Published: 26/09/2002, Volume II2, No. 5824 Page 4 5

The government's plans to import overseas doctors to tackle waiting times are in trouble and a number of schemes have collapsed, investigations by HSJ have revealed.

At least two teams of doctors have been sent home without carrying out a single operation. One major overseas provider has pulled out of talks and another complained that they are not receiving any information about how to proceed, despite being asked to tender for work.

No contracts have been signed with providers in France, Spain or southern Europe and only a handful of small teams are treating patients, Department of Health figures show.

In July, a German team of two ophthalmologists and two anaesthetists arrived in the UK ready to carry out 1,000 eye operations at Birmingham City Hospital's eye centre. But on arrival, they were met with considerable opposition from local consultants and told that Birmingham did not have a long waiting list for cataracts.

After three weeks of negotiations to resolve the issue involving the trust, the strategic health authority and the DoH, they returned to Germany. They had not carried out a single operation.

It is unclear who is bearing the costs of the failed trip.An alternative site is still under negotiation - possibly in Essex.

Hans Finck, managing director of German Medicine Net, the company that put the team together, refused to comment.

'This is a confidential matter, ' he said.

A senior source at the Birmingham and Black Country SHA said: 'It was a project that the trust had put forward but had not been thought through properly and did not get off the ground.'

Sandwell and West Birmingham Hospitals trust, which manages the eye centre, disputed this. 'I think it collapsed for quite plausible reasons around the waiting-list size, ' said chief executive John Adler.

In another case, in Taunton, an ear, nose and throat scheme involving French surgeons collapsed in July when the doctors' English was not considered good enough.

A spokesperson for Taunton and Somerset trust said: 'We picked up the problem early in the discussions.We are taking steps to appoint [another] team from France to help us with our ENT work although that is still at the exploratory stage.'

The DoH added that centrally the incident was viewed 'not as a failure but as proof there is a robust accreditation system'.

Ministers had wanted to see overseas medical teams making a 'real impact' on activity in 200203 and in May asked trusts to identify 'first movers' to start treating patients by the end of July. The priorities were ophthalmology, orthopaedics and ENT.

This was spelt out in a letter from Bob Ricketts, head of capacity and choice at the DoH. It also said that a 'substantial contribution from central funds' would be available to schemes that demonstrably add capacity over and above that agreed in the strategic and financial framework round.

However, at the end of July only three schemes were up and running, each involving small teams of surgeons.

A larger 40-member team from South Africa is due to start work at Morecambe Bay Hospitals trust in October carrying out 800 cataract operations over four weeks. The£750,000 scheme has DoH funding, although negotiations pre-dated the DoH initiative by five months.

By last week, no contracts had been signed with providers in France, Spain and southern Europe.A DoH spokesperson said more were in the pipeline with 37 overseas providers interested in supplying overseas teams. One scheme - at Central Middlesex Hospital - has already treated 200 patients with 1,200 expected by the end of the calendar year.

But according to HSJ sources, none of the eight 'first movers' is off the ground as SHAs found the proposals too complex to put together on such a tight timescale.

A DoH spokesperson said: 'Some schemes have moved slowly because patient safety is a priority.'

Officials are currently drafting guidance for the clinical reference group's comment and due to be issued to the NHS in late October.