International recruitment

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  • UK poaching nurses at expense of poor nations. John Carvel, social affairs editor Guardian Thursday May 16, 2002
  • Go-ahead for foreign staff to cut NHS waiting lists.  John Carvel, social affairs editor Guardian Friday June 7, 2002
  • Milburn offers Europe slice of NHS.  Guardian Tuesday June 25, 2002
  • Milburn woos foreign health firms to UK.  John Carvel, social affairs editor Wednesday June 26, 2002 The Guardian
  • Alarm as US woos nurses from NHS.  Recruitment war puts at risk 'import' of hospital staff.  John Carvel, social affairs editor Guardian Thursday July 18, 2002
  • The first wave of foreign surgeons making flying visits to cut NHS waiting lists under a scheme to process 2,000 patients this summer met Alan Milburn, the health secretary, yesterday.  Guardian Wednesday July 31, 2002
  • Stop poaching. We must respect Africa's health needs. Leader Sunday August 10, 2003 The Observer
  • The government today signed an agreement to bring South African healthcare staff to the UK for set periods. Helene Mulholland Friday October 24, 2003
  • Britain signed an agreement with South Africa yesterday in an attempt to stop doctors and nurses from South Africa's hard-pressed hospitals filling vacancies in the NHS. John Carvel, social affairs editor Saturday October 25, 2003 The Guardian
  • Britain is refusing to sign a code of good practice agreed by 22 Commonwealth countries to stop the poaching of nurses across international borders, it emerged yesterday. John Reid, the health secretary, promised this week to do all he could to avoid damaging the health services of developing countries when recruiting overseas nurses to fill vacancies in the NHS. John Carvel, social affairs editor Friday May 14, 2004 The Guardian
  • Foundation hospitals in England are to be exempt from NHS rules banning the poaching of nurses and other medical staff from developing countries, a confidential Department of Health document has revealed. A draft code of practice seen by the Guardian says foundation trusts will be treated like private hospitals and merely "invited" to adopt ethical recruitment policies, without any sanction if they choose to ignore them. For other NHS organisations - and UK employment agencies that supply them with staff - the rules will be compulsory. John Carvel, social affairs editor Monday July 26, 2004 The Guardian
  • Unions have today reacted with astonishment at the "shameful" u-turn on poaching nurses from developing countries, just two months after the health secretary, John Reid, pledged to strengthen the code of conduct on ethical recruitment. The erosion of the code of conduct on international recruitment comes as hospitals with foundation status are to be exempt from a statutory obligation to adhere to the guidance. Hélène Mulholland Monday July 26, 2004
  • A crackdown on British hospitals poaching nurses from developing nations is to be launched this week after warnings that Aids-stricken African countries are being stripped of vital staff. Ministers will admit that a ban on NHS recruitment from poorer countries, introduced three years ago on ethical grounds, is being flouted. More than 1,300 nurses arrived in Britain last year from South Africa, with another 500 coming from Nigeria. Gaby Hinsliff, chief political correspondent Sunday August 22, 2004 The Observer
  • The government promised yesterday to close loopholes that have allowed NHS hospitals to poach thousands of nurses and doctors from developing countries with a shortage of medical staff. John Hutton, the health minister, said he would stop NHS organisations evading a code of practice that was brought in three years ago to stop unethical recruitment. But the Royal College of Nursing said the problem would not be solved unless the ban was extended to the private sector. John Carvel, social affairs editor Thursday August 26, 2004 The Guardian
  • The Department of Health's proposals on the recruitment of health workers (Minister to close loopholes, August 26) from the world's poorest countries are an improvement, but still ignore the main issue. Domestic agendas are overriding the need to tackle poverty. We should manage migration in a way that puts the needs of poor countries first. Letters Friday August 27, 2004 The Guardian
  • The government recognises that it is unethical to poach nurses from sub-Saharan Africa. But kind words alone won't cure this problem. John Carvel Friday August 27, 2004 The Guardian
  • We already have a largely untapped nursing workforce in this country, in the form of refugee nurses (Nil by mouth, August 27). This is a workforce desperate to make a professional contribution to healthcare in the country that has given them sanctuary. They have had to move on from often very distressing, life-threatening situations - they are not benefit cheats, they are benefit bringers. In July, the Refugee Nurses' Task Force launched its strategy and acknowledged the good practice of a small number of "centres of excellence" (mainly in London) where refugee nurses are being successfully assimilated into the workforce. The health minister, John Hutton, agreed that these examples need to be replicated more widely. Why can't we work smart here instead of raiding our less well to do global neighbours? Letters Monday August 30, 2004 The Guardian
  • The number of nurses who left the UK to work in America more than doubled last year, prompting concerns of an impending exodus and a deterioration in patient care. There are also fears that the NHS, which has become increasingly reliant on the controversial policy of poaching recruits from developing nations to address its critical shortage of nursing staff, may be struggling to retain its foreign recruits as well as its home-grown professionals. Lorna Martin Sunday October 31, 2004 The Observer
  • Nurses' leaders warned last night that the expansion of the NHS was "built on sand", relying too much on the recruitment of overseas and temporary staff who may quit at short notice. The Royal College of Nursing said its annual survey of the NHS labour market had found that the nursing and midwifery workforce in England had grown by 16% to 292,000 over the past four years, exceeding government targets. But this was largely achieved by recruiting foreign nurses - notably from the Philippines, India and South Africa - and increasing the use of casual staff. John Carvel, social affairs editor Monday November 1, 2004 The Guardian
  • The NHS has recruited dentists from Poland and Spain as part of its promise to boost dentist numbers by 1,000 for next October, health minister Rosie Winterton has announced. The first 30 dentists from Poland, which joined the European Union in May, are due to arrive in the UK in January, she told MPs yesterday. Dentists have also been recruited from Spain and are already working in the NHS, she said. Other dentists who have trained outside the European Union and are waiting to take the international qualifying examination to allow them to practise in the UK, should be offered an NHS dentist post by the end of the year, she told MPs. Debbie Andalo Wednesday November 3, 2004
