatively few native Brits are qualifying in computer sciences. And the shortage of young Brits taking STEM subjects is worsening.

So far so good – we need a supply of skilled migrants for the foreseeable future. Hopefully we can all agree on that.

Do we need unskilled migrants?

Because when people with no skills come to the UK, we suffer and so do they. They are either forced into crime, fall into modern slavery, or find themselves exploited working on the black market.

When they are forced into crime, we see more stabbings and rapes and burglaries and murders.

When they fall into modern slavery we see more people-trafficking, more forced prostitution.

When they are exploited, they are forced to work below minimum wage, and the jobs that young British teenagers might have taken are taken by those willing to work for a pittance just to stay alive. When they find themselves working in the black market, they pay no tax and have no protections.

Modern Britain does not need or desire these things – young people enslaved and forced to work for low pay, exploited, or forced into crime. These are profoundly negative developments for our society, and a grotesque abuse of people who were mislead into coming here for what they thought would be a new life.

Modern Britain does not need unskilled migrants, and should not enrich their slavers.

And that brings us to refugees.

Are there genuine refugees? Yes of course.

But we know what refugees look like – men, women and children staggering over the border into the nearest safe nation with the clothes on their backs and often not much else. Poverty-stricken and unable to return to the homelands, they throw themselves on the mercy of their neighbours. Refugees don’t abandon their families in war zones and travel thousands of miles alone. They do not have thousands of dollars to give to slave traders for a seat on their rickety barges.

What we see on the boats are not refugees.

They are mostly young men coming for a better life. And while we cannot begrudge them those intentions, we have already discussed why unskilled migrants cannot be welcomed here in large numbers. And unskilled migrants they mostly are, because skilled migrants come armed with work permits and speak the language. At the very least they have documentation to prove who they are, because being able to prove you are an Iranian heart surgeon is important. Being able to prove you are a penniless and unskilled Eritrean, who doesn’t speak English……………that’s not an identity worth retaining at a border check.

And so the Mediterranean sea floor is littered with their travel documents.

Genuine refuges stagger over the nearest safe border – we must help them if we can.

The unskilled migrants travel here in boats, trafficked by modern-day slavers into the underworlds of our nations. They may have hope in their hearts, but they are bringing misery into a society that cannot absorb them.

That needs doctors, not patients.
People who treat diseases, not carry them.
People who want to program computers, not steal them from our homes.
Above all, we need this modern slave trade to stop.

The Good Samaritan did not take the beaten man into his own home – he paid for him to recover at an inn. We must remain willing to provide financial aid to those that host refugees.

But we need skilled immigration into our country to rise.

And we need unskilled immigration into our country to cease.

If we can all agree that these are our goals, that’s the start of the conversation.

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Alex Noble

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  • Your argument seems reasonable enough but I struggle with this idea we can take other country’s skilled people while neglecting the development of our yoof. First to admit said yoof could at times do with a kick in the pants but those skilled migrants are displacing locals. Perhaps it is too easy to import skills so why bother training a programmer when India has an endless supply?

    • You are not wrong but increasing the number of local skilled programmers and medical personal is really a separate problem.

      I think a good analogy would be would be EMTs responding to a car accident. Even though the person involved needs a Doctor to fix his injuries they still stop the bleeding and stabilize him until they can get him to the hospital.

      Should look at why there are not enough local STEM students and try and fix the problem? Yes

      Should we make sure that companies do not just hire programmers from India because they will work cheaper leaving local programmers unemployed? Again yes.

      However if there really is a local shortage of skilled workers then not letting workers from other countries fill those positions that we need is just hurting ourselves which is stupid.

  • "Britain needs skilled migrants" is G.W. Bush chiding Americans that migrants "do the jobs that [natives] won't do." The missing factor is price; for the right pay, natives will do all jobs. That "There are simply too few native Brits training as nurses" is not a fundamental truth but a reaction to the current low payback of training to be one. (That "it takes too long for them to qualify" is a commentary on the current state of regulation.)

    Sending foreign nurses back home tomorrow would be needlessly disruptive. But if we resolved to not continue using them, nursing salaries would rise to attract more Britons to train to be one.

    If we slammed the border shut, a lot of prices might change. Foreigners underbid us for the provision of work, and foreign tourists overbid us for meals at posh restaurants. But the nation benefits from low-cost labor and demand for tourist services. Having foreigners in the market reduces the cost of, and increases the demand for, a business's product. Making more with less lets Brits' incomes go further. So ignore individuals' complaints that they ought not to have to suffer foreign competition, just as we would ignore corporations' similar complaints. Let's employ foreigners and train ourselves for more lucrative jobs.

    Regarding people "forced into crime," no one is forced into crime, least of all because the money is getting tight, especially in a nation with such an array of anti-poverty services. It is tedious slogging through these clichés masquerading as first principles!

