Just over 10 years ago, in a major speech to a nursing conference in Brighton, Tony Blair promised to boost a desperately short-staffed NHS with 20,000 extra nurses.
Not even Blair, though, could claim to be able to magic up that many British nurses. Training takes at least three years so instead, the NHS began importing them in huge numbers from across the globe.
They came in droves, particularly from India and the Philippines, where hundreds of private nursing schools were set up to meet the new demand from the UK, and the US. Before long, every Philippine higher education institution had to have a nursing school or face closure from lack of business.
A multitude of recruitment agencies were spawned there too, offering to sort out job, travel and visas for nurses lured by the promise of a lucrative salary on the other side of the world.
A decade later, however, the picture is very different. Britain has retrenched. Cutbacks, coupled with the European Union's rules on free movement of labour, mean few nursing vacancies for anyone from outside Europe these days.
Yet in the Philippines the production line continues to roll. Last year an estimated 100,000 nurses were in training there, the vast majority attracted by false promises of jobs in the west.
Many of the country's recruitment agencies often employing British advisers are flirting with, if not flouting, the law, taking a fat fee for the promise of a job they cannot deliver.
False promises
One case, in particular, has gained national attention there. Two Britons, Simon Paice and Nicholas Vickers, have been charged along with four Filipinos with running an illegal, unlicensed recruitment agency and making false promises to clients, allegations they all deny.
Of the 50,000 or so nurses who qualified in the Philippines last year, no more than 13,000 are thought to have found a job abroad.
"That leaves 37,000 nurses who are qualified with a big uncertainty, as there is no shortage of nurses in this country," said Henk Bekedam, regional director of health service development at the World Health Organisation's Manila base.
While the word will, eventually, filter through to Filipino families that nursing in the UK is no longer a good option, Britain's training and recruitment policies for nurses make it likely that the same saga of raised, then dashed, expectations will happen again.
A review by Professor James Buchan of the 2010 labour market for the Royal College of Nursing encapsulated the UK's boom-and-bust approach to nurse education and recruitment.
According to the review, funding for training places is increased when there are shortages, and cut when the supply is good and the country is in economic difficulties.
Because it takes three years to produce a trained nurse in the UK, overseas recruitment surges to fill shortfalls, and then is slashed again.
In the early part of the last decade, between 10,000 and 16,000 international nurses were being added to the UK register. By 2009, that had dropped to 2,700.
Buchan talks of "the massive pendulum swing" in a 10-year period, from low-level international recruitment in the late 1990s to very high levels in the start of the 2000s following the Blair announcement, back down to low levels in recent years.
Now, in fact, the UK is losing nurses rather than importing them. Australia is the prime destination, followed by the US, New Zealand and Canada. In 2008, less than 200 Australian nurses registered to work in the UK, whereas more than 6,000 UK-registered nurses had their qualifications validated to move down under.
