Kenyan Nurses and the Crisis of NHS Nurse Staffing

We’re publishing a guest post today by Dr. Ann Bradshaw, a retired Lecturer in Adult Health Care, about the scandal of the Government’s failed efforts to import nurses from Kenya in a vain attempt to solve Britain’s nursing crisis.

The U.K. nurse staffing crisis shows that the current system of recruitment, retention and training of nurses is not working.

In July 2021, the U.K. Government made a Memorandum of Understanding with the Kenyan Government to take 20,000 of its 30,000 unemployed nurses to Britain. I didn’t see this publicised in the press and thought it strange that Kenya has so many unemployed nurses.   

Then I saw in Nursing Times that the Kenyan Government would be taking a cut of these nurses’ salaries. Then I saw that this was denied by the U.K. Government.

Then I saw that Kenyan nurses were failing English language tests. Then, on November 11th, I saw that this U.K. recruitment of nurses from Kenya was being halted because Kenya is on its list of countries facing a shortage of health workers.

So why is there such a problem recruiting and retaining nurses in the U.K.? Why has the U.K. Government been forced to look to Kenya for nurses? I have argued elsewhere (see here and here) that the move to become academic by the nursing elite was not primarily intended to improve care for patients – its primary objective was to improve the status of the profession and divorce it from medicine.

This revolutionary change to make nursing academic has had, from the evidence that I have adduced, a disastrous impact on both recruitment and retention of nurses. Much of this so-called academic body of nursing literature is esoteric and of extremely dubious academic quality. Indeed, the highly ranked, prestigious, international nursing journal, the Journal of Advanced Nursing, admits this in an editorial by two U.K. nursing professors titled: “Is academic nursing being sabotaged by its own killer elite?”

In my view, nursing’s ‘killer elite’ is the Blob, and it is not merely killing the ‘academy’, it is killing the purpose of nursing: care for the patient. This has been clear to me long before this editorial. Very many of the published ‘research’ papers I read were shoddy methodologically and irrelevant to the needs of patients. Anonymous peer review rejections sent to me over the years, when I sought to publish articles critically analysing these pieces of research, revealed reviewers’ biased ‘gate-keeping’. Reviewers’ comments were devoid of knowledge and revealed a lack interest in any critical thinking. 

It seems to me that so-called ‘academic nursing’ is an emperor with no clothes and a means of protectionism. That is why there is a chasm of division between the needs of NHS patients and the wants of the nursing academy. Nursing professors and lecturers generally do not work on the wards. They are the university nursing Blob, divorced from the concrete realities of practice. That is why the NHS cannot use student nurses as part of the NHS workforce thus immediately solving the nurse staffing crisis. It is why the U.K. looks to Kenya to provide nurses for the NHS. Surely this is a scandal?

Kenya to Ban the Unvaccinated From Indoor Spaces Despite Only 10% Of the Population Being Jabbed

From December 21st, Kenya will prohibit the unvaccinated from entering bars, restaurants, and public transport in an attempt to drive up vaccination rates to avoid a winter surge in cases. However, only 10% of the population have been vaccinated, with the Government setting a target of vaccinating only 20% by the end of December when the restrictions come into force. BBC News has the story.

Kenyans will be barred from bars, restaurants and public transport from December 21st if they are not fully vaccinated against Covid, Health Minister Mutahi Kagwe says.

The measures are aimed at increasing the rate of vaccinations ahead of the festive season.

Less than 10% of the population is currently vaccinated.

Kagwe raised concern about the slow uptake, saying a 10-day vaccination campaign would begin from November 26th.

Despite the concerns that some African countries have a shortage of vaccines, the Kenyan government is confident that it has enough for its inoculation campaign.

It has so far administered only 6.4 million jabs out of the 10.7 million it has received.

It is expecting a further eight million doses.

In a statement, Kagwe said Kenya had seen a decline in Covid cases over the last two months, with a positivity rate over the last 14 days ranging from 0.8% to 2.6%.

“The current decline in the number of new infections may be attributed to a build-up of immunity both through natural exposure to the disease and the ongoing vaccination exercise. Nonetheless we know that it’s not yet time to celebrate.