  • Two hundred Polish dentists will join the NHS over the next year as part of an overseas recruitment drive to plug the gaps in state-funded provision across England. James Meikle, health correspondent Friday November 19, 2004 The Guardian
  • The NHS is to move around 400 jobs to India to save costs as part of a part-privatisation of its back-office accounting and purchasing division. IT services firm Xansa is taking a 50% stake in a Government agency that does purchasing and accounting on behalf of the NHS. The firm has guaranteed to cut costs by 20%, potentially saving the NHS £220m over 10 years. Heather Tomlinson Tuesday November 23, 2004 The Guardian
  • Latest figures from the British Medical Association (BMA) show that the number of refugee doctors living in the UK has topped 1,000 for the first time. There are now nearly 10 times as many medically qualified refugees on the BMA's database as there were three years ago. In May 2001, there were just 110, but numbers have been rising steadily. An overstretched NHS could benefit greatly from the skills of medically qualified refugees if the system for recruiting them is improved, the BMA claims. Mary O'Hara Wednesday December 1, 2004 The Guardian
  • A crackdown on hospitals and care homes poaching nurses from developing countries was announced by the government yesterday after pressure from the nursing unions. John Hutton, the health minister, said he would close a loophole that allowed NHS hospitals to evade controls by recruiting overseas nurses and therapists on temporary contracts. He has also secured agreement from the leading private hospitals, homes and recruitment agencies to stop active recruitment in South Africa and other developing countries with shortages of medical staff. John Carvel, social affairs editor Thursday December 9, 2004 The Guardian
  • The government's attempt to stop hospitals and care homes poaching nurses from developing countries is being thwarted by private recruitment agencies, the Royal College of Nursing said last night. A letter from the Recruitment and Employment Federation, (REC) which represents 250 nursing agencies, shows that they are refusing to sign the code of ethical conduct designed to stop active recruitment of medical staff from poorer countries which are themselves short of nurses and doctors. The letter, of which the Guardian has seen a leaked copy, was sent to the health secretary, John Reid, on December 8, two days before he closed loopholes to stop NHS hospitals in England recruiting overseas staff as temporary locums. John Carvel, social affairs editor Thursday December 30, 2004 The Guardian
  • Why Britain needs help from overseas. There is widespread agreement that Britain suffers from a shortage of trained nurses, and that this problem is likely to worsen. Saturday February 5, 2005 The Guardian
  • Overseas doctors who come to the UK looking for work often face months of unemployment, it emerged today. More than a third (36%) of international medical graduates who qualified to practice in the UK in June 2003 were still jobless six months later, according to the British Medical Journal's careers website. Friday February 11, 2005
  • Sri Lanka - still recovering from the devastation of December's tsunami - has accused Britain of undermining its already embattled health service by failing to prevent hospitals luring away trained doctors and nurses to work in the UK. Jason Burke in Colombo Sunday February 13, 2005 The Observer
  • Concern over nurses' code. February 23 2005
  • Doctors' leaders last night accused Britain and the US of causing a medical emergency in the developing world by poaching healthcare workers from countries struggling to cope with the HIV/Aids epidemic. John Carvel, social affairs editor Wednesday May 11, 2005 The Guardian
  • The British Medical Association is right to warn about the shortage of health workers in a number of developing countries (BMA's poaching crisis warning, May 11). That's why we have strengthened the Department of Health code of practice on international recruitment of healthcare professionals, which ensures that the NHS does not actively recruit health workers from any developing countries unless there is a government-to-government agreement. Letter from Hilary Benn, Secretary of State for International Development, Friday May 13, 2005 The Guardian
  • Poaching doctors and nurses from poorer countries will have dire consequences, says Malcolm Dean. Wednesday May 18, 2005 The Guardian
  • The UK is playing a pivotal role in stripping English-speaking sub-Saharan Africa of its doctors and nurses, says a report published today. The Department of Health forbids the NHS from recruiting from countries struggling to treat sicker populations. The code of practice does not cover private hospitals and agencies, although the health minister John Hutton said last August it would be tightened. Sarah Boseley, health editor Friday May 27, 2005 The Guardian
  • Nurses from the Philippines, the main source of overseas recruitment to the NHS, have started to shun Britain in favour of higher-paid and less stressful jobs becoming available in the US. John Carvel, social affairs editor Wednesday June 8, 2005 The Guardian
  • The world's hospital. A few days in an NHS ward show you what we in Europe are struggling to defend. Timothy Garton Ash Thursday June 16, 2005 The Guardian
  • Doctors' and nurses' organisations yesterday called on the G8 leaders to stop the haemorrhage of healthcare staff from poor countries who are recruited to fill gaps in the developed world.  Sarah Boseley, health editor Saturday June 18, 2005 The Guardian
  • The leader of Britain's 120,000 doctors called on Tony Blair and George Bush yesterday to end their countries' "obscene exploitation" of the developing world through the poaching of scarce medical staff.  John Carvel, social affairs editor Tuesday June 28, 2005 The Guardian
  • Africa's health sector needs more resources, but preventing skilled workers from coming to Britain won't help resolve that, says Salil Tripathi. Tuesday August 9, 2005
  • Olu Obaro is a consultant radiologist. He is Nigerian, he trained to be a doctor in Nigeria and Nigeria would dearly love to have kept him. But Obaro works here, in the NHS, and with each year that goes by, thousands more doctors leave Africa to join him. The fact is that the NHS would collapse without them. With the poaching of overseas doctors rapidly developing into a political hot potato, we interviewed Obaro and two other doctors who left Africa to work in Britain - and visited the hospitals they left behind. Friday November 18, 2005 The Guardian
  • Your article (Out of Africa, G2, November 18) reminds us of the enormous debt the NHS owes to some of the poorest countries in the world. It is vital that the NHS puts something back - and that's exactly what a growing number of hospitals and NHS trusts across the UK are doing through voluntary links with their counterparts in Africa and elsewhere.  Letter in The Guardian Monday November 21, 2005 The Guardian
