so we're close, guys. this is the part where i feel really, really tense. ifeel like, oh, god, i'm coming back to this prison again because it was a prison to me, like to coming back again to this place. dr augustine is a nigerian doctor who came to the uk two years ago. today he's taking me back to that hospital that he says almost broke him. it's my room over there, the fourth floor. there you can see the windows open. so there's a doctor up there right now doing the same job i was doing. i still feel anxious because, you know, i can't explain what it means, likejust being confined to this place for seven days, 2h, seven. every day i work in this hospital, i always thought that something could go wrong.

augustine is one of 9,500 nigerian doctors licensed to work in the uk. recruitment from abroad has never been higher, with almost 40% of uk doctors trained overseas. but his recruitment by a british company called nes health care meant working long hours in a private hospital with potential consequences, he says, for patients�* health. i would wake up at 6.30 behind the ward at seven and it was an 80 bedded hospital. so i was looking after all of the patients on the ward. 0utpatients and x—ray, and i would be working from seven up until 11 at night. and i would think that i'm meant to go to bed, you know, just get some rest. but then when you go to bed, you get called. all patients complain about this and you sleep is ruined. so i'm not able to sleep again up until seven again and the cycle continues for one week. but how do some of these

doctors get here? the bbc has been investigating the story for months. we've discovered a scandal about large scale recruitment and exploitation of foreign doctors in the uk that reaches as high as the british government. nigeria's economic hub, lagos, is a mix of oil—driven wealth and life—shortening poverty. most here don't live beyond 5a. just five miles from the centre, the floating city of makoko. we're just sailing down these backwaters in lagos, nigeria. and we're on our way to a little community to speak to the chief there just to find out what kind of medical care is available here. so have you ever seen a doctor or a nurse around here? no. in our communities here, no doctors, no nurse.

the problem is not one of lack of training, but the doctors are leaving nigeria in record numbers. the world health organization has stepped in, compiling a list of poor countries with health care shortages from where the rest of the world should never actively recruit doctors. the british government incorporated that list into its own code. they call it the red list, effectively making nigeria a no—go area for british medical recruiters. butjust down the road, a surgeon has something to share. dr 0liver djibouti is famous for his philanthropic work among the poor and the sick. and today he's working for free. but his highly trained team is recently depleted and lost to staff. he knows the british

government has a problem. it trains far too few doctors and nurses, offering only seven and a half thousand medical school places when twice that number is needed. it's cheaper to shop abroad. the british government, the uk government is really pushing out doctors now have patients lost their lives because of this exodus of doctors? definitely. they are not staying on painting because access will drop. availability will drop. it will increase patient waiting time because there are fewer doctors. there's no point going to the hospital. so theyjust sit on their arms and just die. back in the city, there's an important event that's caught the imagination of the creme of lagos young doctors. we've arranged to meet one of them. he's got an important examination tomorrow, which is the first stage in his journey to the uk. so i thought you might be working. very good to see you.

hi. how are you? can we come in? thank you. cheers. these are the mock exams i have done so far. fin these are the mock exams i have done so far. , ., , .,, these are the mock exams i have done so far. , , ., so far. on his laptop, revision. this doctor— so far. on his laptop, revision. this doctor is _ so far. on his laptop, revision. this doctor is a _ so far. on his laptop, revision. this doctor is a fully _ so far. on his laptop, revision. this doctor is a fully qualified i this doctor is a fully qualified doctor who works in lagos i day. but to practice in britain, he needs to pass the professional and linguistic assessment board test. a test specific to the uk health care system. a lot of people say you are part of the problem here, you are part of the problem here, you are part of the rain drain. the part of the problem here, you are part of the rain drain.— part of the rain drain. the reason there is a — part of the rain drain. the reason there is a rain _ part of the rain drain. the reason there is a rain drain _ part of the rain drain. the reason there is a rain drain is _ part of the rain drain. the reason there is a rain drain is because i part of the rain drain. the reason. there is a rain drain is because the way nigeria is right now, there isn't a future. the economy is bad, infrastructure is not in place, even the health care system is not that good. the health care system is not that aood. �* , ., the health care system is not that iood, �* , ., ., , the health care system is not that aood. �* ., , ., ., good. but you would be more valued here because — good. but you would be more valued here because there _ good. but you would be more valued here because there is _ good. but you would be more valued

