Surgical tools and equipment made using child labour in Pakistan may be in use in NHS hospitals, according to an investigation by the Guardian.
The alarm was raised after children as young as 12 were found in a dozen small workshops in Sialkot, Punjab – where 99% of Pakistan’s surgical instrument production is based.
Three companies that export to the UK said they buy instruments from these workshops.
In the report, NHS Supply Chain confirmed that it had banned child labour from its “first tier” suppliers, many of whom are based in the UK, but admitted that it did not know which manufacturers were used in Pakistan.
Britain is the third largest buyer of surgical instruments from Pakistan, accounting for 10% of the country’s total exports. Around 80-90% of surgical instruments are manufactured in the country, according to NHS Supply Chain.
Mahmood Bhutta, NHS surgeon and found of the British Medical Association’s (BMA) Medical Fair and Ethical Trade Group, told The Guardian it was likely that some tools being used in NHS were made with child labour.
“We still don’t know where most surgical instruments coming into the NHS are made but we do know a lot of them will have come from Pakistan,” he said.
“I would be amazed if at least some of the instruments used in the NHS weren’t made in these small workshops.”
There are an estimated 12.5m children in forced labour around the world. Up to 3.8m of them are aged between five and 14, according to Child Rights Movement.
In 2015, the BMA and Swedish campaign group SwedWatch produced the Healthier Procurement report following a research trip to Pakistan.
Among several recommendations, the report said the Labour Standards Assurance System (LSAS) should be broadened to require all suppliers to continually report on progress and allow audits of any approved supplier.
It added that the decisive factor in awarding contract should not only be price but should include a supplier’s sustainability performance.
Responding to The Guardian’s report, NHS Supply Chain said that more needed to be done to ensure that the tools used in the UK were not manufactured by child labour.
“We are aware of the potential for labour standards abuses to occur within supply chain for surgical instruments, which is why we have taken steps to increase requirements for supplier due diligence in our contract and have worked to develop guidance and system to address these issues,” it said.
“We believe that the supplier code of conduct, the LSAS approach and the guidance and advice we have provided to our suppliers has been effective in shining a light on the issue across the industry.
“However, we are not complacent and we recognise that it will require continued effort and vigilance across the sector to raise and maintain standards uniformly.”
Cindy Berman, head of modern slavery strategy at the Ethical Trading Initiative said although NHS budgets were tight, savings should not come at the expense of human rights.
“We know child labour exists in the surgical instrument sector in Pakistan, often in the initial stages of production, and it’s likely that some of these instruments will end up here in the UK,” she said.
“While NHS Supply chain has taken important first steps in tacking these abuses more can and should be done.”