  • Thousands of nurses and midwives are still being poached from the world's poorest countries to work in the UK in spite of government attempts to restrict recruitment by private agencies, the Guardian can reveal. The Liberal Democrat MP Andrew George said yesterday that the government's failure to seal a loophole in the code of practice that is intended to stop recruitment from Africa and other underdeveloped countries was undermining efforts to fight Aids, tuberculosis and other epidemic diseases. The impact of losing trained medical staff can be huge for poor countries that have high burdens of disease and chronically understaffed hospitals. Sarah Boseley, health editor Tuesday December 20, 2005 The Guardian
  • Ethical guidelines to stop hospitals poaching nurses from the poorest countries are being ignored by private recruiting agencies, the Royal College of Nursing warns. The college highlighted figures posted yesterday on the website of the NHS Employers' organisation, showing that only 140 of the 800 agencies supplying temporary staff to hospitals and nursing homes had agreed to comply with the government's ethical code. John Carvel, social affairs editor Wednesday January 4, 2006 The Guardian
  • Admin staff in passage to India. East and North Hertfordshire trust, which has forecast an £18.9m debt by the end of the year, is outsourcing its typing and administration work, including typing up patient notes and medical records - traditionally jobs done by specialist medical secretaries. The trust is seeking bids from companies in India and South Africa. Summary by Keep our NHS Public of Health Service Journal 2 February 2006
  • Overseas doctors have vital NHS role.  Letters Wednesday April 19, 2006 The Guardian
  • Hundreds of international doctors will demonstrate against Government immigration rules that stop them working in the UK. Under changes announced last month, all doctors from outside the EU will only be eligible to take up NHS work if the post cannot be filled by a UK resident. The Joint Council for the Welfare of Immigrants (JCWI) estimates that about 15,000 overseas doctors will be stranded in the UK with few employment prospects as a result of the change. Friday April 21, 2006 7:28 AM
  • Hundreds of overseas doctors yesterday demonstrated outside the Department of Health over an abrupt change in the immigration rules which will force many of them to quit the UK. Around 10,000 to 15,000 doctors, mostly from the Indian subcontinent but also from Africa, are working in British hospitals while training to become specialists or are looking for jobs in order to do so. But last month the government announced that any UK or EU applicant, even if not as well qualified, must have priority over doctors from elsewhere. The vast majority of overseas doctors training to get a specialist qualification take one six-month contract after another. Without a job and the work permit that goes with it, thousands of doctors who are moving from one post to another while they train will have to leave the UK. Sarah Boseley, health editor Saturday April 22, 2006 The Guardian
  • Hospital sends admin to India. Medical secretarial work at Nuneaton's cash-strapped George Eliot Hospital is being sent to India's cheaper labour market to be processed. Worried secretarial staff in Nuneaton fear their jobs are now on the line. One said: "We were called in by our manager to be told that, with effect from May 1 all typing work in ophthalmology, obstetrics and gynaecology will be sent to India, initially for a three-month trial. This is aimed at saving money, but we know that it will be extended beyond a trial and lead to redundancies." Summary by Keep our NHS Public of  Coventry Evening Telegraph 24 April 2006
  • Nurse exodus leaves Kenya in crisis. Poor pay and lack of jobs are forcing workers to abandon their country's health service to seek work in the UK, reports Tracy McVeigh in Nairobi. Sunday May 21, 2006 The Observer
  • Export fears over N&N's patient notes. Fears have surfaced over Norfolk and Norwich University Hospital's proposed plan to move vital clerical jobs to India. The hospital, which faces a £15m deficit and a possible 450 redundancies, is considering out-sourcing medical note administration overseas. East and North Herts NHS Trust also plans to cut 50 medical secretary jobs and move typing of medical notes to India. Some have voiced fears that the move could lead to dangerous errors. Small but possibly risky mistakes have already been noticed: In one case hypertension (high blood pressure) was written as hypotension (low blood pressure). Unison have pointed out that picking up these errors may be almost as time consuming as typing them in the first place and, without enough medical secretaries, the load may fall on medical staff. Unison representatives have voiced concerns over the trend across the country towards over-seas outsourcing of medical notes, and strike action is being talked of. Summary by Keep our NHS Public of  Eastern Daily Press 18 May 2006
  • Thousands of international nurses are to be banned from working in the UK to improve the chances of homegrown candidates getting a job, the government announced yesterday. The vast majority of overseas nurses will no longer be able to get work permits unless NHS trusts can prove they are unable to fill the posts with candidates trained in the European Economic Area or the UK.  Sarah Hall, health correspondent Tuesday July 4, 2006 The Guardian
  • Ministers "sacrificing careers of foreign nurses" to solve financial crisis in NHS. The government ban on international recruitment of nurses is being described as a cynical attempt to solve NHS deficits. The ban, which will initially affect the two most junior nursing grades, is expected to see a sharp drop in the 12,000 overseas nurses recruited each year. Beverly Malone, general secretary of the Royal College of Nursing, attacked the government for turning foreign nurses into "scapegoats for the current deficits crisis." She rebutted the government's claim that the extra nurses were no longer needed: "Over 150,000 nurses are due to retire in the next five to ten years and we will not replace them with home-grown nurses alone." The health minister, Lord Warner, claimed that, due to extra investment in training, there was no longer a need to hire junior nurses from abroad. Summary by Keep our NHS Public of Independent 4 July 2006
  • Manufacturers of surgical implements in Pakistan use child labour and subject their workers to sweatshop conditions, according to an article by a surgeon in the British Medical Journal. He argues that the NHS should do more to ensure the products it uses are fairly traded.James Randerson Friday July 28, 2006 The Guardian
  • Hospital work being sent abroad. TWO Birmingham hospitals were today criticised for sending confidential patient notes thousands of miles across the world to be typed up. University Hospital Trust, which runs Selly Oak and Queen Elizabeth NHS hospitals, is the first Birmingham trust to outsource its administrative work abroad - to India, New Zealand and South Africa. Hospital chiefs revealed the move was cheaper and quicker than doing it in the UK. But angry health watchdogs said jobs should have been created in Birmingham instead and possible typing errors could put patients' lives at risk. Errors at other hospitals across the country have been revealed including the word malignant confused with non-malign (the first a cancerous growth, the latter a benign one), septic confused with aseptic (the first meaning infected, the second clean) and -ectomy with -octomy (the former requiring removal, the latter meaning an incision). A handful of hospitals nationwide are starting to use private dictaphone companies who pay as little as 44p an hour to get overseas workers to transcribe doctors' notes and email them back to hospitals. Summary by Keep our NHS Public of Birmingham Mail 3 August 2006
