"Can we have back the million pounds of tax money it cost to train these doctors, please?

John McAllister, Bristol, England"

John, doctors who work in the NHS after graduating (i.e foreign doctors) are net contributors as they provide a service and get little in terms of dedicated training time. Infact, when the foreigners leave , they should be paid back some of the vast amount of taxes and NI contributions which they have not been allowed to use ( as they cannot cliam any tax credits/ child beenfits etc). Our tax and other contributions sustains many local people.

R Bhatia, London,

Having worked in the UK, USA and Singapore after training in India, I admit that there is no perfect system in the world. There are problems in each of these healthcare systems. One should recognise that citizens in the UK are getting healthcare (might not be good) which is free at the point of delivery funded by minority of tax payers. This is the greatest benefit the citizens of the UK can get from the state. The so called "Mecca of Medicine"- USA has nearly 40 million people who are uninsured. These people are exposed to delayed or suboptimal healthcare.
The NHS is failing due to too many changes imposed on provision of healthcare. By creating the new breed of "managers" and "deputy managers" the goverment has lost sight on the fact that healthcare is provided and understood better by the doctors and nurses who care for patients. I am sure that the NHS will get worse before it gets better. It is futile to compare Indian healthcare (private) to NHS (free for all)- Dr Pyati -USA

Srini Pyati, Durham, USA/NC

I trained in a Government Medical College in India and can vouch for the fact that the perinatal mortality at that hospital was far lower than that in many hospitals in Britain, simply because the complications were detected earlier as all pregnant women had access to consultant led care( free of charge). But obviously no randomized controlled trial would have been done to prove that fact as the Government medical college I worked in had no money to spend on trials.
I have several friends in Britain who lost their babies in childbirth in the UK. Not even one of my acquaintances had a similar fate in India. I ask the NHS why?

Michael, Scunthorpe, UK

Can we have back the million pounds of tax money it cost to train these doctors, please?
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Most of these doctors come here AFTER training and end up doing the dead end service job(Any one heard about Staff Grade doctors?There is an entity in NHS like that who are neither consultants nor trainees.)And pay their taxes with out any recourse to public funds.

Saj, London, UK

This reminds me of Nobel prizewinning economist Amartya Sen's observation (in regards to infant mortality rates) that "India seems to manage to fill its cupboard with more skeletons every eight years than China put there in its years of shame" -- which means that the impoverished conditions in India, have caused more deaths than in the entire history of Communism everywhere since 1917 -- over 100 million deaths by 1979, tens of millions more since, in India alone. Just think about it, if the Indians had a socialized healthcare system, how many lives would be saved as a result?

Jarmo, Turku, Finland

This is probably due to

(a) Doctor's getting some respect out there and not being used as the scapegoats for the government.

(b) the unemployment and continuing MTAS farce in the UK

(c) Doctors having autonomy rather than having their clinical decisions being overturned by the unseen hords of middle management with no medical understanding or formal training.

(d) and many more reasons.

R Barber, London, UK

Stephanie James,

your comparison just doesn't make sense. You somehow seem to think that just because India is a "third world" country we can compare it's private provision with the state provision here.

The very point is that the self selecting populace which can afford private healthcare *generates* revenue for hospitals. For every private patient seen, the hospital makes money. Similar to the private care here.

Whereas being committed to universal/state healthcare, means that hospitals lose money the more patients they treat. To compare two different systems like this (where the dynamics are completely reversed) is ridiculous, as is blaming it on staff wages.

Perhaps you should think before you post.

R Arkhan, London,

Having worked both in the govt, and private healthcare in India and in the NHS, while I do share the admiration for NHS delivering a uniform standard of heatlhcare, I have to say that those standards are deteriorating , as is the training of doctors. Standards in Indian private hospitals are one of the best in the world. Yes, MRSA does exist in India, but the cleaning standards in these hospitals are far more rigorous than in NHS, which is why you do not hear of MRSA epidemics. Yes, it is a paid service, but an ever increasing middle class in India ensures the good market for private hospitals, which also get plenty of patients from the rural sector. It is a matter of time before the service becomes accessible to everybody. I think what the article compares is standards and not accessibility. India offers a good training for doctors, and surgical training is better than in the UK. The millions of pounds spent in training these doctors is offset by their painstaking service in the NHS.

