Foreign doctors whose English is so poor that they need interpreters are being allowed to operate on patients in Britain, the medical regulator has warned.
The General Medical Council said current European rules represent a “serious cause of concern” and risk to patient safety by banning it from testing GPs’ language skills before they can start working here.
The regulator said it has some doctors on its books who "are not able to communicate in English" but could not prevent them seeking work here under European law.
It warned that bogus doctors from other countries may find their way into the NHS by presenting fake certificates or ID, because of a lack of security checks, or could hide the fact that they had been suspended from practising in their homeland.
Even genuine doctors from abroad may have little idea of how to carry out procedures that are standard in Britain, because there is no standard training, education or healthcare system.
The GMC’s strongly worded submission to the European Commission, which is reviewing the laws that allow free movement of medics across the continent, comes after the scandal of Daniel Ubani.
The German doctor, who worked mainly as a cosmetic surgeon, gave a lethal dose of painkillers to a 70 year-old English man on his first shift as a locum GP in Cambridgeshire, but the GMC had been unable to check if he had any experience in general practice.
Diane Abbott, Labour’s Shadow Health Minister, said “inherent weaknesses in the vetting system” allowed the Ubani case to happen.
“To suggest that workers can operate in our healthcare system without proper training, assessments or being able to communicate with patients seems to me to be absurd."
Under the current system, doctors from the European Economic Area - the 27 European Union members states, along with Iceland, Liechtenstein and Norway - are allowed to work in Britain and 23,033 are registered to do so.
Unlike doctors who come to Britain from other parts of the world, the European single market means that the GMC has to accept their qualifications and is not allowed to test their competency or their English language skills. Potential NHS employers are allowed to carry out such assessments, however.
The regulator, which keeps a register of qualified doctors and holds disciplinary hearings that can result in them being struck off, has said that a handful of foreign doctors are on its books even though they cannot speak English.
Its submission to the EC states: “Currently, EEA applicants to the GMC register do not need to pass a language assessment even in cases where there is doubt.
“We have recent examples of EEA doctors seeking recognition and registration with the GMC who are not able to communicate in English and were assisted by an interpreter. This is a serious cause of concern to us.”
In such cases, all the watchdog can do is remind doctors they have a duty to understand the language of the country in which they are seeking to work, but it cannot prevent them from registering.
The GMC said it has already carried out fitness to practise cases in which doctors have been struck off or suspended partly as a result of their poor English.
In one case, a doctor was found “apparently speaking in a foreign language” in an operating theatre, leaving the assistant surgeon “unsure what assistance was required”.
The GMC said: “It remains our view that the ability of the professional to communicate effectively in the language of the host member state should be a prerequisite for registration and that we should be able to assess the knowledge of language where appropriate.”
In an apparent reference to the Ubani case, the GMC told the EC: “Recent events in the UK have highlighted some of the regulatory gaps that have the potential to harm patients and undermine confidence in both the single market in general and healthcare in particular.”
It warned the EC not to simplify the system of mutual recognition of doctors across Europe “at the expense of patient safety”.
The submission raised “serious concerns” about a code of conduct that prevents it from getting hold of translated copies of migrant doctors’ diplomas and proof of their identity, and said that a proposed “professional passport” also brings “significant risks” of fraud and forgery.
The GMC said that it and other regulators across Europe “cannot have full confidence in each other’s medical training and education” because there is so little knowledge about standards in different countries.
In addition, European states operate widely differing healthcare systems so that there is “patient safety risk” when foreign GPs are asked to carry out procedures they were unused to in their home countries.
It said doctors should only be registered to work elsewhere “when they are known to be fit and safe to practise and have no conditions or limitations on their registration”.
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