Refusal to test medical staff 'indefensible'


January 17, 2005

The Government has been accused of leaving a gaping hole in the UKs defences against the spread of diseases such as AIDS and TB by its refusal to screen individuals from those countries which have high levels of these diseases before issuing them with visas for entry to Britain. An important aspect of this issue the governments failure to require medical tests for the rapidly rising numbers of health professionals now working in the UK is considered in detail in a new report out today from think-tank Migrationwatch. (Read report).

The current situation is quite unacceptable. The government is simply failing in its duty to protect public health. As a first step there should be compulsory screening for HIV/AIDS, TB and Hepatitis B before recruitment for doctors and nurses wishing to join the professional registers in the UK, said Sir Andrew Green, Migrationwatch chairman.

Sir Andrew said that the requirement for screening health professionals was made more acute by the very large increase in numbers in
recent years.

In 2002/3 more than 40% of the 31,775 nurses joining the register were from abroad and in 2003 nearly three quarters of newly registered doctors qualified outside the UK. Analysis of the countries of origin shows that 3,200 doctors and 1,300 nurses arrived from South Africa where the HIV rate is 1 in 5, and where there is also a high incidence of TB and Hepatitis B, yet none of the recruits were tested for any of these diseases.

The report also reveals that, in addition, nearly 4,000 doctors and 8,000 nurses were recruited from countries with high rates of TB and a further 700 doctors and 6,000 nurses from countries with a high incidence of Hepatitis B.

No-one doubts the commitment of the professionals concerned but the question is whether it is remotely sensible that no checks are made for these very serious and communicable diseases prior to their recruitment, said Sir Andrew. It is incomprehensible that we should leave such a gaping hole in our defences. Furthermore, since 47 other countries, including the US, Canada, Australia and New Zealand, test for HIV before recruitment there must be some risk that those who know that they are infected apply to the UK which does not test.

Sir Andrew added that the testing of health professionals should be the first step in a wider programme of testing immigrants from areas of particularly high risk. The tests for HIV and Hepatitis B were now sufficiently reliable for large scale use; the results should be taken into account in deciding whether to issue a visa. He spoke following the recent disturbing report of the Health Protection Agency which showed that the rate of increase of heterosexually acquired HIV had grown by a factor of five in the past decade to reach 3,800 new cases last year. As the HPA report itself said; This increase is largely contributed to by the migration of people from areas of the world where there is a high prevalence of HIV, such as sub-Saharan Africa. Last year Britain had more than three times as many new cases of HIV as either France
or Germany.

Similarly, a recent report on Hepatitis B quoted a Department of Health estimate that there are about 7,700 new cases of chronic hepatitis B every year. 96% of these cases have entered the UK with the infection, generally from areas of high prevalence. [1]

As testing is routine in 47 other countries it is indefensible to pretend that it is not an issue in the UK. Yet, despite the clear evidence, the Government refuses to take the action that is so obviously necessary, said Sir Andrew.

Notes:
[1] Hepatitis B: Out of the Shadows published by the Foundation for Liver Research, Institute of Hepatology, University College, London.


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