AS, Brighton, UK

sir
As an Indian living in INDIA i appreciate the comments of the doctors returning giving us good hope that we will get experienced hands to care for us, THEY seem to miss out one important point. ALL the private hospitals being set up are catering to a miniscule percentage of Indian citizens and many are vying for medical tourism invitiong foreigners to come to India for lower cost surgeries etc.
THOUGH i have never seen a NHS hospital, the very fact that it provides healthcare to the EVERY citizen irrespective has me feeling envious of british citizens; if i think on behalf of my fellow Indian citizens who may not be as fortunate as I am to afford to go the private hospitals.
We in india would anyday give up the marble foyer and accept the flaws IF there was medical facilities available that 55% of Indian population cannot access! Perhaps an Indian doctor in the UK could compare NHS hospitals with Indian govt hospitals?

uday pasricha, mumbai, maharashtra

I have moved to India for entirely personal reasons. The transition is not because of the state of the NHS or the Hospitals in the UK.
When i said that i have not come across MRSA in my first year of practise, i consider myself fortunate. It is a matter of time before i will come across some in my practise. I don't think it is any different anywhere in the world.
I said that the hospitals in UK have tradition of hundred's of years behind them. It is unfair to compare them to a selected few hospitals in India. These are all private hospitals catering to a very small section.
The hospitals in India are well equipped. we do use the standards set in most of the UK hospitals as benchmark. There is no way i would criticise the standards in operation theatres or ICU'S in the UK.

I am fortunate to be able to practice in India with similar equippment as in the NHS, which was not possible a few years ago.

I would still consider NHS as one of the best in the world as it caters to the whole country and that too at a very high standard. The commitment of the staff is excellent .

I was really upset with the tone of the article as i have thoroughly enjoyed my stay and training in the UK. I have made many friends and it is very unfair to be qouted in this fashion.

M Kulkarni, Pune,

It would be interesting to hear whether the doctors who have moved to India are working in hospitals that treat the average Indian or hospitals that are private and only treat the Indian elite. It's unfair to compare an NHS UK hospital with a hospital that only treats the wealthy. You wouldn't compare an average GP clinic with a private consultant's office in Harley Street either.

India has a greater division between rich and poor - hence Dr Kishore's ability to afford servants and live in a large house.

MB, Edinburgh,

In India its very easy to get an appointment and also if you need a surgery or CT Scan,MRI,Ultrasound etc etc it all takes place on the same day or as early as possible.Nobody needs to wait to get treatment.But in UK,It may true that the treatment by NHS is completely free,but one has to wait a very long time before the treatment or some diagnostic test is offered.A doctor may get a starting salary of 5000 Rs-10,000 Rs In India where as in UK the minimum salary starts from 1 lakh 60,000 Rs.

Dr Sathya, manchester, uk

Erhm Dr Pritchard, why shouldn;t we compare the NHS to private healthcare in India. After all we poor taxpayers here pay a riiculous amount of National Insurance all our working lives to pay for the NHS, surely the least we can expect are the same standards as exist in the private sector in India. Further since the NHS is the biggest employer in the Western World surely it should at least lead the world in the having the least number of MRSA infections?

But it doesn't does it? AS someone who works at a hospital I see where the money is going, and it isn't going on healthcare. Instead it is being thrown into a bottomless blackhole of bureaucracy and incompetence whilst salaries here for Consultants and GP's are rocketing.

The NHS might once have been the envy of the world but no longer. Give me supposed third world standards anytime.

Stephanie James, London, England

Having seen the hospitals in UK, US, Canada and India- I have to say that that the 2 countries with public health systems (i.e. UK and Canada) have the poorest funded and maintained facilities. We need to understand that we get what we pay for.

sanjay ramrakhiani, St. Louis, MO

Well, if you want to compare top private hospitals in India to their equivalent in Britain, it's pointless choosing your typical NHS hospital as a benchmark. Try Harley Street instead. The private hospitals in India are catering for overseas patients who come to India for cheap surgery, and the Indian wealthy classes who can afford treatment. If you are one of the hundreds of millions of Indians living in abject rural poverty you take your chances at a health post that probably hasn't had a qualified doctor visit in years. These are the sorts of places you should be comparing the NHS to - and anyone who has worked, like me, in the public sector of a developing country would not dream of complaining that the NHS is in a worse state than the healthcare offered in any developing country. I wonder how many of the doctors who are leaving the UK are choosing to work in rural health posts or even public hospitals?

Dr Pritchard, West Midlands, England

Can we have back the million pounds of tax money it cost to train these doctors, please?

John McAllister, Bristol, England

This is not true, Indian hospitals do not accept they have a problem with MRSA. Staphylococcal infection has been a major problem for a long time and is likly to be higher. We don't know how the new strain CA-MRSA is going to effect to population.

Dr Kadiyali M Srivatsa, Guildford, UK