How ethical is immigration?

I'm neither a fruitcake or a closet racist: I hate currants and one of my best friends is Welsh. But there's a bit of the immigration debate I don't hear a lot about.

During my time in Darlington I knew a chap whose job included travelling around Europe recruiting NHS nurses from other countries. If you've been treated by a Spanish nurse in the NE, that's probably his doing. I'm grateful, truly I am. There is rumoured to be one ethnically British NHS dentist operating somewhere in the country, our treatment has come from Romanians, Portuguese, and someone whose nationality we haven't quite made out yet. Our local hospital relies heavily on consultants and nursing staff from overseas, as do local nursing homes. We'd be in a mess without them.

But how ethical is this whole set up? Is it fair that other countries pay for the training of 1/3 of our consultants, and then we poach them with the offer of better salaries? 2 out of 5 NHS nurses were born abroad, is it really right that they are practicing here, rather than in India, the Philippines, Eastern Europe? Or is it ok that the countries which can bid the highest, get the workers, no matter who has paid for the training, or what the needs are in their home countries.

We can be rightly proud of hitting the target of 0.7% of Gross National Income being spent on overseas aid. But do we give with one hand and take with the other?

Now it may be that there is a massive global surplus of medical staff, and we are simply doing our bit to make sure that they don't languish on Hungarian dole queues, or ending up serving in the New Delhi Macdonalds. If so, please put me right.

If that means a shortage, there's one place to start looking immediately for trained staff. The market for cosmetic surgery grew 17% last year. Here are hundreds of surgeons and nurses squandering their training and talents on vanity and marketed procedures to conform to media portrayals of 'beauty'. Tony Campolo relates the story of a doctor friend who was employed doing breast enhancements for women. "Without thinking what I was saying, I asked him 'but on judgement day, what are you going to present before the Lord?' " (The guy had originally wanted to become a doctor to save children overseas from dying)

How do we justify stripping poorer countries of their trained medical staff to make up for shortfalls in the NHS, when some of those could be filled by the medical training and gifts currently squandered on vanity surgery? I hope nobody in UKIP has had botox or a boob job.