“We know that during the festive periods many of the known measures against the virus such as social distancing can easily get overlooked as people make merry,” Kagwe added.

From December 21st, people would have to be fully vaccinated to use public transport, including buses and domestic flights, or to enter hotels, bars, restaurants and game reserves, Kagwe added.

The same rule would apply to hospital and prison visits, as well as to Government buildings for education, immigration and tax purposes, he said.

The Government has set a target of vaccinating 10 million people by the end of December.

But this is just 20% of the total population, so the majority of the population could potentially be barred from Government services.

Worth reading in full.

What Is the Nursing and Midwifery Council Doing About Nursing Shortages?

We’re publishing an original post today by Dr. Ann Bradshaw, a retired Senior Lecturer in Adult Health Care at Oxford Brookes University. She notes that the Government is importing nurses from Kenya as a stop-gap measure to address the shortage of trained nurses, but she isn’t happy with the Nursing and Midwifery Council’s (NMC) proposals to address the crisis long-term. Here is an extract:

The NMC is planning a new policy that will reduce placement practice and replace it with simulation in the classroom. This is despite a promise made to the Government in 1988, in response to Secretary of State John Moores. He granted permission to move nurse training to higher education, but warned of “fears that the changes would place nurse education predominantly in a classroom setting, thus unacceptably reducing the practical, patient-orientated content of training”. In fact, he placed on record the joint understanding that nursing education must retain its clinical focus and students would not spend substantially less time in clinical areas than at present. (Letter of John Moores to Audrey Emerton, May 20th 1988).

And the NMC policy is not only reneging on the professional body’s promise to John Moores but also betrays its official response to the Francis Report, which stated categorically that nursing students would continue to spend half their training in clinical settings (albeit as supernumerary learners rather than as salaried members of the workforce).

Worth reading in full.

Kenya and the U.K.’s Dog’s Breakfast of a Vaccine Passport Scheme

We’re publishing a guest post today by Aidan Hartley, a former war correspondent, award-winning author and the owner of a cattle ranch in Kenya. He is dismayed by the introduction of a vaccine passport scheme for travel between Kenya and the U.K. that is such a dog’s breakfast it is damaging relations between the two countries. Incredibly, even if you’ve been double jabbed in Kenya with AstraZeneca donated to the country by the U.K. Government, you still have to quarantine on arrival in the U.K., unlike those who’ve had the U.K.-administered AstraZeneca jab.

A joint statement on 21st September by Jane Marriot, Britain’s High Commissioner to Nairobi, and Kenya’s Health Cabinet Secretary Mutahi Kagwe, announced plans for a “system to mutually recognise each other’s vaccine certificates for a vaccine passport programme for travel”. Unfortunately, since the U.K. refuses to recognise vaccine certificates issued by Kenya, travel between the two countries is cumbersome and needlessly expensive.

In Kenya we heard with great relief that from September 22nd, my home country in East Africa was being moved off Britain’s travel red list. Since early April the travel restrictions had divided families and severely disrupted international businesses, including my own. All non-Britons from Kenya, unless they were U.K. residents, were banned from entering the U.K., while qualifying arrivals to Heathrow or Gatwick faced 11-day incarcerations in squalid quarantine hotels at a cost of £2,250.

The U.K. imposed such extreme measures with the excuse that a “significant” number of passengers arriving in the U.K. from Nairobi had tested positive for a variant of concern – from South Africa. It later transpired that, in fact, only 17 out of 2,993 passengers from Kenya in the six weeks prior to the red-listing had tested positive for the South African variant.

When the red-listing was first introduced, the measures so infuriated Nairobi’s Government that all British passport holders were banned from entry to Kenya, even if they had made their homes here. All other nations were exempted from these sanctions. Later, Kenya mirrored Britain’s measures and decreed that U.K. arrivals would have to quarantine in a Government-approved facility in which conditions were so grim that last year one woman hanged herself while incarcerated. Like other poor countries, Kenya blamed its slow progress against the pandemic on the rich world’s “vaccine apartheid”.

