NHS Foreign Worker Checks are Failing

A review of foreign staff recruitment in the NHS ordered after the Glasgow Airport terrorist attack found inaccurate record-keeping by health boards, it was revealed today.

The Government ordered the UK-wide checks after several of those arrested in connection with the June 30 incident were found to be doctors or trainee doctors. Audit Scotland said as of September 2007 the reported number of employees in NHS Scotland from outside the European Economic Area (EEA) was 1,161 - 89% were doctors or nurses. But the body said this was probably an underestimate as health boards had trouble providing accurate numbers.

Of the 1,161 identified, 945 were classified as being on a highly skilled migrant programme, with 72 working under the government's "Fresh Talent" scheme. The total also included five asylum seekers, and 45 of "other/unidentified immigration" status. The report said: "The NHS in Scotland does not have an accurate picture of the number of overseas staff employed.

"This means we are unable to give an assurance that the sample of personnel records we reviewed is representative.

"Our findings are therefore indicative only."

Health boards were asked to provide the number, and type of overseas staff currently employed, regardless of start date. The review found that not all staff information was held centrally, with manual records kept sometimes locally.

Pre-employment screening procedures at five NHS boards - Ayrshire and Arran, Grampian, Greater Glasgow and Clyde, Lanarkshire and Lothian - were also examined. The review found evidence of work permits for up to 98% staff in the sample checked. But seven cases were found with no evidence of identity checks, 24 with no evidence of work reference checks, and three apparent absences of checks on qualifications.

The report said: "These boards had similar procedures, and there is evidence of high compliance in the sample of personnel records we reviewed.

"However, because of uncertainty about the number of overseas staff it is not possible to place total reliance on these findings."

Audit Scotland has recommended that electronic employee records be prioritised, and that staff immigration status is included. Health boards should also follow the procedures outlined by the Criminal Records Bureau in obtaining overseas criminal record history. There are approximately 158,000 workers in NHS Scotland.

Responding to the report, Dr Peter Terry, chairman of BMA Scotland, said: "It is extremely unlikely that pre-employment checks would identify people who want to work in the NHS who might possibly commit terrorist acts in the future.

"Overseas doctors provide a significant contribution to the NHS in Scotland and I am pleased that this is recognised in the report."

He added: "The report suggests that current pre-employment checks are working well in NHS Scotland and it is not clear what added value the recommendations will deliver.

"Any changes to the existing procedures, however, should not increase the burden of bureaucracy or create delays for employing individuals from overseas."

The Scottish Government is currently revising its policy and guidance on pre-employment checks for overseas staff in the NHS. Liberal Democrat shadow health secretary Ross Finnie urged the Scottish Government to ensure that the bureaucratic burden on NHS staff was not unnecessarily increased.

Mr Finnie said: "I congratulate the NHS Boards on their high levels of compliance.

"I note that the Auditor General has made some procedural recommendations and I share the BMA's concerns that any changes should not increase the burden of bureaucracy on doctors or cause delays in employing healthcare staff from overseas.

"Healthcare professionals from overseas are a valuable resource to our NHS."

Health secretary Nicola Sturgeon said: "I was keen to have this work carried out in the wake of the terror attack on Glasgow Airport.

She added the Scottish Government, in conjunction with health boards, would consider the recommendations of the report and would ensure best practice was reflected in updated guidance on pre-employment checks for all staff - including those from overseas - it planned to publish next month.

Ms Sturgeon said: "Our revised guidance will state that health boards must try to obtain criminal record information in the pre-employment stage for all staff.

"If the staff member's country of origin is unable to provide such a check then the health board must carry out a risk assessment to determine whether or not the individual is safe to employ.

"Extensive records are held about NHS staff in Scotland and as an employer, the NHS must ensure that potential staff are eligible to work in this country."

And she said: "It is reassuring that Audit Scotland have reported that all five sample boards had high compliance with the key checks and that the report suggests current pre-employment checks are working well."

The Daily Record – November, 2007