UK Hospitals accused of exploiting foreign doctors in fellowship schemes

An investigation by the British Medical Journal has accused UK hospitals of using foreign doctors who are a part of the fellowship schemes as “cheap labour” in which they are paid less than NHS trust employed doctors and are sent home if they become pregnant.

Foreign doctors come into the UK hospitals trust as fellows as part of the Academy of Medical Royal Colleges’ Medical Training Initiative.

They work for two years in the NHS (UK’s public healthcare system) to gain experience and return to their home countries.

Since it began in 2009, there have been 6,986 trainees through the scheme from countries including Nigeria, India, Pakistan, Saudi Arabia, Egypt and Sri Lanka.

The Investigation

In some hospital NHS trusts, fellows receive the same pay and benefits as trust-employed doctors (local doctors), but the British Medical Journal discovered that some hospital trusts like University Hospitals Birmingham (UHB) trust, Dudley Group NHS trust, and Walsall NHS trust have a specific agreement with the foreign country’s regulatory bodies for doctors, that fellows can be paid less than and have fewer benefits than trust-employed doctors.

Findings

Senior fellows who work at UHB as grade 3 registrars are paid £2700-£3600 a month by their home country’s regulatory body, the equivalent of £32,400-£43,200 tax-free a year. They are not guaranteed payment for overtime.

UHB would not confirm its payment to local doctors at the same grade but NHS pay scales show they are paid £55,328 this year as basic gross excluding overtime.

More findings

Under the UHB agreement, fellows do not get paid paternity leave. This is after an incident in 2017 when UHB terminated the contract of a fellow who got pregnant.

The doctor described her experience to the British Medical Journal as traumatic. She was sent home when she got pregnant.

What She Said

• “I was not the priority and that the trust’s trainees and trust grade doctors were the priority.”
• I was told, ‘You are just to cover the clinics and on-calls.”
• “There was no enhanced payment for on-call or weekend work.”
• “One lady from the international team seemed angry and said, ‘We don’t expect you guys to get pregnant while you’re here,’ and that my fellowship would be terminated. It was a shock to me how she spoke.”

Responses so far

A consultant who works with the UHB told the British Medical Journal anonymously that it uses fellows as cheap labour.

Michael Newman, an employment lawyer at Leigh Day called the scheme exploitative and says that terminating a fellow because she got pregnant is outrageous.

Foreign doctor’s regulatory bodies like the College of Physicians and Surgeons Pakistan have said they would review and rewrite their guidelines.

Another UHB spokesperson said the program benefits the NHS and the overseas healthcare system.

Dudley Group said they do not directly employ these foreign doctors so they are not responsible for their remuneration, and they haven’t received any complaints from their fellows.

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