Kate Middleton's Nurse: How Britain's Health Service Depends Upon South Asian Talent

Like tens of thousands of health care workers in the UK, Saldanha was from India, having moved to Britain 10 years ago to work at the prestigious King Edward VII hospital (where many members of the royal family seek treatment). Her husband, Benedict Barboza, works as a hospital accountant.

Immigrants from India like Saldanha and her husband occupy a significant portion of Britain’s National Health Service, or NHS -- according to some reports, one-third of NHS’ 1.2 million-strong workforce originated in India, Pakistan, Bangladesh and Sri Lanka (while only about 8 percent of the UK population comprises ethnic minorities).

In some deprived parts of Britain, like rural Wales, an astonishing 75 percent of doctors are South Asian.

Ironically, in the early 1960s, when the NHS found itself mired in a dire shortage of qualified labor, it was none other than Enoch Powell (the conservative politician who would later become the face of the anti-immigration movement) who expanded the health care service and encouraged the mass migration of Indian-Pakistani doctors to fill the gap in Britain.

Of course, South Asian medical professionals encountered much racism and discrimination in 1960s Britain, including limited opportunities, difficulties in advancement and assignments in the poorest, most deprived neighborhoods.

"There was a pecking order and we just accepted it," Dr. Bashir Qureshi, a Pakistani who arrived in Britain in the early 1960s, told the BBC. "If a job came up, the English person would get it first, followed by the Scot, the Welshman, the Irish, the Pakistani, the Indian, the Sri Lankan, the West Indian and then the African. This was always regardless of qualification, but it meant I knew I would get the fifth job to come up."

Nonetheless, South Asians became a crucial part of Britain’s massive health care foundation.

"It is the South Asian doctors who have provided the service to these communities. I believe that without them the NHS would have collapsed,” Dr. Aneez Esmail of Manchester University told the BBC.

Indeed, such words were echoed as far back as 1961 during a session in the House of Lords, when Lord Cohen of Birkenhead declared, "The health service would have collapsed if it had not been for the enormous influx from junior doctors from such countries as India and Pakistan.”

“[South Asian doctors] are here to provide pairs of hands in the rottenest, worst hospitals in the country, because there is nobody else to do it,” Lord Taylor of Harlow similarly said.

Thus, as the 1960s progressed into the 1970s and beyond, South Asian medical professionals in the UK found themselves in an odd and uncomfortable position. Their skills were highly regarded and demanded by the nation's health services, but people of their ethnic background, on the whole, were increasingly unwanted in the country due to the huge influx of both skilled and unskilled immigrants from India and Pakistan.

And now in the 21st century, Britain again faces a shortage of doctors and nurses.

Last month, the Royal College of Nursing warned that due to a combination of government spending cuts and fewer spaces available in nursing courses, Britain will see an exodus of nursing talent in the coming years.

“It is becoming clearer that NHS nurse staffing levels in England are likely to reduce significantly over the next five to 10 years if current policies and trends continue,” wrote health care workforce experts from Edinburgh’s Queen Margaret University.

“We know we risk a nursing shortage, and failure to deal with it now will lead to a failure to improve health care. Without policy change, the overall policy direction of the NHS in England is now toward reduced nurse staffing.”

Similarly, the Daily Mail reported last year that the UK is also facing a shortage of doctors, particularly family doctors who work in deprived inner city areas, with one in eight GPs planning to return soon with no successors on the horizon.

NHS officials are further concerned that reform proposals by the government, incluing pay freezes, changes in the pension scheme and an increased workload, will make the problem worse by forcing more physicians into early retirement or moving abroad.

It is unclear if South Asian doctors and nurses will again fill the void given tighter immigration restrictions from non-E.U. migrants.