Some doctors from overseas paid less than the NHS rate

It is alleged that several NHS hospitals are failing to pay doctors from abroad the same rates as UK staff.

The claim stems from a British Medical Journal investigation of a scheme that allows foreign doctors to work at English hospital trusts to gain experience. The doctors return to practise in their home countries after two years.

Researchers found that foreign trainees could be paid several thousand pounds less than UK-trained junior doctors employed by the NHS, and did not receive the same levels of overtime pay.

Since the Medical Training Initiative scheme, run by the Academy of Medical Royal Colleges, begun in 2009 there have been about 7,000 trainees from countries such as Pakistan, India, Sri Lanka, Egypt, Nigeria and Saudi Arabia.

In some NHS trusts doctors on the scheme have received the same pay and benefits as trust-employed UK doctors of the same level, but in others they are not paid equally.

According to a report in The Times, this includes at University Hospitals Birmingham (UHB), Dudley Group NHS Foundation Trust, and Walsall Healthcare, which have an specific agreement in place with the College of Physicians and Surgeons Pakistan, which allows them to pay fellows from Pakistan less than the going rate.

For example, doctors from Pakistan who worked at the Birmingham trust as grade three specialty trainee registrars or above were paid the equivalent of £32,400 to £43,200 tax-free a year.

This is less than doctors at the same level employed by the trust, who were paid £51,017 in 2022-23 and £55,328 a year in 2023-24 as a basic gross salary, excluding any overtime or enhanced hours payments.

Under the agreement with the Birmingham trust, foreign fellows also do not receive paid parental leave. In 2017 UHB terminated the contract of a fellow who became pregnant.

A spokesman for the Academy of Medical Royal Colleges said the institution was concerned by the issues raised by the BMJ. He told The Times: “All doctors should be paid the correct rate for their work, regardless of whether they are on the MTI scheme or not. But this is a matter between the doctor and the NHS organisation that employs them.”

An employment lawyer at law firm Leigh Day, said the scheme was “exploitative” and added that every worker was by law entitled to maternity leave after they began employment.

UHB said the programme benefited the NHS, healthcare overseas and the doctors themselves and such programmes were backed by the World Health Organisation.

An NHS spokesperson said: “While the salary of these positions is agreed between the individual trust and their international partner, fellows play an important role in treating NHS patients at the same time as learning new advanced clinical skills in a high-quality and fair learning environment, before returning to their home countries.”

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