  • "Errors" fear for patients. A package of cuts to services at Nottingham's hospitals has elicited anger from unions over plans to have medical notes typed up overseas. Dave Prentis, General Secretary of public sector union Unison said: "Lives are being put at risk by hospitals desperate to save money. Trusts are being wooed by companies promising free trials and pilots and huge financial savings if they allow medical typing abroad." Queens Medical Centre and Nottingham City Hospital have announced the loss of 123 medical secretary posts as they struggle to make up a £60m shortfall. One local mother whose son is to undergo an operation at the hospital next month said the move worried her. She pointed out that "the medical secretary I have been dealing with knows me and my son's history. It is the human contact that is important." She also voiced fears over the quality of outsourced notes with easily confusable terms such as hypo and hyper. Mr Prentis said: "The consequences of typing errors are too frightening to contemplate. Medical secretaries in the NHS work to 99.8% accuracy targets and once 'phased out' their knowledge and expertise will be lost forever." Summary by Keep our NHS Public of Nottingham Evening Post 7 August 2006
  • Foreign nurse clampdown comes in. Restrictions on international nurse recruitment have come into force in the NHS in England. The government says the health service no longer needs to recruit from overseas to meet health service needs. But the change comes as nurse leaders warn up to 70% of newly qualified nurses cannot find jobs in the health service. And university leaders warn planned cuts in training budgets could lead to shortages of nurses in the future. Nurse training is paid for out of regional NHS budgets. In 2004-05 the national average cost of tuition to train a nurse was £19,740. There are warnings that there might be too few nurses in the future. The Council of Deans warns the planned cutbacks in nurse training budgets for this academic year will have a long-term impact. Summary by Keep our NHS Public of BBC Online 14 August 2006
  • Migrant workers account for almost half of new NHS dentists, according to a report published yesterday. But concerns over a shortage of dentists working in the NHS persist, as the figures were compiled before controversial new contracts led some to quit the service. The data, from the Information Centre for health and social care, was released amid growing calls to block open access for Romanian and Bulgarian workers when their countries join the EU. Tania Branigan and Sarah Hall Thursday August 24, 2006 The Guardian
  • Jobs anger hits streets. 60 Medical secretaries whose jobs are under threat have staged a protest outside Queen's Medical Centre in Nottingham. Their protest attracted the support of passers by and they were joined in solidarity by consultants. Hospital bosses in Nottingham plan to axe 1,184 posts in order to make £60m in savings. The cuts will include 120 medical secretary posts to be replaced by typing pools, possibly based abroad. Many have already voiced fears over the loss of medical secretary expertise, particularly when notes are outsourced overseas where small but vital mistakes may be more likely to occur. Kevin Gibbon, a consultant in the medical centre's ear nose and throat department, warned: "Day-to-day telephone contact with patients will be lost. Delays and mistakes will happen." Brain surgeon Richard Ashpole said: "People do not realise how important they are. But as a neurosurgeon, my job involves complex vocabulary and a secretary needs to be highly trained to work with that." Summary by Keep our NHS Public of Nottingham Evening Post 28 August 2006
  • Anger as Leeds hospital jobs go to India. Medical secretaries at Leeds hospitals are being axed and their work sent to India. Around 60 specialist posts will go as the typing of treatment notes and letters is outsourced in a move saving up to £1m a year. Hospital bosses in Leeds are grappling with debts of £84m. The plans have been fiercely criticised by union leaders and MPs who fear lives could be put at risk. Dave Prentis, general secretary of Unison, said serious mistakes had been uncovered at hospitals which had already tried sending work abroad. Mr Prentis said: "Patients' medical records must be absolutely up to date and accurate. The consequences of typing errors are too frightening to contemplate." Leeds East MP George Mudie said: "I am very worried about the security of sending patient information overseas especially as we know that hackers can get into anything on the internet. Also medical secretaries are highly trained in their areas. If there are any queries, they are usually in the same building as the doctor to be able to check. That can't and won't happen if the person typing is in India or anywhere else." Medical secretaries at St James's and Leeds General hospitals earn around £20,000 a year. Workers in India can earn as little as 44p an hour. Medical secretary vacancies across Leeds Teaching Hospitals NHS Trust have been frozen in advance of the project and the trust is advertising for a private firm to co-ordinate it. Summary by Keep our NHS Public of Yorkshire Evening Post 7 September 2006
  • Anger over NHS-notes-abroad plan. Hospital workers in Sussex say plans to send patient notes and letters to South Africa or India to be typed could lead to deaths if mistakes are made. Managers at Brighton and Sussex University Hospitals NHS Trust say the plan could save more than £1m a year as well as clearing a backlog of typing. "We don't believe it is in patients' interests," said Mark Sargent from public service union Unison. Staff have already been consulted about a trial of medical secretarial services, which took place with two companies in South Africa and India. An internal NHS document, seen by the BBC, said the trial was a success but admits the accuracy of a company in India was "variable". It gives an example of one mistake where hypertension and hypotension were mixed up. "If in listening to dictation you hear hypertension and type hypotension - one meaning high blood pressure, the other low - the treatment could be incorrect and the outcome could be death for the patient," said medical secretary Elaine Bass. If it goes ahead it would reduce local staffing by up to 70 jobs. Summary by Keep our NHS Public of BBC Online 20 September 2006
