hello this is bbc news. the headlines. chancellorjeremy hunt has been pictured in the back of a car leaving chequers, the prime minister's country retreat, after meeting liz truss to discuss the government's economic plans. the first tory mp has publicly called for liz truss to go. china's president xijinping has been defending his controversial zero covid strategy as a historic communist party congress kicks off in beijing. the iranian authorities say four inmates are dead after a fire at a prison in the capital as protests continue . more than a thousand paddington bears and other teddies left by the public in memory of the late queen elizabeth are to be sent to charity. now on bbc news, medical brain drain staff uk hospitals.

this is the story of a quiet scandal that's depleting nigeria of some of its finest medical talent. it's crazy. you spend all your training here. yeah. and everything is supposed to give back to your community at the point of your best time, your best energy. you're leaving the country. nigerian doctors are queuing to practice abroad and the uk is taking more of them than ever, despite the british government supposedly cracking down on active recruitment from developing nations. where do you want to go? uk. but the bbc has discovered that once they arrive in the uk, some nigerian doctors find themselves open to exploitation. i felt really trapped. a lot of people, theyjust can't fathom how you are able to be confined in a hospital for seven days working 2a seven. and when they try to leave their contracts, it's not always as simple

as they think. this is a slave type work with excess hours, the like of which we thought had been gone 30 years ago. 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. and how did you feel? i felt unctuous. 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. outpatients and x—ray, and i would be working from seven up until 11 at night. all patients at the seaton x—ray ray and i'll be working from seven 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. why this community? we can't have a hospital in our community here. everybody can benefit. 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 oliver djiboutu 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. i have lost to staff to the uk this year. 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. availability will drop. it will increase patient waiting time because there are fewer doctors. see more patients. 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 cream

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. on his laptop, revision. this doctor is a fully qualified doctor who works in lagos a&e. 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 brain drain. the reason there is a brain 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. but you would be more valued here because there is a shortage of doctors. true, but there are no incentives to keep us here. and here 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. well, i think about 328. 328 people, and this is one of just three examples.

odd, 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 plab i 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. 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 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 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 it's 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 again. for many of us, it has been a financial underpinning with sunshine around but the weather is beginning to change. this is how we

started off the morning in east sussex. over more recent hours we have seen the clouds gather and there is some rain on the way. this area of low— there is some rain on the way. this area of low pressure _ there is some rain on the way. this area of low pressure is going to be putting its way northwards and eastwards over tonight and we will see some rain for the time but the wettest area will be across western areas. this evening, the rain arrives across england and northern ireland and then drive scotland are heavy at times accompanied by south—westerly winds we talking about pretty wild air so temperatures for many of us overnight double figures six to 8 degrees but later in the night is that air groups degrees but later in the night is thatair groups in degrees but later in the night is that air groups in temperatures that link bitter about ten. tomorrow rain creeps away from eastern england blustery showers through northern

ireland and scotland but otherwise should be an improving story for wales and much of england where it's going to be another very mild day for october with temperatures other and i9 for october with temperatures other and 19 in london the average for the stage of october is about 16. now for the middle part of the week, this area of high pressure builds across the north and east of the uk but the south—west we got a pressure throwing up bands of range from time to time. tuesday are largely prior, a few missed patches to be expected in the morning the lot of sunshine, a few bursts of rain arriving towards a south—west later in the day for many it is mild, temperatures dropping a little bit in scotland with highs of around 12 or 13 degrees which is quite close to average for this stage of october. wednesday, we see rain encroach across northern ireland south—west england still very mild for many but it is turning a little bit cooler in scotland with temperature is about 11 in aberdeen about 11 as well in newcastle. on thursday, it starts to turn rather

again, but we will see this pulse of heavier rain moving its way northwards across the country accompanied by pretty mild south to south—easterly winds, temperatures about 18 degrees in the south. that is the latest.