Some Nigerian physicians hired to work in UK hospitals have expressed regret amid claims of exploitation and excessive workload.
According to a BBC investigation, a British healthcare corporation is hiring Nigerian physicians and expecting them to serve in private hospitals under circumstances that are not permitted by the National Health Service.
The situation has been called “awful” by the British Medical Association (BMA), who also stated that the sector has to be brought in line with NHS working procedures.
Augustine Enekwechi, a young Nigerian physician who worked at the exclusive Nuffield Health Leeds Hospital in 2021, disclosed that his hours were extremely long; he was on call twenty-four hours a day for a week at a time. He also said he can’t leave the hospital, which makes him feel terrible
Nigerian doctors recruited to work in UK hospitals lament
Augustine added that there are times he became worried he couldn’t properly function. He said;
“I knew that working tired puts the patients at risk and puts myself also at risk, as well for litigation.
“I felt powerless… helpless, you know, constant stress and thinking something could go wrong.”
However, according to Nuffield Health, doctors are given regular breaks, time off in between shifts, and the option to switch shifts if necessary. The business states that its top focus is “the health and wellness of patients and healthcare team members.”
Augustine was leased from a private enterprise, NES Healthcare, to the Nuffield Health Leeds Hospital. It specializes in using foreign doctors, many of whom are from Nigeria, as Resident Medical Officers, or RMOs—live-in physicians who are most frequently found in the private sector.
Augustine claims that he hardly even glanced at the NES contract since he was so thrilled to be given a job. In fact, it disqualified him from the Working Time Directive, which safeguards UK workers from excessive working hours, and left him without protection.
The results of a survey conducted to 188 Resident Medical Officers were made exclusively available to the BBC’s File on 4 and Newsnight by the BMA and the primary lobbying body, the Doctors’ Association. Although some of the doctors worked for other companies, NES employed the majority of them.
It was discovered that 81% of those hired had come from Nigeria and that 92% had come from Africa. The bulk of complaints were to unjustified compensation deductions and excessive working hours.
The World Health Organization (WHO) has cautioned against the “active recruitment” of physicians and nurses from underdeveloped nations (mostly in Africa) where there is a severe shortage of medical professionals, but the UK government has also incorporated that list into its own code of practice, dubbed the “red list.” In essence, it prevents British medical recruiters from traveling to Nigeria.
It was learned that Nigerian doctors are selected using the Professional and Linguistic Assessments Board test, also known as PLAB 1. The exam, administered by the General Medical Council in London, is the first step needed to obtain a license to practice medicine in the UK.
The Nigerian doctors who spoke with the news agency claimed that the possibility of higher pay and better working conditions lured them in. Staff from the British Council, an organization supported by the Foreign Office, were in charge of overseeing the event.
Ghana, Sudan, Pakistan, and Bangladesh are among the other nations on the “Red List” where the GMC also administers the tests.
Both the GMC and the British Council assert that they are not engaged in “active recruitment” and are merely assisting in the provision of a service for physicians seeking to travel independently to the UK, which is permitted under the regulations.
In Augustine’s instance, NES Healthcare reached him while he was in the UK studying for the second portion of the PLAB tests, and later offered to sponsor his visa and provide him with a job.
Even though it seems like there was “active recruitment,” NES claims it wasn’t since it isn’t a recruitment agency and only contacts foreign doctors who have already decided to work in the UK. The UK code of practice did, however, extend to NES, hence the corporation was in violation of it, the Department of Health and Social Care informed BBC.
Several African doctors that NES had in this way hired spoke with us. After being rented out to private UK hospitals, they all related anecdotes concerning what the clauses of their contracts actually meant.
Another victim who BBC spoke to is Dr Femi Johnson was sent to a different hospital to Augustine. He said he was also expected to work 14 to 16-hour days and then be on call overnight. “I was burnt out,” he says. “I was tired, I needed sleep. It’s not humanly possible to do that every day for seven days.”
Nigerian doctors recruited to work in UK hospitals lament
But when he needed a break because he was too exhausted to continue, NES were entitled to deduct money from his salary. The company says that is to cover the cost of finding a replacement doctor, but Femi says it leaves NES doctors in a terrible dilemma.
“In situations like that, I always make that internal discussion with my inner self, ‘Femi are you doing right by yourself and are you doing right by the patient?'” he told BBC. “Unfortunately, I haven’t always been able to answer that question.”
The Doctors’ Association’s Dr. Jenny Vaughan has provided assistance to several NES physicians. She claims that the UK healthcare system has split into two tiers, one for NHS doctors and the other for foreign recruitment working in the commercial sector, and that she hears numerous complaints from resident medical officers about this.
NHS doctors can only be scheduled to work up to 48 hours per week, or 72 hours per week if they so choose.
Dr Vaughan said;
“No doctor in the NHS does more than four nights consecutively because we know that it’s frankly not safe.
“This is a slave-type work with… excess hours, the like of which we thought had been gone 30 years ago.
“It is not acceptable for patients for patient-safety reasons. It is not acceptable for doctors.?“
The findings were taken to the BMA, and its deputy chair, Emma Runswick, said the situation is a “disgrace to UK medicine”.
Runswick said;
“Our international colleagues have come a long way to the UK, and have found conditions so exploitative it beggars belief.”
NES Healthcare also said that the “feedback about doctors’ experiences” with the company was “extremely positive”. It also claimed that it provides doctors “with a safe and supportive route to pursue their career choice in the National Health Service, and in the UK healthcare system more generally, and that their work is of “great benefit to the British public.”
