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GPs go forth

British GP unable to work in NHS as GMC says laws are 'not fit for purpose'

Exclusive A British GP who trained and practised for 20 years in Australia has been prevented from working in the NHS under legislation the GMC has called 'not fit for purpose'. 

The GMC will not automatically recognise the qualifications of GP Dr Benjamin Tarsh in the way it would if he had trained within the European Economic Area (EEA) - despite Dr Tarsh having been a GP tutor and examiner of fellowship candidates at the Australian equivalent of the RCGP. 

Instead GPs from outside the EEA are legally required to provide the GMC with evidence that their qualifications are ‘equivalent’ to those of GPs who trained in the UK, which is then assessed by the RCGP.

Dr Tarsh said the rules meant he had effectively been 'barred' from working in the NHS because since November 2018 he has been unable to get hold of key documents from a GP practice he used to work at back in Australia, which is not legally obliged to provide them.

The GMC admitted to Pulse that the current legislation was not 'fit for purpose' and it was doing 'everything we can' to support the growth of the GP workforce in the UK.

Dr Tarsh said he had encountered ‘unnecessarily excessive bureaucracy’ while planning his return to the UK, and has urged regulatory bodies to rethink their rules.

The rules stopping Dr Tarsh from working in the NHS come at a time of an ongoing GP shortagethe RCGP's calls for 5,000 more GPs to meet workforce targets, and the BMA predicting the worst winter in NHS history

Una Lane, director of registration and revalidation at the GMC, said: ‘The current legislation is not fit for purpose and makes it very challenging for GPs who qualified outside the EEA to register as GPs here.

‘We are doing everything we can to support the growth of our GP workforce and we have worked closely with the RCGP to streamline and simplify the process for GPs qualified in Australia, Canada, South Africa and New Zealand.'

She added: ‘We are pleased that the Department of Health and Social Care has committed to changing legislation in this area and we look forward to working with them in developing a system that will benefits GP from overseas who wish to work here while maintaining the standards that all patients have a right to expect from their doctors.’

Dr Tarsh recently completed an MA in medical ethics and law at King's College London, which focused on NHS commissioning and resource allocation. He said he hopes the reforms will bring about improvements for the sake of both NHS patients and 'overwhelmed staff’.

He told Pulse: ‘If the Government truly wants to recruit highly-qualified Australian-trained GPs to the NHS, they urgently need to fix the current insurmountable legal obstacles.

‘In my view, they should accept the RCGP's recognition that GPs trained under appropriately-approved Royal Australian College of GP's curriculums have received equivalent training.

‘For added confidence and to ensure applicants have an appropriate medical regulatory record, these doctors could provide certificates of "good standing" from the Australian Health Professionals Regulation Agency and a duly-certified copy of their qualifications to the GMC as the sole requirements for equivalence registration.’

The GMC recently announced that from 2023 it will introduce a new skills test for overseas medical students wanting to practise in the UK, which it expects will boost recruitment.

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Readers' comments (31)

  • ‘he has been unable to get hold of key documents from a GP practice he used to work at back in Australia, which is not legally obliged to provide them.‘

    What cloud did you leave under for them to not want to help you?

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  • Katharine, I don't think you are correct. Please see the link below

    https://www.gpjobsinaustralia.co.uk/good-news-for-uk-irish-gps-going-to-australia-

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  • The issues are legally complex. Australian privacy Law prevents access to medical records for third parties except in the 3 scenarios, 1) For the benefit of medical treatment of the patient
    2) anonymised for audit purposes
    3) anonymised for research purposes
    The legal advice I have is that providing even anonymised records for equivalence recognition in another country would breach Australian Privacy Law.
    Further unless one's contract with a clinic specifically included a clause that permits access for the purposes of obtaining euqivalence recognition in another country, the legal advice I have is that providing access by a clinic for this purpose would fall foul of Australian Privacy Law as relates to medical records.
    thus the Streamlined CEGPR process is not fit for purpose as the GMC is seeking provision of documents that it is prima facie
    unlawful to provide.

