THE Government is to overhaul the code of practice governing the recruitment of nurses from overseas amid accusations that NHS managers are “human trafficking” to fill vital health service jobs.

John Reid, the Health Secretary, said that employment agencies bringing in staff from abroad would be subject to much tighter ethical rules to stop the exploitation of developing countries that are losing key health workers to Britain.

Speaking at the annual congress of the Royal College of Nursing (RCN), Mr Reid defended the mass recruitment of foreigners to fill nursing jobs, but said that the Government was determined to close loopholes in the current system, including introducing greater scrutiny of the private health sector.

The current code of practice for the hiring of nurses from abroad, introduced in 2001, bans recruitment from 150 of the world’s poorest countries, including South Africa, Brazil, India and Ghana. The rules do not apply to independent health providers, however, and many nurses from banned countries end up working in the NHS after transferring from the private sector.

Mr Reid said the code had already had a significant impact. “However, we want to ensure we make it even stronger by clearing up any ambiguities, so that those organisations that provide overseas staff recruit only from countries whose governments feel they are not short-staffed with nurses.”

Senior nurses and NHS managers expressed growing concern yesterday over increasing numbers of nurses brought in from developing countries to meet the Department of Health’s staffing targets. Of the 80,000 new nurses registered in Britain since 2001, almost half have come from overseas.

Speaking in an RCN debate on international recruitment at the congress in Harrogate, Sandra James, a clinical nurse manager, said that ethical issues were being forgotten in the drive to meet the targets.

Describing how she had visited the Philippines to recruit nurses, Ms James said: “This is all about money. Let’s not con ourselves. I found myself asking myself what I was doing and whether I was doing anything different from the people who do people trafficking. It really bugs me. I had a crisis of conscience.”

Thomas Keighley, a nurse adviser to the European Commission, said: “My concern is that we are projecting a health service that we cannot staff. I think there is an issue of honesty — about how much of the service we are offering we can really provide.”

Lena Masondo, a nurse from Johannesburg now working for the Salford Royal Hospitals NHS Trust in Greater Manchester, said that she had initially been drawn by the financial incentives of a private nursing job in Britain, before transferring to the NHS.

“My salary is almost triple what it was in South Africa,” she said. “I now send it back to my family. It is not nice to leave a young son and the country of your birth, but I felt that it was important for me to go.”

Thembka Gwagwa, chief officer of the South African Nurses Association, said that emigration was causing severe problems for her country’s health service, which is short of more than 1,000 nurses and losing about 300 a month. Many were being attracted to Britain and Saudi Arabia by huge salaries and other perks.

“The recruiters know they are going too far,” she said. “As long as they make money they don’t care what they are doing to the state of the healthcare of our nation.”

Beverly Malone, general secretary of the RCN, accepted that the nursing organisation had a role to play in the processing of nurses’ registrations. She added that it was vital for inspectorates such as the Healthcare Commission to help to scrutinise the recruitment of foreign staff by private health providers. “We need to see urgent action to prevent recruiters from the UK from targeting countries that can ill afford to lose their experienced nursing staff, but we can achieve this only by extending the Government’s ethical guidelines to all employers across the UK,” she said.

The nursing shortage is being aggravated by “aggressive strategies” by American agencies to poach British nurses, the RCN congress was told. Barbara Nicholls, chief executive of the US-based Commission on Graduates for Foreign Nursing Schools, said that American hospitals would pay a £15,000 bounty for British nurses.

Mrs Nicholls said that many were not British citizens but had registered as nurses in the UK to use it as a stepping stone to the US.

Last year more than 2,200 nurses emigrated from the UK to work in America, attracted by higher salaries and better working conditions.

Opposition politicians said that findings from the RCN, which show that nearly half of all new entrants to the UK’s nursing register came from overseas, must act as a warning to the Government.

Paul Burstow, the Liberal Democrat Shadow Health Secretary, said: “Overseas recruitment is the Government’s sticking-plaster solution to the nurse recruitment problem.

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