Britain looks abroad for nurses

"This is really resulting in big shortages in South Africa," Dr. Marais says. "Sometimes we have to close operating theaters for a time and have to cancel operations like open heart surgery.

"We would like Britain to train [its] own nurses."

Increasing the number of nurses is at the heart of the Labour government's program, which pledged to recruit 80,00 nurses over a 10-year period to 2006.

Labour has staked its reputation on improving public services and reversing a generation of benign neglect in the NHS which has resulted in formidable waiting lists for operations and daily scare stories of primitive treatment at public hospitals.

The problem is that training nurses domestically takes at least four years.

The Geneva-based ICN says that it is too simplistic to just lambaste developed countries for poaching - some poorer countries actually have unemployed nurses who should be allowed to find work overseas.

But in Britain there are tens of thousands of qualified nurses who choose not to practice for reasons of low pay and grueling working conditions. That should be addressed before the government seeks to replace them with cheap foreign labor, says the council.

"It is not ethical to recruit nurses into a dysfunctional system," says Mireille Kingma, a consultant in nursing and health policy for the ICN.

The British government has set ethical rules preventing staff from being poached from developing countries that cannot afford to lose their nurses. But private recruitment "sharks" often ignore these guidelines, say experts.

Marais says recruitment companies often came to her hospital to snap up staff. Ms. Ranes says the Philippines has many organizations that specialize in bringing nurses to Western countries.

And not all of these treat their recruits fairly. Britain's RCN recently claimed that exploitation in the recruitment of foreign nurses was endemic, particularly in the private sector.

The RCN's senior employment relations adviser, Howard Catton, says that some foreign nurses have complained of poor pay, excessive fees to recruitment agencies, and even "slavery" in which they are doing menial chores well below their level of expertise.

"There is more than just an odd one or two nurses that have had bad experiences," he says.

One unhappy recruit is Mi, a Korean nurse who didn't want to give her surname. "I'm very disappointed with nursing in Britain," she says. "The general standard of nursing skills is much lower than in a Korean hospital. I'm going to stay one more year and then go home."

Back outside the children's ward at Kingston Hospital, Ranes agrees that many foreign nurses will not stay in Britain for ever.

"I'll still go back to Manila one day," she says, "but most Filipino nurses here eventually want to go to America. There are even better opportunities there."

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