When Boris Johnson was fighting for breath in intensive care, two nurses in particular earned his seemingly undying gratitude. Jenny McGee was originally from New Zealand, and Luis Pitarma from Portugal. Both risked their lives to work on Britain’s Covid frontline, and the prime minister later marvelled at the dedication with which they watched over him “every second of the night”. But words are cheap; it’s action that counts. Which brings us to the Tory peer Dido Harding, fresh from presiding over the chaos of track and trace, and her audacious application to follow that by taking over the running of the NHS in England. Crucially, her pitch for the job reportedly includes a pledge to stop relying on overseas-born doctors and nurses and train British-born replacements instead. Short of stringing up a banner reading “Go Home, Foreigners!” outside every hospital, it’s hard to think of a bigger kick in the teeth for the 14% of NHS staff who weren’t born in Britain and who will have arrived for work this morning, presumably wondering which of the patients whose lives they may save today would secretly prefer they weren’t here. After a traumatic year fighting Covid, their reward is seemingly to become pawns in a game that can only embolden racist patients. It’s hard to know for certain whether all this is part of a shockingly politicised public campaign for the job, or a leak designed to damage Harding by uniting NHS staff against her. But either way, it’s playing with fire. Running NHS England isn’t some cushy part-time quango job, to be dished out like a campaign medal for service in the Brexit wars, but a job on which millions of lives depend. Its outgoing chief executive, Simon Stevens, brought to the job a lifetime’s experience, gained first within hospital trusts and second by running health policy inside a Labour government. He is also one of the smartest political operators I’ve ever met. Harding, meanwhile, is a former telecoms boss turned chair of the quango NHS Improvement, hand-picked by her friend Matt Hancock to run a £37bn test-and-trace scheme that has failed to make a measurable difference to the path of the pandemic or prevent further lockdowns, according to parliament’s public accounts select committee. She’s far from the only author of that failure. But it’s easy to see why she might prefer to talk up her ideological closeness to Downing Street – which has grown increasingly irritated with the independent-minded Stevens – rather than her track record. For anyone working in an overstretched service that would collapse without its 170,000 overseas-born staff, however, all this beggars belief. An expansion of the homegrown NHS workforce is actually already under way, following plans laid by Jeremy Hunt when he was health secretary, enabling the Tories to promise in their last manifesto to recruit 50,000 new nurses and 6,000 new GPs. But if they can’t hold on to the NHS staff they already have in the meantime, they might as well be pouring water into a colander. Before Covid hit, NHS trust chiefs worried about the prospect of a post-Brexit exodus among European staff. Now they fear pandemic burnout and disillusionment, too. McGee resigned this May, saying she was sick of nurses “not getting the respect and now pay that we deserve”, and a recent Royal College of Nursing survey found one in three respondents were considering leaving nursing. Pharmacists, public health directors, nursing assistants and a host of other healthcare professions are already in such short supply they’ve been added to the Home Office’s shortage occupation list, while around 24,000 overseas health and care workers whose visas would otherwise have expired over the past year have been offered free extensions in recognition that we couldn’t have got through the pandemic without them. A new fast-track NHS visa scheme has attracted thousands of recruits so far, but how many will want to come to a country publicly trumpeting its desire to get rid of them as soon as possible? Whether what has been reported is a fair summation of Harding’s bid to run the NHS or an attempt to undermine her, Downing Street needs to make clear now where it actually stands. If anyone in government still cares about reality, rather than pandering to populist fantasy, they should treat nativist messages like this with the public contempt they deserve. Gaby Hinsliff is a Guardian columnist