‘Exploited’ foreign doctors dey worry about risk to UK patients

Doctors wey dem employ from some of di world poorest kontris go work for UK hospitals dey complain of exploitation. Di doctors believe say di work too much and dey fear make dem no go put dia patient health at risk. One BBC investigation show evidence of how one British healthcare company dey employ doctors from Nigeria to work for private hospitals under conditions wey no dey allowed for di National Health Service. Di British Medical Association (BMA) don describe di situation as "shocking" and say di sector gatz dey in line wit NHS working practices. Di BBC don follow plenty foreign medics tok - including one young Nigerian doctor wey work for di private Nuffield Health Leeds Hospital for 2021. Augustine Enekwechi say im working hours dey extreme – im go dey on-call 24 hours a day for a week at a time – and im no fit leave di hospital grounds. E say to work for there be like "prison". E say di stress too much and sometimes e dey worry am say im fit no function properly. "I know say to dey work wen you don tire fit put di patients at risk and put myself also at risk, plus e dey against di law," e tok. "I feel powerless… helpless, you know, constant stress and I dey tink say something fit go wrong." WHO, Nuffield react on di mata Nuffield Health disagree wit di working hours, e say dem dey allow doctors take regular breaks, time off between shifts, and di ability to swap shifts if need dey. Di company add say “di health and wellbeing of patients and hospital team members" na dia priority. Na one private company – NES Healthcare hire Augustine give Nuffield Health Leeds Hospital. Dia specialty na to employ doctors from overseas, many from Nigeria, and use dem as Resident Medical Officers, or RMOs - live-in doctors wey plenty for di private sector. Augustine say im happy well-well wen dem offer am job and im no look di NES contract. In fact di contract no cover law wey protect UK workers from excessive working hours - di Working Time Directive - and e leave am to suffer punishing salary deductions. No be only Augustine dey for dis kain situation. Di BMA plus di front line lobbying group di Doctors' Association don give BBC File on 4 and Newsnight exclusive access to di findings of one questionnaire dem give188 Resident Medical Officers. Na NES employ some of these doctors, but some na oda employers recruit dem. Dem see say dem employ 92% from Africa and most - 81% - na from Nigeria. Most of dem complain about excessive working hours and unfair salary deductions. For years now, di World Health Organization (WHO) don warn against di "active recruitment" of doctors and nurses from developing countries wey get severe shortages of medical personnel. Di WHO bin compile list of 47 of such kontris - most of them na Africa. Di UK goment don combine di list into dia own code of practice – and e call am di "red list". In effect, e make Nigeria a no-go destination for British medical recruiters. Wetin di BBC Investigation reveal So how dis doctors take enta UK begin dey work in di first place? We travel go Nigeria and witness anoda troubling side to dis story. For inside one exam hall for Lagos, di kontri biggest city, we see hundreds of doctors wey queue to write something dem call di Professional and Linguistic Assessments Board test - or PLAB 1. Na General Medical Council for London dey set di paper. Na di first step wey di British medical authorities dey ask for to secure licence to work for di UK. Di doctors we follow tok say dem dey attracted by di potential of higher salaries and better working conditions. Na one staff from di British Council dey oversee di event - one organisation wey di Foreign Office dey sponsor. Di GMC dey also offer di exams for several oda red-list kontris like - Ghana, Sudan, Pakistan and Bangladesh. Both di GMC and British Council deny say dem no get hand for "active recruitment" and say wetin dem dey do na to provide service for doctors wey wan go UK independently - something wey dey allowed under di guidelines. Even though e appear to be "active recruitment" - NES say no be so because dem no be recruitment agency and, as such, dey only engage wit doctors from overseas once dem don already commit to practising for di UK. But di Department of Health and Social Care tell us say di UK code of practice dey apply to NES - so di company dey breach am. We follow plenty African doctors wey NES target tok. All of dem share similar stories about wetin di terms and conditions for dia contracts mean in reality, once dem hire dem out to private UK hospitals. Dem send Dr Femi Johnson go hospital wey dey different from Augustine own, but e say dem expect am to work 14 to 16-hour days and then he go be on call overnight. "I dey burnt out," he tok. "I tire, I need sleep. E no dey humanly possible to do dat every day for seven days." Wen e need a break because e don too tire to continue, NES dey entitled to deduct money from im salary. Di company say na to cover di cost of finding a replacement doctor, but Femi say e leave NES doctors for terrible dilemma. "In situations like that, I dey always ask myself - 'Femi wetin you dey do to yourself dey right and you dey do di right thing to your patient?'" e tell us. "Unfortunately, I no fit answer that question." Some NES doctors don receive help from Dr Jenny Vaughan from di Doctors' Association. She receive many complaints from Resident Medical Officers and say di UK healthcare system don break into two tiers - one for NHS doctors, di other for international recruits wey dey work for di private sector. NHS doctors can only be scheduled to work up to 48 hours, and if they request, up to 72 hours a week. "No doctor for di NHS dey do more than four nights consecutively because we know say e no dey safe," Dr Vaughan tok. "Dis na slave-type of work wit… excess hours, di type wey we reason say don end 30 years ago.” "E no dey acceptable for patients safety reasons. E no dey acceptable for doctors. " We cari our findings go di BMA - and di deputy chair, Emma Runswick. She tell us say di situation na "disgrace to UK medicine". "Our international colleagues don come a long way to di UK, and see say di conditions no good dat no dey fair." NES Healthcare tell us say our "feedback about doctors' experiences" wit di company dey “extremely positive". E say dem dey provide doctors "wit a safe and supportive route to pursue dia career choice for di National Health Service, and for di UK healthcare system more generally, plus dia work na of "great benefit to di British public."