The last company I worked for, a multinational engineering services consultant, were quite heavily involved in what they euphemistically called "High Value Engineering", which was pretty cynical code for cheap labour.
Over the last 5 years, I've heard all the horror stories of piping designers laying out major pipes through walls, totally undersized switchgear, etc etc. Mostly it meant that expats would have to go to the foreign office and sort out the issues. They'd come back raving on about how useless the engineers were and so on.
But these bad experiences were DEVELOPING the foreign office. They learn how to get better, and just as importantly, they learn what "better" actually looks like. And with more and more systems in place designed specially for outsourcing, the management of the work is getting easier and more efficient.
Staff turnover in the foreign office is a problem, but most companies realise that the most important thing is to have good technical lead engineers and designers and they make sure to retain them.
Over the years I've noticed a growth in the use of low cost centre offices. Most of the major projects are now bid with a portion of the job done in a low cost centre, mainly the tedious "sausage-making" parts of the project, e.g. cranking out drawings, MTO's, data sheets, etc
My personal view on this has been to advocate the expanded use of automation and database tools, for instance in electrical engineering, things like Intergraph's Smartplant Electrical. The managers all thought this was a terrific idea, but never wanted to invest in it properly - most just wanted a plum project to come along so they could develop the capability on the client's dime.