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Improving the Healthcare Supply Chain Through Guidelines

"There are some horrible working conditions; kids as young as seven making surgical instruments; people losing limbs. It's horrendous," says Mahmoud Bhutta, consultant surgeon and founder of the British Medical Association's (BMA) Medical Fair and Ethical Trade Group, established in 2007. "Many of the companies [which supply the NHS] have been burying their heads in the sand."

Bhutta does not hold back in his criticism of the companies that collectively spend 30bn of public money on behalf of the NHS. The publication of new BMA guidance for GPs and commissioners, which strive to protect workers' rights in medical supply chains, only highlights the lack of progress since 2008 when the guidelines were released.

Part of the problem is the disparate way in which goods are sourced within the NHS. There is no single large customer, but rather individual hospitals, GP surgeries and dentists buying the kit they need. But there is no way of getting round the painful paradox that sees products used to improve health being sourced from developing nations where workers' health is endangered, and sometimes destroyed, as a result of their production.

Bhutta wants the NHS to incorporate a statement on ethical procurement into its constitution. "We've been trying to target government, and the Department of Health are broadly supportive, but apparently they can't put this into policy," he says. "My opinion is that it's now time for some ministers to stand up and say: 'Our NHS is going to support ethical procurement'."

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