  • Hospital jobs 'may go to India or United States'. Hospital staff say hundreds of local jobs could be threatened by the outsourcing of secretarial work to foreign workers in India or the United States. Fears that the Oxford Radcliffe Hospitals NHS Trust might transfer a hefty slice of clerical and administration work overseas has raised the spectre of a second wave of NHS redundancies in Oxfordshire. In the West Country hospital workers are threatening industrial action to stop redundancies because of the Royal Cornwall Hospitals Trust's plans to send typing work abroad. Unison this week called for a campaign to resist any outsourcing moves, saying up to 500 jobs at the John Radcliffe, Churchill, Radcliffe Infirmary and Horton in Banbury could be affected, with medical secretaries, personal assistants and audio typists seen as vulnerable. In a message to its members Unison's Oxfordshire health branch warns: "The trust is right to be concerned how its staff could react. Members are already coming forward to say if outsourcing takes place they want to take action just like their counterparts at the Royal Cornwall Hospital." With rumours circulating that an outsourcing deal with the US-owned company Dictate IT was being lined up, Unison officials called on the trust to "come clean". The ORH trust is well into the process of shedding 600 jobs across its hospitals, along with 160 beds. Summary by Keep our NHS Public of BBC Oxford Times 6 October 2006
  • Investigated firm in NHS pilot. Bedford Hospital is planning to outsource transcription services to a company which is being sued for billing fraud and is under investigation by US authorities. The hospital is running a pilot using transcription service MedQuist. If the pilot is successful, the hospital's pool of medical secretaries will be reduced from 60 to 22. MedQuist is currently facing a class action from US governmental hospitals and medical centres, which allege the company overcharged for transcription services. Summary by Keep our NHS Public of Hospital Doctor 19 October 2006
  • Error warning on letters from India. A hospital which has outsourced transcription of consultant letters to India is warning GPs that correspondence they receive from one of its departments will not be checked for errors. Royal Surrey County Hospital's department of breast, general and melanoma surgery is piloting the move in order to save time. GPs have described the move as 'extraordinary'. Medical defence bodies said that as GPs had been warned the letters may contain errors, they had a duty to make proper checks themselves. Dr John Williams, a GP in Guildford, Surrey, said the situation was 'bizarre'. He said: 'When you're dealing with people who have had lumps and are worried about the results and want to get them back quickly and reliably - what an extraordinary thing to do.' Summary by Keep our NHS Public of Pulse 14 December 2006
  • Your doctors don't want to be GPs, says Italian paid £3,200. An Italian doctor who was paid £3,200 for five days' work in Scotland said that foreign GPs were in demand because their British counterparts regarded it as "an awful job" and wanted to be consultants. Dr Bertollo said: "From the £3,200, you have to deduct English tax, and then divide it by the number of hours I worked. I will be lucky to get £13.50 an hour for working on Christmas Day. There are hundreds of advertisements here in Italy for doctors to go to the UK, and there are hundreds of English agencies hiring doctors," he said. NHS contracts, introduced two years ago, allow doctors to refuse "out-of-hours" duties in exchange for a reduction in pay. The move has created a market for European doctors in the UK and thousands are believed to commute from France, Germany and Poland. Summary by Keep our NHS Public of Telegraph 4 January 2007
  • Healthcare outsourcing now $300m biz, growing at 150%. Outsourcing in the healthcare sector is booming in India - from low-end claims processing and medical transcription to medical analytics and clinical processing. The bulk of outsourcing is from the US while some work comes also from the UK and the Middle East. Summary by Keep our NHS Public of India Times 8 January 2007
  • Hospital send patient notes via Africa to save cash. Confidential patients' records are secretly being sent halfway around the world in a penny-pinching move by the Royal Berkshire Hospital to save cash on medical secretaries. Personal details are now being processed in South Africa by a cut-price global transcribing service. Meanwhile highly-qualified and experienced medical secretaries are losing their jobs or being shunted into relatively menial roles with minimal responsibilities. Sources inside the hospital say patients' treatment is being delayed because South African workers with little command of English are taking so long to transcribe vital information contained in consultants' letters from a dictaphone. The letters then have to be sent back to Reading and posted out to patients and their GPs across Berkshire. Letters are taking up to 10 days to be returned to the hospital, a delay which can spell real danger for a patient needing treatment. A 46-year-old medical secretary, who asked not to be named, said: "I know of one case where a patient's treatment was delayed two weeks because of the time it took to get his results and it ended up being very serious. People are not getting their test results back in time, so the patients come back angry and we get the brunt of it. You have to lie to them if they ring up, and say there is a backlog of work or a secretary is off sick. It is not in my nature to lie and I hate doing it. It is cheaper for the hospital because it only costs £12,000 a year, rather than the price of three secretaries. It is all target-driven and the consultants just do what they are told." Unison said medical secretaries across the country have lost their jobs because patients' details are being sent to India, South Africa, China and the Philippines. Unison's regional head of health for the south east Steve Brazier said: "Staff positions in the south east are under threat. It is a very short-sighted issue and is finance-driven rather than patient-driven. With details being sent abroad, it leaves things open to misinterpretation and misunderstanding and it is not being done for the best interest of the patients. We are trying to lobby all around the country. But the main issue is with the Government and Department of Health and there needs to be a decision change." Summary by Keep our NHS Public of Reading Chronicle 12 January 2007
  • The system wasn't 'completely clean' but it is now, says hospital boss. Royal Berkshire Hospital chairman Colin Maclean has acted to reassure patients that the confidentiality of their medical records is not at risk from sending them to South Africa to be transcribed. But Mr Maclean admitted that the hospital was not "completely clean" and that the system has produced errors. The Royal Berks is using a cut-price global transcription service to save cash on medical secretaries. Mr Maclean confirmed that a patient's initials, NHS number, date of birth and details of their condition are on the notes now being processed in South Africa and India. Mr Maclean admits that he has found "a couple of issues" involving instances where a patient's first name was used. He said that using typists with poor command of English was not a problem because any mistakes will be picked up by the medical secretary and consultant before the letter goes out. Sources inside the hospital say highly-qualified and experienced medical secretaries are being shunted sideways into relatively menial roles with minimal responsibilities. But one RBH secretary said last night: "I know two of my consultants who put the patient's full name. It is happening. The letters come back after seven to 10 days. That's just normal and patients are waiting. Mr Maclean also didn't mention that last year there was a massive walk-out when medical secretaries were downgraded to a more basic role. He seems to have a very short memory." And the woman added: "I am surprised by what he said. But then it's all for the benefit of the hospital not the patient." Summary by Keep our NHS Public of Reading Chronicle 19 January 2007
