Hospital trusts faced criticism from Britain's biggest trade union yesterday over a scheme to send tens of thousands of confidential patient records to be transcribed in India, the Philippines and South Africa under a new form of outsourcing that will save the NHS millions of pounds.
Hospitals in London, the south-east, the Midlands, Hull and the south-west are replacing their medical secretaries with staff employed overseas by private British dictaphone companies who pay 6.5p a line to transcribe doctors' notes and email them back to hospitals.
Unison accused hospital trusts of putting lives at risk because of typing errors by staff thousands of miles away who are not able to cross-check the information by accessing a patient's medical history or talking to a consultant.
Dave Prentis, general secretary of Unison, said: "Lives are being put at risk by hospitals desperate to save money. Medical secretaries work to 99.8% accuracy and once phased out their knowledge and expertise will be lost for ever. They have years of experience and are familiar with the consultants and their patients."
The union says it has evidence of an incorrect incident report which led to a patient being given the wrong treatment, and has examples of other typing errors in the private transcription services which could lead to life and death decisions.
One example shows that hypertension has been confused with hypotension, meaning the wrong treatment can be life threatening. Other examples show known malignant confused with non-malign, the former meaning a cancerous growth, the latter a benign growth; a septic confused with aseptic, the first meaning infected, the second clean; and ectomy with -octomy, the former requiring removal, the latter meaning an incision.
The switch to using private companies - some offering free trials - comes as some hospital trusts face big deficits. The union says the former health secretaryJohn Reid pledged not to introduce such an economy measure.
Patients are also entitled to object and ask that their notes are not transcribed abroad, though a request by one patient in Southampton was ignored.
After protests from Unison, the Cambridge University Hospitals NHS Foundation trust, which includes Addenbrooke's hospital, has dropped its plan to outsource to the Philippines where overseas staff are being paid 44p an hour.
Hospitals in Hertfordshire have gone ahead with the scheme, threatening one-third of all 160 medical secretaries with the sack. Other big hospitals trialling the service include Hammersmith, Charing Cross, Stoke Mandeville, St Mary's Paddington, the Whittington, the Norfolk and Norwich and the Royal Cornwall.
Private outsourcing company Uscribe promises to cap and reduce the cost of wages and save a hospital the cost and time of recruiting and training staff and any overtime payments.
