A new industry survey by Mintel, reveals a high level of customer dissatisfaction with the quality of service provided by call centres in India, prompting calls by unions to return offshored jobs back to Britain. Reports also mention complaints about the quality of medical transcription work offshored to India, resulting in delays in vital communication with implications on the treatment received by patients in Britain.

During the last year, several banks and financial service and utility companies have "repatriated" their call centre services to the UK from India. These include Abbey, NatWest, Lloyds TSB, Aviva and Powergen. Unions and some experts claim that cultural misunderstandings and concerns over the quality of service from offshore call centres is forcing companies to rethink their strategies.

The survey by analysts Mintel found that 82% of people questioned indicated they would rather not speak to someone in an overseas call center when discussing their financial affairs.

Pete O'Grady, the assistant secretary for Lloyds TSB Union, said the results echoed an existing trend. "Many companies are now making a big play of the fact that their call centres are based here - the Royal Bank of Scotland has, and they seemed to have benefited from this - so as ever, where the market leads, others follow.

"Lloyds TSB brought their call centres back because they claimed that technology here gave them greater capacity, but our view was that they were dealing with an increasing number of problems caused specifically by being offshore."

More than four out of five of adults questioned were worried about the increased potential for account misunderstandings, while security fears are also a genuine area of concern for three-quarters of consumers, even though there is actually no evidence that security problems at offshore call centres are any worse than in their UK counterparts.

Philip Taylor, professor of human resources at Strathclyde University and an expert on the international and domestic call centre industry, said companies no longer believed that they were a straightforward solution. He said: "All the evidence shows that there are powerful forces pushing companies overseas, the fact that 40% savings can be realized by doing that being the top of them."

"But difficulties have emerged in India. There are questions over the quality of service; turnover of staff according to research is about 75% per annum."

Taylor added that while he did not believe that banks would start a wholesale restructuring of their operations, he said that there had been a "segmentation" of them, with premium accounts being dealt with at home, while standard accounts would continue to be dealt with abroad.

Anne Marie Forsyth, chief executive of the Call Centre Association, said: "Organisations have to understand what their customers really want before they shift their operations overseas, and this is something that I think companies are beginning to do.

"If it is simply a case of shifting the services overseas in order to save money, it won't work. But if enough effort and investment is put in to making the move work and ensure customer service is maintained then it can."

However, according to Ann-Marie Stagg, chairwoman of industry body, the Call Centre Management Association, the broad opinion was that overseas operations were still viable.

Meanwhile, a heart patient has criticised the National Health Service (NHS) after her treatment was delayed for months while she waited for her doctor's letter to be typed up in India. Dorothy Nicol, 64, had an angiogram for a hole in her heart at the end of February. Her consultant at the Southampton General Hospital in Hampshire said he would write to her within a week outlining her treatment.

But the letter was sent to India to be typed up and only arrived back at the hospital two months later. Nicol, from Christchurch, Dorset, is still waiting for her drug treatment to be prescribed while the letter and angiogram pictures are sent to her consultant at the Royal Bournemouth Hospital, in Dorset.

She said: "It's not the hospital I'm complaining about. It's the system. It's just ridiculous. The NHS is letting us down. I'm sure there's plenty of people in this country who can still type. But evidently it's cheaper to send it all the way to India by email to be typed up and sent back by email. "It makes no sense at all to me. It may be cheaper, but it has been a nightmare waiting and waiting."