  • Hospital notes are sent out to India. A second Staffordshire hospital has started sending doctors' notes to India to be typed up to tackle a growing backlog of paperwork. The Haywood Hospital in Burslem turned to the sub-continent after failing to replace two medical secretaries who left last summer. Remaining staff have been left so overworked by the mountain of typing that a number have gone off sick. Now Stoke-on-Trent Primary Care Trust, which runs the hospital, has taken up an offer to send the notes to India electronically to be typed up overnight and returned to the hospital the following day. But union leaders rounded on the decision, saying it undermined the NHS workforce in North Staffordshire and represented more "creeping privatisation" of the service. The project is being offered free of charge during a month-long experiment, which started last week. Officials from the PCT's Unison union branch said they were opposed to outsourcing by the NHS. Spokesman Geoff Wilson said: "The fact it is India is irrelevant - we would be against this if it were Ireland, Argentina, or a private company in Staffordshire." Summary by Keep our NHS Public of Stoke Sentinel 5 February 2007
  • NHS to export accounting jobs to India. The NHS is to export hundreds of clerical jobs to India. Peter Coates, deputy director of finance at the Department of Health, said that as many as two thirds of NHS accounting and finance functions would be outsourced, with much of the work being done in India. "I recently gave permission to outsource 60 per cent of the work to India," Mr Coates told a conference in Bombay. "It could go higher, but the constraint is that we cannot move jobs to India at the expense of shedding jobs in the UK. Politics will be an important factor." Unison, the NHS staff union, was taken aback by the announcement. "It is extraordinary that the NHS is making major announcements of this sort abroad when it should be talking to staff here first," Karen Jennings, head of health, said. "We obviously want to get more details because we would be very concerned if more jobs were threatened." In 2004 the NHS set up a joint venture with Xansa, the leading outsourcing company, which has since grown rapidly. So far 142 NHS trusts are signed up, £15 billion in payments are being processed per year, achieving savings of 32 per cent, according to the joint venture, NHS Shared Business Services (SBS). Xansa's original NHS contract stipulated that the venture could only source up to 37 per cent of its work from India. The Government's change of heart in December reflects the growing pressure to cut NHS costs. Summary by Keep our NHS Public of Times 9 February 2007
  • Nurses leave for Australia in thousands as NHS halts recruitment. Thousands of nurses are leaving Britain to work abroad after being headhunted by international recruitment teams. Hospitals and nursing agencies in Australia and other countries are encouraging British health workers to emigrate in an attempt to capitalise on a shortage of jobs in the NHS, the country's top nurse has said. Many local NHS trusts have imposed a recruitment freeze as the health service struggles to balance its books before the end of the financial year. An estimated 20,000 nursing posts have been cut in hospitals and surgeries across the country, leaving many newly qualified nurses out of work. Peter Carter, the new general secretary of the Royal College of Nursing, described the situation as shambolic, saying that he knew of nearly 100 nurses from the West Midlands alone who left to work in Australia this week. This is despite an anticipated shortfall of 14,000 trained nurses in the NHS by 2010, he said. Last year, about 3,000 nurses and midwives left Britain to work in Australia - more than double the number making the same trip ten years ago - making it the most popular destination for the 8,000 nurses who emigrated to work abroad. Dr Carter said that Britain was facing a "massive skills shortage" as a result of the Government's "yo-yo work-force planning" and predicted that British hospitals would soon have to recruit nurses from abroad to make up staff numbers. About 180,000 British nurses are due to retire over the next ten years, according to a leaked government report last month. Summary by Keep our NHS Public of Times 17 February 2007
  • Foreign doctors could be forced to leave. Thousands of foreign doctors who came to Britain to work in the NHS could be forced home, after the High Court backed the government's controversial decision to change the rules on immigration. The decision means hospitals must prove that vacant posts could not be filled by British or European Union practitioners before they recommend foreign doctors for work permits.  Jo Revill, health editor Sunday February 18, 2007 The Observer
  • Effective eye treatments - at home and abroad. In a letter to the Guardian, Simon Kelly, a consultant ophthalmic surgeon, writes: "Nigel Crisp's report to the prime minster on the UK contribution to health in developing countries (Report, February 13) should help us see Africa's healthcare problems and offer some solutions. Private sector surgeons and nurses from South Africa are doing rather nicely here in independent sector treatment centres - paid for by the NHS - while ministers and rock stars worry about health and poverty in Africa. Ophthalmic personnel from South Africa come here on lucrative short breaks to undertake NHS cataract surgery in ISTCs. This costs UK taxpayers more than if local NHS services undertook the same work. The irony is that there is a backlog of public sector patients blind from untreated cataracts or for want of spectacles in South Africa. Meanwhile, NHS eye departments are suffering from disinvestment due to this resource reallocation to the private health provider from South Africa, while schemes such as the National Refractive Error Program for South Africa are supported by international agencies and gift aid. Surely local eye healthcare staff are more needed in Africa than in ISTCs. Our needless mobile cataract units would be ideal for Africa's eye care. Perhaps Nigel Crisp would agree that such ophthalmic equipment not needed by NHS could be sent overseas ?" Summary by Keep our NHS Public of Guardian 19 February 2007
  • Scans being sent to South Africa. Hospital bosses are sending cancer scans to South Africa - because of a lack of experts here. Patients face a fraught two-day wait to see if they need treatment as the MRI tests are checked in Johannesburg. It would take just two hours to do the readings at Worcestershire Royal Hospital. One angry patient said: "Why couldn't the hospital employ someone here to study the scan straight away ?" Hospital chiefs blamed a lack of British radiographers. A spokesman said: "The NHS contract with Alliance Medical which has access to radiologists overseas has helped cut waiting times." But The Society and College of Radiographers found half of 34 Midlands hospitals had frozen vacancies or cut jobs. Dr Steve Eldridge who worked at the Queen's Medical Centre in Nottingham, said students he knew who trained as radiographers had spent months on the dole because there wasn't the money to take them on. The trade union Unison yesterday called for a probe into "obscene" profits made from the NHS by firms. Summary by Keep our NHS Public of Mirror 19 February 2007
