- The recruitment of health workers from Africa, many of
whom have been found to be HIV-positive, has been under review by the Department
of Health for more than a year.
- The problem came to light in January 2001 when Wolverhampton
University School of Midwifery and Nursing recruited 180 students from
sub-Saharan Africa, principally Zimbabwe, and discovered that at least
five were HIV-positive. It was decided to treat them then place them in
hospital jobs across the country.
- Jane Eminson, the chief executive of the Wolverhampton
Health Authority, said at the time in a press conference that they would
be valuable NHS employees and posed no danger provided that they were not
involved in procedures where there was a risk of patients being exposed
to their blood. She said that the African nurses were just some of a number
of HIV-positive staff working in the NHS under strict government guidelines.
- The nurses complained that they were victims of racist
hysteria. One said: "We are being targeted because we are African.
There are students here from all over the world. You can get HIV anywhere."
- Gisela Stuart, who was then a Health Minister, backed
Wolverhampton Health Authority's policy of letting HIV-positive nurses
stay, saying: "Just because someone has HIV doesn't mean they develop
Aids. The authority is taking a very responsible attitude." (Note
- Most physicians consulted on this subject disagree with Ms. Stuart's
assertion. The 'gestation' period for symptoms can be as long as 10-12
years...all the while the patient is infectious. AIDS is commonly broken
down into three stages, the first being: infected but asymptomatic. -ed)
- The authority admitted that it had no idea how many of
the trainee nurses were HIV-positive. The test for HIV was voluntary and,
the authority did not know how many had been tested or how many were infected.
- There is no evidence that any patient in Britain has
been infected by an HIV-positive healthcare worker. The Department of Health
says that guidelines banning HIV-positive staff from working in operating
theatres and giving injections prevents any risk. But since hospitals have
little idea of which staff are HIV-positive, they cannot be certain of
who should be subjected to the restrictions.
- By hiring overseas nurses who require lifelong treatment,
the NHS could be adding to its problems rather than solving them. The nurses,
recruited to help to relieve staff shortages in the NHS, would need treatment
that adds at least £10,000 a year to the cost of employing them.
- As returning to Africa could cost them their lives, they
are likely to stay in Britain, probably needing treatment costing the NHS
several hundred thousands of pounds. There is also the risk of transmission
to sexual partners in Britain.
- After the events at Wolverhampton, the Department of
Health reviewed the way in which nursing schools admit overseas student
nurses. Since then, there have been periodic expressions of concern about
HIV-positive NHS workers.
- At Hull and East Yorkshire NHS Hospitals Trust and at
Raigmore Hospital in Inverness, hundreds of patients were offered blood
tests after being exposed to HIV-positive staff who had conducted procedures
that involved a risk of transmission.
- Last year the Government was so alarmed by the repeated
outbreaks of "excessive public concern that it ruled that patients
would no longer automatically be told when an HIV-positive worker had performed
a risky procedure on them. Each case would be reviewed on its merits, it
- But since January 2001 the number of HIV-positive nurses
recruited from overseas has increased to the extent that it is not "unusual
as the Government said, but common. Hospitals across the country are recruiting
increasing numbers of nurses from sub-Saharan Africa. Despite accusations
of racism, the Africa connection matters because its rates of HIV are higher
than anywhere else. The NHS recruits most overseas nurses from the Philippines,
but the United Nations rates HIV infection there at less than 0.1 per cent.
- By contrast, the number of nurses drafted from South
Africa, where one in five adults has HIV, has increased from 599 in 1998
to 2,114 in 2001. Recruitment from Zimbabwe, where one third of adults
are HIV-positive, has risen from 52 in 1998 to 473 last year.
- Botswana is the country most ravaged by Aids, cutting
life expectancy to just 27 years. Yet nursing recruits from there have
risen 25-fold, from four in 1998 to 100 in 2001.
- The Government has been repeatedly criticised for taking
nurses from countries that can ill afford to lose them but it says that
they approach the NHS and it does not actively seek them. The Government
does not even have estimates for the numbers of HIV-positive nurses it
drafts; the Royal College of Nursing says that intakes are low.
- But if nurses have HIV in proportions similar to the
general populations they come from, then the NHS recruited 737 HIV-positive
nurses from overseas last year - of which 727 came from Africa, eight from
India, one from Australia and one from America. In contrast, the NHS recruited
14,000 British nurses last year, of which data would suggest 14 to be HIV-positive.
Epidemiologists who have examined the figures say that it is a reasonable
estimate. It could even be an underestimate.
- Nurses from Africa tend to be women from cities aged
20-30, the peak group in Africa for HIV infection. One study in South Africa
showed that half the student nurses in Johannesburg were HIV-positive.
If that figure holds for nurses across the country, then Britain last year
took about 1,000 HIV-positive nurses from South Africa alone.
- The broad recruitment of HIV-positive nurses from Africa
is part of the new pattern of the HIV epidemic in Britain.
- The Times revealed last week that the number of diagnosed
HIV cases among African immigrants last year had overtaken those among
gay men.Many other countries such as America and Australia, require HIV
tests before people are allowed to immigrate. Canada began insisting on
HIV tests for immigrants this year. Britain is planning the same for medical
staff hired by the NHS.