ENGLAND may once have been a nation of shopkeepers, but it is becoming a country of healthcare workers, with one in every twenty-three of the working population being employed by the NHS.

Almost 1.3 million people — or the combined populations of Birmingham and Coventry — work for the NHS, which is one of the world’s biggest employers.

Since 1997, the number of NHS staff has risen by nearly 230,000, with a record 59,000 people — enough to fill Old Trafford football stadium — joining last year alone.

According to the latest workforce census, the NHS employs 386,400 nurses — matching the entire population of Edinburgh — 109,000 doctors and 122,100 scientists and other therapists.

An extra 18,800 nurses were employed in 2003, up 5.1 per cent on the previous year, and there were 5,600 more doctors — an increase of 5.5 per cent. Although the number of managers rose by a relatively modest 3,000, this amounted to a 9.4 per cent increase in a year — almost double the growth rate in nurses’ numbers.

A total of 1,282,900 people in England have jobs with the NHS: 2 per cent of the 30 million people of working age.

Only the Chinese Army and the Indian State Railways are believed to employ more people — with 2.3 million and 1.5 million staff respectively — but both workforces represent a far smaller proportion of the national populations.

John Reid, the Health Secretary, said he was delighted with the growth, but added that he was aware that more action was needed to tackle existing staff shortages.

“The NHS has more doctors, nurses, scientists and therapists than ever before — as we promised in the NHS plan,” he said. “Despite the record increases in numbers of doctors and nurses this year, I know the NHS still struggles with shortages in some specialties and we all have a lot more to do. I can’t create skilled medical professionals overnight but the Government is putting in place the training places needed for the future.”

The figures come a day after a report into cancer services by the National Audit Office, the parliamentary watchdog, revealed that a shortage of diagnostic specialists was partly to blame for England’s poor cancer survival rates.

Mr Reid said that the “snapshot” census figures exploded the myth that everyone working in the NHS was a bureaucrat, with 84 per cent of NHS staff directly involved in patient care and managers only making up 3 per cent of the total workforce.

Half of all employees are fully qualified clinical staff, while 16 per cent provide support to keep hospitals and other NHS organisations running, such as cleaning, catering and IT.

Although NHS leaders vowed to continue the recruitment drive, one sector is scheduled to dwindle: the number of staff at the Department of Health is to be cut by a third in an attempt to make savings.

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