London, Aug. 19: Yet another fault has been found by British unions with the quality of outsourcing to India but this time perhaps with some justification.

Medical letters are being transcribed by secretaries in India but potentially life-threatening errors are creeping in because of insufficient knowledge of either the English language or of complicated terms, it was claimed yesterday.

It is also possible that the use of computer spell checkers is leading to some words being replaced by unlikely ones. In one example, the drug “Lansoprazole”, used to treat stomach ulcers, was transcribed as the popular holiday resort “Lanzarote”.

In another case, “phlebitis (vein inflammation) left leg” was changed to “flea bite his left leg”. And a “below knee amputation” was transcribed as “baloney amputation”. One note referred to a patient’s “cute angina” instead of “acute angina”. “Euston station tube malfunction” should have read “Eustachian tube malfunction”.

The problem is that most employers in the UK today find that many young British people cannot spell even easy words correctly.

In order to save money and clear up a backlog of untyped letters, eight London hospitals are using the services of an Indian outsourcing company called Omnimedical. The service is being used by St George’s Hospital in Tooting, one of the biggest in London, and seven others around the capital to type around 7,000 letters a month.

Doctors dictate their letters on to tape recorders as usual before the sound is encrypted and sent to India. The patients’ names are removed to maintain confidentiality and added when the typed results come back.

The work is done in India by secretaries who are paid about a third of the £14,000 a year earned by their UK counterparts in the National Health Service — and the latter are said to be poorly paid.

A spokesman for St George’s Hospital said: “The bottom line is that the transcription service is better for patients, better for GPs and better for medical secretaries. GPs now receive timely information about the care given to their patients, while medical secretaries have been freed up to provide better support to consultants and the patients they see.”

He added: “The transcription service is secure and confidential, and there are rigorous safeguards in place to ensure the accuracy of letters before they are sent.”

But Michael Fiennes, of the Association of Medical Secretaries, alleged he had heard of many examples of mistakes creeping into letters, some so serious that they could lead to patients being given the wrong dose of medication. For example, 5mg could easily become 50mg.

“Medical secretaries should be properly trained, but they are appallingly badly paid for the work they do and that is why the work is being sent abroad,” he said. “This increases the chances of mistakes creeping in that could put patients’ lives at risk.”

GPs were generally picking up the errors, he acknowledged, but because of their workload the potential for mistakes not being spotted was “very worrying”.

“We would always recommend that medical secretaries are properly trained and rewarded for the work they do,” he said.

Omnimedical’s record was defended by Gorav Datta, its marketing director, who rejected claims that the service was compromising patient safety. “All letters are signed and checked by doctors before they are sent to GPs.”

Datta said the NHS had been forced to use temporary staff to type letters because of a shortage of secretaries and their standards were “very poor”, leading hospitals to outsource the work. He said the service offered by Omnimedical was “infinitely better than temps”.