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Friday, 28 July 2006 09:25

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The NHS could be exploiting developing countries

Dr Mahmood Bhutta, a specialist registrar in otolaryngology at Guy's and St Thomas' Hospital in London, claims that the NHS could be exploiting developing countries who produce medical equipment.

Writing in the British Medical Journal, he said: "No systematic investigation has been undertaken into the sourcing of healthcare goods used in the developed world.

"When these have come from manufacturers in the developing world then, as is the case with other goods, the trade may be open to the exploitation of power by transnational companies, driving down prices and labour standards."

Dr Bhutta said the global trade in hand-held stainless steel surgical instruments was worth at least £352 million a year and many of these instruments were made by firms in Europe and Asia.

The two largest producers were Tuttlingen in Germany and Sialkot in Pakistan.

Dr Bhutta said: "Manufacturers of surgical instruments in Sialkot need to minimise costs to remain competitive.

"To reduce overheads, most firms subcontract the initial production of instruments to workers employed in a small workshop or their own home, with finishing and quality checking of the product in house.

"Manufacturing firms in Pakistan, however, rarely have the infrastructure or marketing presence to allow direct trade with the end users in the destination countries. Most therefore sell to suppliers and retailers in the developed world with only a small profit margin."

Dr Bhutta said more could be done and that the solution lay "in purchasers insisting on fair and ethical trade when sourcing instruments".