General Practice

Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

Donald H Taylor Jr, assistant research professor, ^a Aneez Esmail, visiting professor of social medicine. ^b

^a Center for Health Policy, Law and Management, Box 90253, Duke University, Durham, NC 27708, USA, ^b Harvard Medical School, Cambridge, MA 0211, USA

Correspondence to: Dr Taylor dtaylor{at}hpolicy.duke.edu

Objectives: To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire.
Design: Retrospective analysis of yearly data and projection of future trends.
Setting: England and Wales.
Subjects: General practitioners who qualified medically in the countries of Bangladesh, India, Pakistan, and Sri Lanka and who were practising in the NHS on 1 October 1992.
Main outcome measures: Proportion and age of general practitioners who qualified in South Asia by health authority; the Benzeval and Judge measure of population need at the health authority level.
Results: 4192 of 25 333 (16.5%) of all unrestricted general practitioners practising full time on 1 October 1992 qualified in South Asian medical schools. The proportion varied by health authority from 0.007% to 56.5%. Roughly two thirds who were practising in 1992 will have retired by 2007; in some health authorities this will represent a loss of one in four general practitioners. The practices that these doctors will leave seem to be in relatively deprived areas as measured by deprivation payments and a health authority measure of population need.
Conclusion: Many general practitioners who qualified in South Asian medical schools will retire within the next decade. The impact will vary greatly by health authority. Those health authorities with the greatest number of such doctors are in some of the most deprived areas in the United Kingdom and have experienced the most difficulty in filling vacancies. Various responses will be required by workforce planners to mitigate the impact of these retirements.