How do foreign staff view the NHS

By Jane Dreaper
Health correspondent, BBC News

Nurses from overseas have helped sustain the NHS

The NHS is Britain's biggest workforce and experts say immigration has helped sustain it at many hospitals in recent years.

The number of new health service staff who've come from eastern Europe is surprisingly small among the clinical professions - but countries such as India and the Philippines have been major contributors.

Last year more than 11,000 foreign-trained doctors, nurses and midwives registered to work in the UK although the numbers have slowed down considerably since earlier this decade.

Bradford has always been synonymous with ethnic diversity - but as with many parts of the UK, immigration has had a big recent impact.

One patient said it's like I just breezed in and didn't sweat it out. But I told him I had to pay for my education Angela Ward sister

At the Royal Infirmary in Bradford, only just over half the staff describe themselves as white British - and one of the significant other groups is Filipino nurses.

Among them is Lilibeth dela Fuente, who works on a ward where patients recover after being in intensive care.

Lilibeth said she cried every day when she first arrived, and it took time to adjust to the contrast from the private hospital where she'd previously worked.

She said: "When I first started here I was expecting high technology - thinking of what England would be like.

"But most of the machinery in the hospital in the Philippines is much more ahead of what I've seen here in the NHS. It felt like a downgrade."

Culture shock

Another staff nurse on the ward, Vincent Rios, values the fact that Bradford is compact and cheap.

"I would say there are big differences between us and British nurses, especially the culture.

"We look after the patients as though they were a part of our family, so maybe I could say we are more caring."

What I've noticed is the lack of initiative from the people themselves Tita Donna Halili Nurse

The accident and emergency unit in Bradford is one of the UK's busiest.

One of the sisters, Angela, paid tribute to her foreign recruits.

"They've been absolutely fantastic," she said. "They're excellent workers and they really muck in."

Although one member of the team said some patients could be "a bit obnoxious".

"They think that we just got here for free.

"One patient said it's like I just breezed in and didn't sweat it out. But I told him I had to pay for my education."

Immigration is a sensitive subject and many NHS hospitals said they were too busy to discuss this with the BBC.

But Bradford Royal Infirmary is proud of the welcome it's given its Filipino workers, including Catholic church services so they could get to know each other.

Tita Donna Halili, who works on a day surgery ward sometimes feels unsafe outside the hospital.

"I've experienced people shouting racist abuse at me on the way home from work.

"It wasn't good but I can't do anything about it. I just put it down to experience."

Her work in the NHS has led her to believe the system is overburdened.

"In other countries they won't give you free medical treatment at all," she said. "It's quite something, what the British people have.

"But I think some of them are abusing the system.

"The government has been helping people to improve their lives, with measures on smoking and obesity. But what I've noticed is the lack of initiative from the people themselves."