Ethical advice issued for NHS purchasing

16 May 2011

16 May 2011| Angeline Albert  

NHS procurement guidelines have been published to raise awareness and prevent violations of labour rights in the supply chain.

The British Medical Association (BMA), in partnership with the Ethical Trading Initiative (ETI) and the Departmentof Health (DH), today launched Ethical Procurement for Health. This practical online guide is intended to help UK health organisations improve working conditions in which goods for the NHS are produced.

According to the ETI and BMA, labour rights violations in the NHS supply chain include workers being paid below the minimum wage, child labour, excessive working hours and poor health and safety conditions. 

Dr Mahmood Bhutta, adviser to the BMA’s Fair Medical and Ethical Trade group, described in a blog posted on the ETI website his visit to Sialkot in northern Pakistan where apparently 100,000 surgical instruments are produced every year with some bound for the NHS.

He said: “The conditions were shocking. In my mind I had associated surgical instruments with the clean sterile environment of the operating theatre. But here they were being ground and filed by 10-year-old children working full-time in small open garages on the street. The noise was deafening, the heat and dust unbearable, the risk of serious injury palpable.”

The NHS spends in excess of £30 billion a year on the procurement of goods and services.

The guidelines recommend that the business case for ethical procurement be agreed and signed off by senior management. It also recommends that a champion within senior management, ideally at board level, should be identified as well as another individual who will have lead responsibility for implementing ethical procurement. This second person should be experienced in procurement, of a sufficient level of seniority to influence decision-makers and be able to contribute enough time to the role.

A previous DH consultation with stakeholders identified limited resources and competing pressures at the procurer level to comply with ethical procurement, a perception that ethical trading criteria may contravene EU procurement rules and no system for collectively storing ethical trading information from suppliers.

Dr Vivienne Nathanson, director of professional activities at the BMA, said: “The NHS is experiencing a very challenging economic environment, but this cannot be used as an excuse to continue to exploit overseas workers.”

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