Developing nations losing out as NHS accused of poaching specialists

While Britain is exporting low-grade jobs to India, the NHS is today accused of poaching top specialists from the sub-continent to shore up the health service.

Dubbed the "great brain robbery", overseas recruitment schemes launched by the NHS are targeting senior psychiatrists in India and luring them to Britain with promises of a UK consultant's salary and up to £46,000 in relocation and housing costs. Vikram Patel, a senior lecturer at the London School of Hygiene and Tropical Medicine, says that India has one psychiatrist per 300,000 population compared with one per 9,000 population in Britain. "Despite this inequality, the NHS has launched a scheme to recruit senior psychiatrists and other specialists from India and other developing countries," he says in the British Medical Journal. "This scheme will worsen the brain drain and inequities in global health unless it is linked with measures to enable the flow of doctors back to developing countries."

The allegation follows criticism that Britain is poaching nurses from the developing world. Figures published by the Nursing and Midwifery Council in May show 3,472 were hired last year from countries where direct recruitment by the NHS is banned. Most are hired by private agencies.

Dr Patel says that the opportunity to work in different countries is an important part of medical education and that there is "no place for creating new barriers to the movement of people". But he says developed countries have an ethical obligation to help doctors return to their country of origin, which has normally paid for their training. "In effect, the people of poor countries are paying for the health care of those who live in one of the richest," he said.

Dr Patel said that when he finished his training in psychiatry in the UK in 1992 there was no assistance for him return to India and his work in developing countries since has been funded by research grants.

In a response published in the BMJ, Debbie Mellor, head of NHS employment policy, says 304 doctors have been recruited from abroad, 82 of them from India, under separate schemes launched in August 2001 and February 2002.

She says: "We are committed not to recruit from a country if its government has any concerns ... and work only with recruitment agencies that comply with [our] code of practice."

Ms Mellor says the Indian Ministry of Health is "supportive of the opportunities we are offering doctors" and cites a parliamentary answer by the Minister of Health last July who said the "overall availability of doctors in India is sufficient".