  • Britain to Explore Opportunities in Bengal Medical Sector. The British Healthcare Mission, a seven-member delegation visiting Kolkata, is exploring opportunities in the healthcare sector of West Bengal. The team comprises five British medical service companies. Kevin McCole, deputy head of British Deputy High Commission, Kolkata, said Britain's National Health Service (NHS) with an annual budget of $100 billion is also interested to go for PPP ventures with the Indian healthcare system and talks were on with the Indian government and the Planning Commission. He said: "The seminar was held for exploring opportunities of partnership between India and the UK healthcare sector. We are interested to invest in the healthcare services like medical equipment, in knowledge sharing of the recent development in the medical sector, genetic disorder services in Kolkata, medical software, training and overall into the public-private partnership venture". Parminder Sunda, one of the members of the delegation, said that several healthcare organisations of Indian origin were also queuing up to set up hospitals in Britain. "Almost 20 to 30 organisations have already approached us but nothing has been finalised so far," said Sunda. "Since we have limited resources we are welcoming other organisations to come and set up their medical units in the UK," Sunda added. Apollo Gleneagles Hospitals has already been granted permission to establish its new hospital in Britain. The five companies, which have come to Kolkata for exploring trade investment opportunities, are also going for joint ventures in India. Summary by Keep our NHS Public of MedIndia 6 March 2007
  • Hospital work may be switched to the Far East. Administrative work carried out by a Merseyside hospital trust could be done in the Far East under plans to save money. Southport & Ormskirk NHS Trust has admitted the idea is among the options it is looking at to make cost savings and improve the efficiency of its services. However, unions are warning such a move could put patients' lives at risk. In December last year, Unison held a one-day conference aimed at fighting the outsourcing of NHS medical secretaries, saying that hospitals were being 'aggressively targeted' by private companies. A report from Unison steward and medical secretary Susan Parkinson stated: 'Thousands of patients' lives could be put at risk because a growing number of hospitals are sending medical notes abroad for typing. The consequences of typing errors are too frightening to contemplate - for example the difference between hypertension and hypotension can be a matter of life or death. Medical secretaries in the NHS work to 99. 8% accuracy targets and if their services are out- sourced and their roles phased out their knowledge and expertise will be lost forever.' Preventing further job losses at the Trust was part of the reason given for a raise in its car parking charges by 50pc to £3 per visit in January this year. Last October, it was announced that the trust's historic debt of £14m was being written off by the Merseyside and Cheshire Strategic Health Authority in an effort to help the hospitals prepare to apply for foundation trust status in 2008 in line with Government targets. Summary by Keep our NHS Public of Liverpool Daily Post 31 March 2007
  • Switching medical records to India 'could cost lives'. Union leaders have warned that plans to out-source medical record typing at Southport and Ormskirk NHS Trust to India may put patient care at risk. Staff and patients are demanding that the work remain "in-house" with trained medical secretaries instead of being passed on to those with little or no medical experience. Kathy Perkins, chairman of the British Society of Medical Secretaries said: "Inevitably there will be a patient death directly attributable to the wrongful interpretation of a crucial word or drug dosage by an out sourced worker unfamiliar with the language or terminology. This will cause an outcry and the emphasis will shift back to requiring medical transcription by trained medical secretaries. But the damage will have been done. The majority of medical secretaries will either have been made redundant or left the service." British medical secretaries aim for 99.8% accuracy in transcriptions. Southport's Liberal Democrat MP John Pugh said: "The one thing there needs to be in any good hospital is a close connection between the administrative and the clerical staff. If you have them in two different places, on different continents then it's going to be very hard to achieve. It has been shown that the hospitals who make best use of their resources are the ones where there is a transparent and open dialogue between clerical and clinical staff. If the hospital goes ahead with these plans, they will be inviting major potential problems." Clare Vattev, business manager at the Trust said: "The Trust is currently reviewing its secretarial functions with a view to improving both the efficiency and timeliness of its communications. As part of this work, we will be looking at a number of options and the use of digital dictation and out-sourced transcribing may be considered." Summary by Keep our NHS Public of Liverpool Daily Post 10 April 2007
  • Hospitals rule out extra checks on foreign recruits. No extra vetting of overseas doctors and medical students was being contemplated yesterday by hospitals or the Department of Health in spite of reports linking the recent terrorist car bomb attacks to health service staff. The Department of Health insisted vetting was the business of the employers, namely the hospitals offering short-term contracts to overseas doctors. The employers said the checks already in place are extensive. The vetting, however, focuses on medical qualifications, identity and the applicant's criminal record. There is little scope for picking up radicalisation, militancy or revolutionary tendencies. The NHS Employers said in a statement that hospital management teams "carry out rigorous checks before they appoint any member of staff, including verification of identity, qualifications, registration and eligibility to work in the UK. The nature of their work means that staff are dealing with people who are vulnerable and we need to be confident that patients are safe". But there was clear unease at the idea of singling out the overseas doctors for new scrutiny. There are more than 80,000 in Britain. Sarah Boseley, health editor Wednesday July 4, 2007 The Guardian
  • Foreign doctors face NHS jobs crackdown. An urgent review of how NHS doctors are recruited from overseas was announced by Gordon Brown on Wednesday. The investigation was ordered after eight suspects with links to the health service were held over failed car bomb attacks on London and Glasgow. It is part of a series of measures intended to defeat terrorism which were announced by Mr Brown during his first session of Prime Minister's Questions.  Metro Wednesday, July 4, 2007
