This could unleash a legal nightmare

ALLOWING staff to work from abroad is a huge mistake that can only undermine patient safety and efficacy of treatment. Medical teams who see each other in person, day in, day out, know one another’s strengths, weaknesses, foibles and attitudes to risk.

Modern medicine is very much a team exercise. I have lost count of the number of times, as a consultant oncologist, I’ve picked up a file of clinical notes and wandered down the hospital corridor to seek the advice of colleagues.

I’d speak to the radiologist – how big are the tumours on the X-ray? What’s the likelihood they have spread to the lymph nodes? I’d then take the case to the surgeon – have we caught it early enough to operate? Do risks outweigh benefits? I’d also consult chemo and radiotherapy specialists.

It is only in person that you can gauge the reaction of colleagues, get an idea of how firm their opinion is and what it’s based on.

You need to know them, and phone and video call conversations are no substitute.

It is alarming that hundreds of NHS staff are not based in the UK. To not even be in the same building as patients you are treating makes me question why they went into medicine. And what of their obligations to junior staff? It’s hard to see how senior medics can pass down knowledge as effectively from a sun lounger.

But Covid changed working patterns for millions, not just NHS staff. Many GPs now primarily see patients remotely.

Similarly, radiologists can access digital images (that have long since replaced X-ray films) from any computer screen.

The staffing crisis in radiology is so acute that many ‘non-urgent’ chest X-rays often lie unseen for three months – with many sent to India to be reviewed by specialists employed by private firms.

Amid crippling staff shortages, it’s understandable that hospital trusts prefer to grant unheard-of freedoms to senior staff rather than leave vital posts unfilled.

But those freedoms could risk a litigation nightmare for the NHS because of the questionable legal and ethical status of crossborder consultation.

Where are these consultations taking place, in the UK or a foreign country? Which country’s laws apply? Are doctors overseas subject to the authority of the General Medical Council, or to overseas professional bodies?

For medico-legal reasons alone, it’s hard to imagine the American health system allowing its doctors to work remotely from Mexico. For patients’ sake, I hope the NHS comes to the same decision here. And soon.