Well, who knew?
The purchase of surgical equipment should be bound by the same fair trade rules as foodstuffs like coffee, sugar or bananas, a researcher suggests.
Dr Mahmood Bhutta said he had anecdotal evidence there was exploitation of workers in developing countries.
In the British Medical Journal, the ear, nose and throat doctor said it was down to purchasers such as the NHS to press for fair trade.
The Department of Health said buying equipment was down to NHS trusts.
But Dr Bhutta said no systematic investigation had been undertaken into the sourcing of healthcare goods from developing countries.
Pakistan and Malaysia are centres for surgical instrument manufacturing.
Dr Bhutta, whose family comes from the Sialkot area of Pakistan – a centre for instrument making – has interviewed a number of workers and focussed on issues relating to global health and medical ethics.
He wrote in the BMJ: “When surgical instruments have come from manufacturers in the developing world then, as is the case with other goods, the trade may be open to the exploitation of power by transnational companies, driving down prices and labour standards.”
The global trade in hand-held stainless steel surgical instruments was worth at least £352m a year, he added.
In developing countries, much of the early stage of manufacture – forging, filing, grinding – is subcontracted out to workers employed in a small workshop or their own home.
Manual labourers are paid per instrument, and Dr Bhutta said workers often earn just $2 a day, with no job security, medical insurance or education for their children.
He highlighted past research which has shown many subcontracted workers in developing countries are children.
Only finishing and quality checks are carried out by companies in-house.
Fair trade would be a good start, but the NHS is dropping the ball in a big way by passing the pound. Clearly, what’s needed above all is to treat medicine as a public service, not a profit-making industry as it currently is in far too much of the world.