  • Brown orders review of recruitment checks on NHS overseas staff. An urgent review of recruitment checks on overseas staff working in the NHS is to be launched by the new counter-terrorism minister Admiral Sir Alan West, Gordon Brown announced yesterday, in the wake of the revelations that all eight suspects in the London and Glasgow terror bombings worked in the health service. News of the review, unveiled at Mr Brown's first prime minister's questions, caught the Home Office and the Department of Health off guard, suggesting it was a last-minute decision. Nearly 90,000 doctors in the UK qualified overseas, and, after changes last year, most are now securing jobs by obtaining work permits. As many as 28,000 Indian doctors are registered as fit to practise in Britain by the main regulatory overseer, the General Medical Council. Mr Brown also announced he would tighten background checks on workers coming into the country under the highly skilled migrant workers programme. He said: "When people sponsor them, we will ask them to give our background checks." Ministers say they will flag up potential terror suspects using profiling based on information gathered in recent investigations. They say it is now possible to build up a picture, using certain attributes, to identify those who are potential threats. Patrick Wintour Thursday July 5, 2007 The Guardian
  • NHS's overseas doctors left stunned and fearful. Just last month, a senior Iraqi doctor wrote a report for the all-party commission on Iraq detailing the deaths and kidnapping of Iraqi intellectuals and calling for pressure on the Home Office to stop turning away Iraqi doctors wanting to work in the UK. Senior doctors fear this week may have wrecked any hope of that. Arab and Indian doctors, who have given great service to the NHS over the years, are dismayed and apprehensive for their future in the UK. The government had already made it harder for them to get jobs in Britain by imposing new visa requirements last April and giving priority to applicants from Europe. Now overseas doctors fear getting specialist medical training in the UK - once the gold standard in many countries - will become tougher still. Sarah Boseley, health editor Saturday July 7, 2007 The Guardian
  • Health watchdog blames botched operations on foreign doctors hired by clinics without vetting. Ministers are to be warned this week that independent clinics set up to take the pressure off mainstream NHS hospitals are responsible for unacceptable levels of mistakes. A report by health watchdogs will say clinics that rely heavily on foreign doctors have been responsible for a number of botched operations that had to be rectified by mainstream hospitals. The Department of Health was warned three and a half years ago about failing to screen foreign doctors working in clinics carrying out surgery for the NHS. Inquiries into botched operations in independent surgical clinics revealed worrying weaknesses in the vetting of overseas practitioners and prompted senior NHS staff to demand a review of vetting procedures at the end of 2003. Almost four in 10 doctors registered to work in the UK qualified overseas, coming from 150 different countries. Government reports suggest there will be a shortage of 1,000 doctors and over 14,000 nurses by 2010. A report by the medical watchdog, the Healthcare Commission, is likely to highlight not only the cost of NHS clinics set up to perform quick operations, but also the standard of operations carried out in them. The Independent Sector Treatment Centres (ISTCS), which are staffed by a high proportion of doctors from abroad, have led to negligence cases involving medics whose backgrounds haven't been fully scrutinised. ISTCS were part of Tony Blair's flagship NHS reforms designed to cut waiting times. Set up within the NHS, they were meant to take the pressure off hospitals and perform procedures such as shoulder, hip and knee operations. Lawyers representing patients suffering from faulty hip and knee replacements say claims on doctors' CVs were not properly checked, and that the NHS was warned of the vetting problems in 2003 after several botched operations. Sandra Patton, a lawyer with Kester Cunningham John, represented one patient who suffered a bungled operation performed by a foreign doctor who was referring to a textbook as he operated. "We have been concerned for some time about the standards of screening and recruitment of overseas surgeons, and have sought to bring the Government's attention to these issues. "My client believes that had their doctor been properly screened, they would not find themselves in the position they are today, left with permanent disabilities." Summary by Keep our NHS Public of Independent 15 July 2007
  • "Records will stay". The outsourcing of medical record typing to the Philippines by Hull and East Yorkshire NHS Trust has been scrapped after the trust said that a pilot scheme had raised concerns about cost. Staff had opposed the move over worries about jobs and possible inaccuracies. The trust did not say whether there had been any errors, but said it had decided that it made more sense to spend money on in house technology instead. David Haire, director of planning, said: "Whenever you outsource something you have to pay for a contract, and if we had out-sourced all of our work it would have worked out more expensive line for line than doing it in-house." He added that the trust was looking for a company to provide the software to enable existing staff to utilise voice recognition, and that any changes would not lead to redundancies with any jobs shed through "natural wastage". Unison branch secretary and Hull Royal Infirmary nurse Thelma Gray said: "The medical secretaries seem to be happy with the decision. We are pleased the service is being kept in-house and from a patient point of view it means we can keep a better service going for them." Summary by Keep our NHS Public of Hull Daily Mail 1 August 2007

  • Visa rule changes put care homes on alert. Elderly people could be left without adequate care because changes to migration rules will create a "forced mass exodus" of thousands of overseas workers, an MP has warned. The new points-based system may prevent essential workers from renewing or gaining visas, according to the English Community Care Association, which represents residential homes. The Philippine embassy has told the government that it will have a particular impact on its nationals, who make up around 25,000 of the senior carers in Britain. Around 10% to 15% of those cannot apply for settlement or permanent residence status because they have been here for less than five years. Mark Pritchard, the Tory chairman of the all party group for the Philippines, said the changes could force the departure of thousands of Filipino workers. Tania Branigan, political correspondent Monday August 20, 2007 The Guardian

     

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Sheila Porter-Williams
Campaign for Health Service Democracy
Green Haven, Halfway Lane
Dunchurch
Rugby, Warwickshire CV22 6RD
sheilaCHSD@porter-williams.freeserve.co.uk