here because there is a _ good. but you would be more valued here because there is a shortage - good. but you would be more valued here because there is a shortage of i here because there is a shortage of doctors. , ., ., doctors. true, but there are no incentives _ doctors. true, but there are no incentives to _ doctors. true, but there are no incentives to keep _ doctors. true, but there are no incentives to keep us _ doctors. true, but there are no incentives to keep us here. - doctors. true, but there are no| incentives to keep us here. and doctors. true, but there are no - incentives to keep us here. and here is the thing. — incentives to keep us here. and here is the thing. the _ incentives to keep us here. and here is the thing, the exam _ incentives to keep us here. and here is the thing, the exam he _ incentives to keep us here. and here is the thing, the exam he will- incentives to keep us here. and here is the thing, the exam he will sit - is the thing, the exam he will sit tomorrow it's set by the gmc, the general medical council in the uk. the next morning at the exam hall, we find hundreds of young doctors queuing. the event was booked up months ago. among the hopefuls, dotun. look how many people are here this morning. well, i think about 328. 328 people, and this is one of just three examples. in lagos, the people you see in blue bibs work for the british council, which is sponsored by the foreign office and is overseeing the exam. 0dd, you might think, when that same government proclaims its commitment to the red list and no active recruitment. turns out we're not welcome.

we've just been thrown out of the car park at the examination hall, and it was the british council who threw us out and they said, it's just not good to have you here. and they said it's about the candidate's privacy. but i wonder if it's also to do with the fact that they know that nigeria is on the red list and theyjust don't want to be associated with the brain drain. 3 hours later, the candidates emerge into the nigerian sunshine. where do you want to go if you succeed? i want to go to the uk, uk. i want fulfilment in my craft. i want to get i mean, the nhs has a working system and that's what i want. when i go to the uk, i want to consider a residency in family medicine. in general practice. we described what we'd seen to the british medical association, the trade union for doctors in the uk. is the british government complicit,

do you think, in active recruitment? certainly they will be aware if the british council is enabling a mass scale taking of the plab exam. it would be a, i think, misleading for the department of health and social care to say that they did not know about this. indeed, they are trying to take some active steps with the code of practice to discourage it. but they know this is a red list country, don't they? absolutely. and yet this is overseen by the british council, which is funded by the foreign office. absolutely. so there's an element of one hand giving in the code of practice and the other hand taking away. the department for health and social care rejects that and says responsibility for arranging lab exams lies with the gmc, which is independent of government. the gmc say they have no role in the recruitment of doctors and that they have a legal obligation to provide routes

to registration for doctors abroad. and the british council says it simply delivers the pleb one exams in line with gmc requirements. remember augustine, the doctor from the start of this report? well, it was whilst he was studying for the second part of those plab exams here in the uk that he was approached by nes health care, the company behind me, and later offered visa sponsorship and a potential job. it sounds like that's a breach of the government's code of practice on no active recruitment from red list countries says it's not because the company is not a recruitment agency and the doctors nes says it's not because the company is not a recruitment agency and the doctors it engages with have already committed themselves to working in the uk anyway. but a spokesman for the department of health and social care told us that the code does apply and so it's in breach of it.

augustine was so eager to practice here. he signed an nis contract that opted him out of something called he signed an nis contract that opted him out of something called the working time directive. legislation that protects people from long working hours. do you think that you were so tired that there was a potential that you weren't doing the best or weren't delivering the best care for the patients? yes. that's the and that was my worry, because i knew that working tired puts the patients at risk and puts myself also at risk as well for litigation and other things. so i was really, really worried. if he was too tired to work and needed a back—up doctor to take his place. augustine's contract permitted deductions from his salary. did it act as a disincentive when you knew you were going to lose money, if you were actually doing the right thing and getting a replacement to come in? yes, there are times when i was sick, you know, you have like a flu or something and you just can't even

because i wasn't so willing to call in to say, oh, i'm not filled because i felt i'll lose money. yes. nuffield health, which runs the hospital in leeds where augustine worked, told us they expect all their service providers to comply with applicable laws and regulations and they'd review their relationship with any service provider found to be operating unethically. they say they closely monitor the workloads of their resident medical officers and stipulate regular breaks and rest days. this is where some nes doctors come for help. i have multiple night disturbances because i woke up multiple times at night to attend to this patient. drjenny vaughn from the doctors association hears similar stories again and again. i was very, very tired. i asked her if these long hours could be excused in any way at night, for instance, when doctors are only on call, not actually on the ward unless needed.

