Scandal Unfolds: 700 Pakistani Doctors Exploited in £40m UK Medical Training “Cheap Labour” Scheme

Islamabad (Nadeem Ch) – A devastating investigation by the British Medical Journal (BMJ) has exposed a massive governance and ethical collapse at University Hospitals Birmingham (UHB), leading to the termination of a £40.5 million overseas recruitment program.

​The scheme, which brought over 700 international doctors—mostly from Pakistan—to the UK under the guise of “International Training Fellows” (ITFs), has been branded by auditors as a vehicle for systemic exploitation and “cheap labour.”

​KPMG Audit Reveals Financial ‘Black Hole’

​The program was halted following an independent audit by KPMG, which uncovered startling financial irregularities. Key findings include:
​Third-Party Payments: Stipends of £47,520 per year were funneled through an external company without formal contracts or oversight. UHB admitted it could not verify the final amounts received by the doctors.

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​Tax Avoidance: Doctors were wrongly classified as “students” to avoid income tax, a move auditors deemed legally indefensible.

​Missing Protections: Employment contracts omitted statutory rights such as the minimum wage, sick pay, and annual leave.

​Security Lapses: Criminal record (DBS) checks were not consistently performed, raising serious patient safety concerns.

​The “Brain Drain” and Ethical Violations

​The scheme operated despite Pakistan being on the World Health Organization (WHO) “red list”, which prohibits active recruitment by wealthier nations to prevent the depletion of local health workforces.

​While the program’s official slogan was “learn and return,” a survey revealed that 68% of the fellows chose to remain in the UK. Furthermore, the audit exposed a “culture of perks,” with UHB staff spending over £122,000 on luxury recruitment trips to Pakistan. These trips included undeclared hospitality and lavish banquets that were never disclosed under conflict-of-interest policies.

​Immediate Fallout and Severed Ties

​In the wake of the report, UHB has taken drastic measures:
​CPSP Partnership Terminated: The Trust has officially cut ties with the College of Physicians and Surgeons Pakistan.

​Contract Reform: Remaining fellows have been shifted to standard NHS employment contracts to ensure their legal protection.

​National Withdrawal: UHB has pulled out of the national NHS England-coordinated international recruitment scheme.

​”Tip of the Iceberg”

​Advocacy groups and medical experts warn that the Birmingham scandal may be symptomatic of a wider national issue. Calls are intensifying for an urgent review of all similar international fellowship schemes across the UK.

​”This investigation exposes a dark side of international recruitment,” said a senior medical consultant. “It is a wake-up call for the NHS to ensure that doctors from developing nations are treated with the dignity and professional respect they deserve, rather than being used as a low-cost solution to staffing crises.”