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Don’t just hire an Indian doctor, hire an Indian clinic!

Faced by huge shortages of doctors, Europe is keen to hire Indian doctors. But there is a much better solution.

Hire an Indian ophthalmologist and plug him or her into a public sector hospital in Europe and he or she will perform 10-15 cataract operations a day, if you are lucky. A much better solution is give a contract to an Indian ophthalmology group such as Dr Agarwal or Aravind to set up in your country. Their ophthalmologists regularly perform 40-60 cataracts a day, a four-fold productivity improvement on hired individual Indian doctors. Big productivity improvements are on offer elsewhere, such as in cardiology (Narayana) and dialysis (Nephroplus). Let’s give these operators licences to work with Indian or European labour in Europe.

Given the extraordinary productivity gains on offer, the question we need to ask is “why is there almost no chance of this happening?”

It is not because this higher productivity comes with worse patient outcomes. On the contrary, a 2011 McKinsey report quoted the CEO of Aravind claiming that his eye surgeons report half the complication levels of those in the English NHS. And there is no reason to doubt this. After all, surgeons who do lots of a particular operation tend to be the safest.

No, the main reason this won’t happen is the challenge it poses to existing public health delivery systems in Europe and to the livelihood and work approach of their doctors. This is the nasty little secret. We can be proud of our international NHS workforce as long as the guys we bribe to join from countries where they are desperately needed don’t challenge our working practices.

Of course, none of that will be said. A refusal to grant a licence would be put down entirely to safety concerns and worries. But, given the crisis we face across Europe, it is time we challenged the doctors unions that control productivity.

That should extend to enabling providers to set up private schools to train fee-paying doctors to supplement the trickle of newly qualified doctors produced by many rich European countries.

Yes, this would enable people with wealthy parents or who were prepared to take on more of the massive debt that training involves to sometimes get places ahead of poorer, cleverer people. Even if it is supplemental addition to the workforce that’s bad. There would be howls of rage.

But the alternative, the continued trade in stealing doctors from countries where their absence will inevitably lead to many deaths is far, far worse.

We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.