if you're on duty, you're on duty and you're in a hospital room. you could be called at any time. that is a basic understanding of a doctor who's on duty. if they can be called at any time, they're on duty. that's why no doctor in the nhs on the nhs contracts does more than four nights consecutively because we know that it's frankly not safe. she's particularly concerned that nhs doctors can't leave their contracts without three months notice. she's particularly concerned that nes doctors can't leave their contracts without three months notice. if they do, they face more salary deductions. this is a slave type work with excess hours, the like of which we thought had been gone 30 years ago. it is not acceptable for patients for patient safety reasons. it is not acceptable for doctors. why is it that nobody�*s intervened to stop this from happening? we have tried to raise this, and i think it is the fact that there is a tolerance

of a culture that is acceptable for international medical graduates to be treated in a two tier system, which is what's going on in this country at the moment. nes told us that they work entirely in line with the letter and spirit of government guidelines. they say feedback about doctors experiences with them is extremely positive. they also say they provide a pathway for thousands of additional doctors to work in the nhs, greatly benefiting the british public. back in nigeria, more gmc exams are organised for the new year as they are in pakistan, ghana and sudan. britain will continue to recruit doctors in developing countries because it's cheaper than training them at home. it raises an uncomfortable question— how can we be serious about honouring the red list

when our own system can't function without shopping for doctors abroad? hello. it is a typical autumn forecast coming up, blustery showers, gusty winds, some sunshine, too, no sign of any significant frost in the near future. and for the weekend, a weekend of two halves, most of the showers around today, tomorrow will be much drier. we have had plenty of showers and spells rain around this afternoon, this first band extending into north—eastern scotland and the northern isles, plenty of showers piling into the western scotland,

northern ireland, north—west, south—west england, and wales, some of those showers pushing a little bit eastwards. most of these will tend to fade as we head through this evening and overnight, but we will keep the showers going for much of the night across northern ireland, england, and northern scotland, still with us gusty winds, particularly through irish sea coasts. temperatures generally in a range of six to nine celsius, could fall perhaps to three or four some rural parts of scotland and northern england. for tomorrow, our area of low pressure is responsible for today's rain is pulling away north and eastwards. second area pushing in from the south west later in the day, but in between, something quieter, still some showers first thing for northern ireland, scotland, and northern england, they will soon fade. plenty of sunshine, actually, for much of the uk tomorrow, before this second area of cloud and rain pushes into northern ireland, wales, south—west and southern england through the afternoon. the winds not as strong as they have been today but still quite gusty for the northern isles and along some irish sea coasts as well. temperatures on a par

with this afternoon, really, so 11 to 13 celsius for scotland, northern england, and northern ireland, ia to 18 celsius further south. and then this band of showers and longer spells of rain then starts to push its way gradually north and eastwards through sunday evening and overnight. some of that rain could be particularly heavy for parts of northern ireland, north—west england, and western scotland. and it is all tied in with this area of low pressure which slowly starts to pull away north and eastwards as we head through monday. notice that the isobars are much further spaced apart, so the winds will be lighter as well. still some rain around on monday morning for parts of scotland and northern ireland, and maybe south—east england, but it will be starting to pull away through the day. so, for most on monday, it is mainly dry, there will be some warm spells of sunshine, and temperatures still in the mid if not high teens, just 11 or 12 across parts of scotland. so, really, for the week ahead it is looking like a drier day on both monday and tuesday, before some wetter, windier weather starts to arrive through the second half of the week.

this is bbc news. the headlines at 6pm... we are going to take some tough decisions, notjust on spending but also on tax because we have to show the world that we have a plan that adds up financially and that is the way we will get stability back in the situation. but there's more bad news for the government on the economy — the head of the bank of england says interest rates may have to go up even higher than predicted: we will not hesitate to raise interest rates to meet the inflation target as things stand... stand today, my best guesses inflationary pressures will require a stronger response than we perhaps in august. manchester united and england footballer mason greenwood is charged with attempted rape, engaging in controlling and coercive behaviour, and assault.

more than a0 turkish miners are now known to have died