The centres will help to cut NHS waiting times

This is despite assurances last year that the centres would mainly use staff from overseas or outside the NHS.

The Department of Health has denied that the move will leave hospitals short of doctors and nurses.

However, the British Medical Association has warned that it could destabilise the NHS.

Extra operations

The decision to allow overseas firms to employ NHS staff was revealed at a meeting between doctors and Department of Health officials in July.

According to the BMA, officials said overseas companies would be allowed to second up to 70% of their staff from the NHS.

There has been no change whatever in our position on this Health Minister John Hutton

The diagnostic and treatment centres are a key part of government efforts to cut NHS waiting times in England.

Ministers hope the centres will provide an extra 250,000 operations a year by 2005, helping to cut waiting lists and deliver savings elsewhere in the NHS.

The centres will focus on operations like hip or knee replacement or the removal of cataracts, which are among the most commonly performed surgery in NHS hospitals.

Patients referred to one of the centres will be able to choose the date and time of their initial appointment - usually within six weeks of referral - and arrange any necessary treatment at a time which suits them.

They will stay just long enough to recover from their surgery - often a matter of hours.

Around half of the centres are being run by the NHS. However, private overseas companies are being lined up to run the rest.

The government entered negotiations with 11 foreign firms interested in running the centres earlier this year. Some are expected to be up and running by the end of the year.

Under the original plan, these centres were expected to bring in their own doctors and nurses or appoint staff not working in the health service.

The medical staff from these units will be from overseas and additional to the existing NHS workforce Department of Health, June 2002

In a press release issued in June last year, the department said allowing overseas private companies to run centres would deliver "real increases in the number of medical professionals working in England".

It added: "The medical staff from these units will be from overseas and additional to the existing NHS workforce."

Health Minister John Hutton insisted that the foreign companies will not be able to poach staff.

"There has been no change whatever in our position on this," he said.

"Most of the independent contractors will be bringing in teams from abroad.

"They will be contractually forbidden from taking staff from the NHS where no agreement has been made with the local NHS.

"No NHS staff are being transferred to the independent sector."

'Destabilise NHS'

The British Medical Association suggested allowing these firms to poach NHS staff could destabilise the health service.

"We very much welcome the increased capacity which would be provided by the diagnostic and treatment centres," said chairman Mr James Johnson.

"They should mean that patients will be treated more quickly than the NHS can cope with at the moment and this will bring waiting lists down."

But he added: "We don't want to see NHS hospitals destabilised by taking either money or staff away from them."

Shadow Health Secretary Liam Fox said the government's policy was in "complete disarray".

"Everyone believed originally that DTCs would not be able to recruit NHS staff.

"This is now obviously not the case. But will they be seconded or simply leave the NHS? What will their terms of conditions be?

"Ministers clearly are making policy up as they go along. What a shocking state of affairs for a government that has been in office for six years."