Professor Shabas’ concern for African medics is laudable but in proposing technical solutions to a political problem, the cause of the problem - Africa’s chronic underdevelopment remains unchallenged.

As a former ‘aid’ worker, I have first hand experience of Africa’s healthcare systems and agree that the numbers of healthcare professionals practising are paltry in comparison with what’s actually needed. The UK’s Department of Health, for example, has worked with the Department for International Development to produce a list of countries from which there should be no active recruitment, based on the OECD Development Assistance Committees list of aid recipients. The UK also has a Code of Practice to try to curb the activities of unscrupulous recruiters who poach healhcare professionals such as nurses.

While these initiatives have made little difference in practice to address Africa’s underdevelopment, they have further restricted the freedom of movement of some people to the developing world - a freedom that we in the West take for granted. Penalising recruiters or developing even more restrictive measures, as the Professor suggests, will not solve the immense problems facing healthcare systems in the developing world - which incidentally are not due to personnel shortages. Nor will they address the fundamental problem of underdevelopment in Africa or elsewhere either - a problem which makes aspirational healthcare workers ripe for the picking.

This problem urgently needs addressing in the political arena and a discussion as to its real cause is long overdue.

Brid Hehir, UK

William Schabas is quite right that we are draining Africa of medics. What is equally shocking is that the costs of paying doctors and surgeons are rising faster than inflation and our growth rate. In any other market where salaries are huge, more workers would be attracted to that market thus bringing salaries down. But not in the British healthcare sector. We see average GP salaries now of £100,000 (not forgetting their astonishingly generous pensions on top of that) and surgeons’ salaries even higher. The consequence is that Africans die needlessly and we get a healthcare system which we have realised with the credit crunch we simply can’t afford.

So, what’s the solution? First, encourage individual freedom of medics trained abroad to work here, but make sure they return to care for their compatriots after a time. Second, allow market dynamics to determine salaries (as they do in the private sector) which would inevitably drive down salaries. Third, split the savings between the British taxpayer and the under-cared-for Africans.

Medics won’t like it, but those who should be getting healthcare, namely the British taxpayer and the needy Africans, will benefit more than they realise!

Charles Fiddes Payne, UK