Stranded Britons got no help from the FCDO – known as “Fuck-Do” to its own employees here in Kenya – who told them to ask the Kenyan authorities for guidance. The GOV.UK website copied and pasted a Kenyan airport authority’s poorly drafted statement about sanctions against U.K. citizens.

During one of her elbow-bumping meetings with Nairobi officials, Jane Marriot promised that Kenya could come off the U.K.’s red list when the African country had vaccinated more people and improved its national capacity to carry out genomic sequencing in order to identify new Covid variants. In July, to coincide with Kenyan President Uhuru Kenyatta’s visit to London, Britain announced that a donation of 817,000 Oxford-AstraZeneca vaccines were on their way to its former colony. Uhuru and Boris also agreed a new programme to send up to 20,000 unemployed Kenyan nurses over to work for the NHS.

After several months and apparently thanks to lobbying by dozens of British mothers desperate to bring their children home for the summer holidays rather than the FCDO, Kenya announced that Britons were welcome to fly into the country without quarantine restrictions.

In the post-Brexit world, Kenya is a pillar of good relations in the Commonwealth, a key trade partner, base for dozens of MI6 agents and host for the largest British Army infantry training exercises anywhere overseas. Kenya was among the countries that took part in phase one trials of the AstraZeneca vaccine last year. Up to 30,000 Britons live in this former colony and British companies are among the top investors and taxpayers. Until Covid, the U.K. was the second most important source of tourism income to Kenya’s safaris and beach holidays. In the eyes of many Kenyans, the travel restrictions have damaged relations.

Even celebrations at Kenya’s removal from the red list – alongside Turkey, Pakistan, the Maldives, Egypt, Sri Lanka, Oman and Bangladesh – were cut short. To this day, the U.K. refuses to recognise certificates of vaccination from Kenya – even if, like me, you’ve been jabbed with one of the 817,000 AstraZeneca vaccine donated by Britain to Kenya. Passengers from Kenya to the U.K. must still take a pre-departure PCR test, then self-isolate after arrival with day two and day eight tests (unless released after a day five negative PCR).

Kenyans have understandably become suspicious, wondering whether the U.K. is dumping dodgy batches of the AstraZeneca vaccine in Africa. Why else would vaccinated Kenyans be treated differently by the British authorities to arrivals from other countries? Many Kenyans are already reluctant to submit to any type of Covid jab – and less than 2% of the population has been injected. An additional irony is that there are so many medical personnel now on their way to the U.K. that there’s a good chance the nurse who jabs you in the NHS will be a Kenyan national anyway.

The September 21st joint U.K.-Kenyan statement about plans to introduce vaccine passports was issued to “clear up any concerns on vaccine certification”. Nairobi has previously said that from 2022 all citizens will have to obtain a vaccine passport if they wish to travel overseas.

Passengers en route to the U.K., meanwhile, are at risk of incarceration on arrival due to contradictory information on the GOV.UK website – even if they’ve been double-jabbed in the U.K. I have just heard about the case of a retired British police officer who visited Kenya to work on a brief contract for the United Nations. She had an NHS double vaccination certificate and her flight home was booked via Addis Ababa in Ethiopia, timed to land at Heathrow on the morning of 22nd September, by which time Kenya would be off the red list. Despite Ethiopia still being on the red list, the woman assumed she was in the clear because the GOV.UK website advised that “transiting passengers are exempt from the current quarantine restrictions for COVID-19”.

While in transit in Ethiopia, the former police officer was thrown off her connecting flight to London and told the only way she could get home would be if she paid up front for a quarantine hotel package at Heathrow and filled out a new red list passenger locator form. On arrival at Heathrow, “border force refused to accept their own Ethiopia specific guidance… Despite having travelled from an amber country, with proof of NHS issued vaccinations, and following FCDO issued advice, I find myself facing a £2,250 hotel bill simply because FCDO cannot issue coherent advice to its nationals or ensure that border force and immigration have clear guidance”.

Welcome to the post-Covid world, where you cannot travel between countries without a vaccine passport and even if you’ve got one you’ll be incarcerated in a quarantine ‘hotel’ anyway.