Published: 10/10/2002, Volume II2, No.5826 Page 22

Regarding your coverage of foreign surgical teams operating in the NHS (news, pages 4-5, 26 September): first, the failed cataract project in Birmingham.

I originally refused to comment as I felt it was confidential, but there have been some inaccurate portrayals in the media that I would like to correct.

One local paper wrote: 'After a day's visit to the hospital, it was established that the German team were specialists in cataracts - not ocular plastics and vitreo retinal work which they had been brought in for.'

This information is incorrect.

Our organisation had been asked to bring in surgeons to perform cataracts - no other type of operation had been mentioned before the visit. A little later we received a list of about 15-20 different types of eye operations, some of which required a high degree of specialisation. We then started identifying suitable German surgeons for these procedures.

None of these surgeons has received a call to Birmingham, though, because we were told that the project was 'dead'.

On the BBC health website, an article on the same incident stated: 'NHS bosses and consultants there needed help carrying out more complex operations, skills far beyond the ophthalmologists from Germany.'

This is a misleading comment on the abilities of the German surgeons, which could be interpreted as insulting. I must emphasise that Birmingham's professed needs were different, and required a different specialisation. Surgeons who do ocular plastics, vitreo retinal work or dacryo-cystorhinostomy (to name some of the areas requested) are much rarer than cataract surgeons.

That does not make them more important, better or more capable than cataract surgeons, which seems to be implied in the words 'far beyond their skills'.

On the 'skills of the foreign surgeons', I am certain the medical education, abilities, skills and experience of the average surgeon in the UK, Germany, France, Belgium or other European countries are very similar.

While I agree that there should be reasonable checks on the professional background of a foreign surgeon, there is no need for the media to constantly put a big question mark over their abilities. I am sure the doctors we have brought into this country, and will continue bringing in, are at least as well qualified as their UK counterparts - and we are ready to prove this any time.

UK patients waiting months and years to be treated by UK consultants (unless they decide to 'go private') will greatly benefit from the help of our doctors.

With regard to the language abilities which have been repeatedly raised in the media, it is obvious that foreign surgeons should speak fairly good English. It is less obvious that they should speak very, very, very good English, because it is more important that they do their job well. After all, we are not talking about importing Freudian psychotherapists, where language skills would indeed seem to be an important prerequisite. In any case, I have always suggested the use of a translator where necessary.

BBC and British newspaper interviewers have asked me repeatedly: 'Do you think UK consultants are trying to block these projects?' My answer is:

'We are very optimistic that our services will be requested and required in many parts of England because we know it has worked well in the past.'

One of our doctors has seen about 600 dermatology outpatients and performed many minor and major surgical procedures.

Patients, managers, nurses and UK colleagues were all very satisfied with his work, and the trust does very well with waiting-list targets. In several other cases, our orthopaedic and ear nose and throat surgeons again helped make significant cuts in outpatient waiting lists.

But it seems to me there is a conflict in financial interests for some parties in some local UK health economies, because a long waiting list seems to be an incentive for the patients to get private treatment. I know this is not often said in public, but I have heard it from numerous NHS managers. As an NHS outsider, I am not sure to what extent this relates to individual NHS consultants and if it might explain some delays in the current projects. But I feel it needs to be addressed openly to ensure that the 'flying doctor' projects can go forward smoothly and achieve the intended effect of helping tens of thousands of UK patients at short notice.

Hans Finck Managing director German Medicine Net