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Healthcare is a big business. The global market for medical goods runs into the billions and the supply chains that service this businesses are vast, employing millions of people worldwide.
If you were now asked to put a human face to this market, what would you imagine?
Could you imagine a seven year old child working on a grinding mill, or a migrant working more than 80 hours a week?
The British Medical Association (BMA), through independent research, exposed that many supplies used in the NHS are produced in unhealthy, unsafe and unfair working conditions. Wide scale abuses have been reported in numerous manufacturing sites – from uniforms, to latex gloves, to disposable surgical instruments – international labour core conventions are persistently disregarded, and the use of child labour is widespread.
2017 marks a decade of the BMA working to raise awareness of wide scale abuses within healthcare supply chains. We have been calling for ethical trade within the NHS, and along the way have made considerable progress, and helped leverage the significant purchasing power of the healthcare sector to foster real improvements in the working conditions for workers globally, promote decent work for all, and eradicate modern slavery from within its supply chains.
Global demand and competition turn human labour into a commodity and labour standards become secondary to price.
This creates a distressing paradox, set against the core of what the healthcare sector is built on and throws into the foreground the moral and ethical responsibilities of this sector.
Ethical trade is a model which aims to make international trade work better for poor and otherwise disadvantaged people. It is principally about the overall practices of public purchasing organisations and the steps they take to ensure that employment conditions and workers’ rights, in the supply chains of the products and services they procure, are maintained in line with internationally recognised conventions and local laws, as a minimum.
In reality this movement relies on transparency, open dialogue and continual improvement in setting ethical standards. Effective ethical procurement is not easy. It needs commitment from many levels. At the BMA, we have worked across the system from NHS providers and procurement practitioners, to government agencies and national policy makers, to the healthcare industry, and with the end users – the doctors using the goods on a daily basis. We have developed a number of learning tools and guidance documents for all stakeholders across the value chain, identifying opportunities for the healthcare community to lead and shape this movement.
Today is NHS Sustainability Day – it unites all those working to create a sustainable future, led and delivered by the health professionals. There is an opportunity for all doctors to become agents for change. Small changes at local levels can have a big impact, especially when shared and implemented at scale. We have revised our edition of Ethical Procurement for Health – to include more case studies from within the healthcare sector, learning from other countries and organisations. If you are interested in becoming an ethical champion in your healthcare organisation, please visit, this page to find out more.
Over the past 10 years, we have sent a clear signal that this is not business as usual – and that healthcare organisations around the world want the goods they use NOT to come at a cost to basic human rights and wellbeing.
Arthy Santhakumar is Head of international and Immigration at the BMA