    Now, every soldier in that anti-poverty army of taking money seized through taxes, frittering it around, and noting the occasional good it does, develops a self-justifying world-view. It assumes that letting individuals transact voluntarily would not work and it portrays coerced transfers as valiant. To this army, the function of the border is to recruit the most desperate to come to Britain, precisely because there is so much remediation for the caseworker to do. This is the basis of the open-borders movement. Thank you for arguing that not all "refugees" are genuine, but your follow-up assertion that "we" must take in genuine refugees is another cliché begging for a rationale. Even those of us who do not want to? Not we but our alms industry? Why indeed is need a claim check against ability?

    One key to the right level of immigration is assimilation. Foreigners who assimilate as Britons do not opt for crime. Agitation in the cities for the use of Sharia Law in the courts is a clear signal that immigration has been too rapid and is admitting too many people with no intention of assimilating. Once we scale back immigration until this phenomenon goes away, restore the immigration service to its historical function of identifying foreigners who will be a net asset to the nation — not of achieving specific changes to the levels of wages and prices.

    (This all presumes that Britain regains its sovereignty and is once again able to decide for itself how many foreigners it is willing to take in. This means sweeping away the technocrats and negotiators and achieving Brexit.)

  • Legally the only refugees we need to accept are from France or Ireland. And we have no obligation to feed house or clothe them, we are only obliged to let them escape violence. If out of charity we wish to help those from further away, then we could more conveniently for them and us provide safe places near to their homes, and if for the same purpose we wish to feed clothe and house them we could provide more help in that way than by bringing them here.
    A sensible immigration policy would address all of three issues:
    Do they have skills we can use? If not we gain nothing from their entry. If so we consider the next two items- and make such changes to our incentives and training that we do not become forever dependent on immigrants.
    Will they fit in? However skilled they are if they seek to overthrow our system of government or law, or simply to disregard the law, they are far more of a nuisance than a help. If we think they will fit in then we pass to the third test.
    Is there accomodation for them? Are we happy or at least prepared to build more housing, some of it likely on green belt or equivalent to accomodation them? Are we prepared to lower our own housing standards, say by pricing twenty somethings out of housing and forcing them to stay with their parents and delay family formation in order to accommodate immigrants?
    It seems to me we have allowed too many immigrants who fail both of the first two tests, and for whom the public are unhappy to make the sacrifices called for in the third- albeit the public has not yet all made the connection between mass immigration and a housing shortage.
    Of course what Spike calls the alms industry (wonderful title) needs to be sorted out before such a rationale is possible. I call for an end to tax relief on charitable giving and charities generally. Also the end of government/local government donations to charities. If taxation is needed for some essential project why should anyone be excused it for doing something he wants done? And why should people who, for example, hate cats be forced to bear any of the tax burden of the cat's protection league or it's donors?

  • "And there aren’t enough native Brits skilled in these areas "

    There are, it's just that employers don't want to employ them. I'm sitting at home waiting for a phone call for the occasional delivery job while applying for hundreds of programming jobs.

    "We need lots of computer programmers and only relatively few native Brits are qualifying in computer sciences."

    There's your problem right there. Computing Science courses doesn't make you a programmer, they make you a admin. Just as Driver's Ed doesn't make you a motor mechanic.

  • I might add that one of the problems we have with many immigrants is a mismatched perception of status. Many of the immigrants see themselves as high status. The native population disagree, whether by talking of them as charity cases or by calling for their expulsion we see them as low status- a mismatch in perception that causes considerable trouble. Indeed much of the trouble we get from Muslims comes from their sense of superiority which is not universally accepted.

    • After mastering English (plus the local slang that was never taught back home), then the bus schedule, how to pay an electric bill, and the reasons not to throw the windows open and issue a loud Call to Prayer at the crack of dawn, the possibility that the immigrant's self-image is at odds with neighbors' opinions of them is a very low priority. The problem is not that assimilation led to mismatches in perception, but that the immigrant had no interest in assimilation in the first place.

  • Who is this 'we' that cropped up so many times in this opinion piece? 'We' need one set of goals. 'We' must provide to those that host refugees.
    My view is that we're all different. I don't want any refugees, just economic migrants only. Bob Geldof wants refugees living at his house. If there is a 'we' then it's in having a market economy, where externalities are priced in, and 'we' can all have our preferences satisfied. So Bob Geldof can have his family of 8 in his house. some economist can work out the costs of that in healthcare, education and a bit of extra policing and deporting for more serious crimes, and Bob can pay the relevant price to have 'em.

  • Very true.

    IIRC the percentage of EU migrants who are nurses is the same as the rest of the population. So we don't need them as they meet the demand that they create.

  • Very true.

    IIRC the percentage of EU migrants who are nurses is the same as the rest of the population. So we don't need them as they meet the demand that they create.

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Alex Noble

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