How Nigerian doctors, other foreigners are ‘exploited’ in UK —BBC investigation

NIGERIAN doctors recruited to practice in the United Kingdom (UK) are being professionally exploited, a report put together by the British Broadcasting Corporation (BBC) has claimed. 

In the BBC report by Paul Kenyon and Anna Meisel, the medium disclosed that the doctors are being overworked to the detriment of patients. 

There is also the possibility of laws being broken in the recruitment process, as being handled by a British healthcare company. 

The report states, “A BBC investigation has found evidence that doctors from Nigeria are being recruited by a British healthcare company and expected to work in private hospitals under conditions not allowed in the National Health Service (NHS).” 

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The British Medical Association (BMA) was quoted describing the situation as shocking, saying the sector needed to be brought in line with NHS working practices. 

BBC claimed it spoke to several foreign doctors, “including a young Nigerian doctor who worked at the private Nuffield Health Leeds Hospital in 2021. Augustine Enekwechi says his hours were extreme – on-call 24 hours a day for a week at a time – and that he was unable to leave the hospital grounds. He says working there felt like being in a prison. The tiredness was so intense, he says, there were times he worried he couldn’t properly function.” 

The report also quoted the Nigerian doctor as saying, “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.” 

Augustine’s employer, Nuffield Health, reportedly countered his claim. 

The firm, according to the report, said doctors are offered regular breaks, time-off between shifts and the ability to swap shifts if needed, adding that “the health and well-being of patients and hospital team members is its priority.” 

Augustine’s employment history showed he was hired out to the Nuffield Health Leeds Hospital from a private company – NES Healthcare, which specialises in employing doctors from overseas, many from Nigeria and using them as Resident Medical Officers, or RMOs – live-in doctors found mainly in the private sector. 

He allegedly told the investigators that he was so excited to be offered a job that he barely looked at the NES contract, which was said to have opted him out of legislation that protects UK workers from excessive working hours – the Working Time Directive – and left him vulnerable to a range of punishing salary deductions. 

The news medium said it also got exclusive access to the findings of a questionnaire put to 188 Resident Medical Officers. 

Most of the doctors were reportedly employed by NES but some were with other employers. It found that 92 per cent had been recruited from Africa and most – 81 per cent – were from Nigeria. The majority complained about excessive working hours and unfair salary deductions. The World Health Organisation (WHO) has warned against the “active recruitment” of doctors and nurses from developing countries with severe shortages of medical personnel. 

The global body has also compiled a list of 47 such countries – most of them in Africa. 

The UK government has incorporated that list into its own code of practice, calling it the “red list”. 

In effect, it makes Nigeria a no-go destination for British medical recruiters. Despite the inclusion of Nigeria on the red list, BBC said it found out in an exam hall in Lagos, hundreds of doctors queuing to take what’s called a Professional and Linguistic Assessments Board test – or PLAB 1. 

The paper is set by the General Medical Council in London and is the first step required by the British medical authorities to secure a licence to work in the UK. 

The doctors spoken to, according to the report, said they were attracted by the potential of higher salaries and better working conditions, with the event being overseen by staff from the British Council – an organisation sponsored by the Foreign Office. 

The GMC also offers the examination in other red-list countries, like Ghana, Sudan, Pakistan and Bangladesh. 

Both the GMC and British Council reportedly denied involvement in active recruitment. 

Another doctor from Nigeria, Dr Femi Johnson, was quoted as saying “It’s not humanly possible to do that every day for seven days,” talking about the allegedly punishing work schedule. Dr Johnson works at a different hospital to Augustine’s but alleged that he was also expected to work 14 to 16- hour days and then be on-call overnight. 

“I was burnt out. I was tired, I needed sleep. It’s not humanly possible to do that every day for seven days,” the report quoted him as saying. 

Another dimension to his plight is that if he took a break because he was too exhausted to continue, NES is entitled to deduct money from his salary which the company said was to cover the cost of finding a replacement doctor. 

“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 reportedly lamented. 

Dr Jenny Vaughan from the Doctors’ Association was quoted as saying, “This is a slave-type work. 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.” Countering the claims, NES Healthcare said “our feedback about doctors’ experiences” with the company was “extremely positive.” 

It said, it provides doctors “with a safe and supportive route to pursue their career choice in the NHS and in the UK healthcare system more generally and that their work is of “great benefit to the British public.” 

NES further said it is not a recruitment agency and only engages with doctors from overseas once they have already committed to practising in the UK.

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