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  • Completely ridiculous. The NHS should be biting this chaps hand off if he wants to work in the UK. The bureaucracy involved needs a flamethrower. Named individual at the GMC to fast track all returning doctors within let’s say 30 days to be generous. And Responsible officers need to apply common sense when it comes to signing off doctors. What message does it send to our exiles?

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  • A good friend of mine who trained in the UK and worked in the Middle East for 3 years tried to return to UK NHS General Practice last year. So many barriers resulted in her working as a GP in the private sector in London. A narrow escape for her.

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  • Took Early Retirement

    I have to say it and risk getting flamed, but so many of the latest generation of GPs, as a result of being swamped with the RCGP's obsession with naval-gazing and psychobabble, couldn't deal with a really sick person, other than perhaps recognising that they WERE sick and then dialling 999. To some extent understandable with the less exposure to sick people and decision making in the role of FY1 & FY2. Sad really, and i don't blame our younger colleagues; I blame the RCGP. Mind you, we might be good at signing sky-diving forms and checking old people's boilers.

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  • Status: -British National, British trained (Edinburgh) and a principal in UK GP practice for 7 years before leaving to practice in Canada.

    In 2004, after 30 yrs has a full-time, full service (including hospital in-patient care) GP in Canada, I decided to do UK Locum GP work.

    Although it took around 6 months, various documentation and a fee, GMC allowed me to transfer from the Overseas list to the Active List - but only then advised this did not permit me to practice - I would require a Certificate to Practice.

    A very long story shortened: of all the 'categories' to obtain the Certificate, 'Equivalence' (as per Dr. Trash) was the only option. Equivalence meaning being able to show that one's training and experience was equivalent to the then GP vocational training programme.

    The 'Acquired Rights' route, which one would have thought would be applicable based on UK training and UK GP practice, was deemed not to apply and was only available to graduates from the EU, whether or not they could speak English (in 2004 there was no requirement to show English language proficiency).

    Over a 4yr period, 2004 - 2008, all involved 'Committees' maintained that, despite having produced evidence of full & continued Medical Education programmes and peer references of a high quality professional practice, I did not qualify for Equivalence and would need 6 months training the UK practice before a Certificate could be issued.

    Needless to say, politely, I told the GMC & their Committees to shove it and challenged their decisions by dragging them to the NHS Litigation Authority. The dossier they presented to the Authority to defend their actions contained factual inaccuracies and misrepresentations, lies really.

    Outcome: - NHS Litigation Authority took time to review the situation but ruled in my favour and, again putting it politely, advised the 'talking heads' to get their heads out of the sand and immediately issue me with a Certificate to Practice'. GMC took their time but did so.

    So, 4 years is a long time - but as they say, 'it's never over until the fat lady sings'.

    In 2008, I returned to UK locum GP practice and then had to deal with Appraisals &, finally, Recertification -successfully.

    Along the way, a frequently heard comment from friends and peers was 'You must be mad'. They could have been right - but: -
    Illegitimi Non Carborundum.

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  • There is severe power abuse in UK medicine that's got far worse in the last 10y. It's causing suffering both for GPs and patients to the extent that we are now in a full blow crisis. The profession only has itself to blame though by standing by whilst we are pulled apart and suffocated by educationalist and regulatory red tape. The tragedy is that it's the patients that suffer at the end of the day.

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  • Dr Tarsh, it is a blessing in disguise. Don't come here. You are spot on with the ‘unnecessarily excessive bureaucracy’ which is only the tip of the iceberg. Things like safeguarding, multiple areas and regulators for patients to complain leading to multiple jeopardys, pension tax, QoF, CQC,yearly changing contracts, home visits, the toxic practice climate, medication barring and changes as well as shortages, delayed referrals. You must really find a good reason coming to the uk. I am sure you will regret it if you come.

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  • Truth finder is spot on.

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