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GMC unveils plan for crackdown on foreign GPs
20 Jan 10
Plans for a major regulatory crackdown on the fitness to practice of foreign GPs have been revealed in a GMC report.
The proposals, which would see significant new training hurdles put in the way of EU doctors qualifying outside the UK, have been mooted as a way for the body to protect patients against unsafe GPs while staying within European laws which currently limit the scrutiny regulators can apply.
The move comes with controversy over EU doctors to the fore, with the national spotlight on the inquest into the death of David Gray, a Cambridgeshire patient who died after being given an overdose of diamorphine by Dr Daniel Ubani, a German doctor on his first shift in the UK.
Commissioned by the GMC and the Post Graduate Medical Education and Training Board, the draft report, including 27 recommendations on improving the training and regulation of doctors, follows an independent review led by Lord Naren Patel.
The reports says it is vital that the public and employers have confidence in the in the fitness to practise of doctors, adding: ‘One factor militating against this is the lack of equivalence between the standards required of UK and EEA doctors entering the specialist and GP registers.’
While European law on the recognition of professional qualifications sets out the minimum training requirements for doctors across the European Economic Area (EEA), providing training satisfies those minimum requirements, member states are required by law to recognise the qualifications held by nationals of other EEA states.
It means the GMC has to treat EEA qualifications held by EEA nationals in the same way as UK qualifications and cannot carry out any assessment of the knowledge and skills of incoming EEA doctors who hold recognised qualifications.
The report claims patients are being put at risk because of ‘the shortcomings in current legislation’.
It says there is ‘significant variation between the training undertaken in different EEA countries,’ adding ‘as a result the GMC is unable to ensure that all new registrants are of an equivalent standard to UK trained doctors.’
‘This clearly limits the effectiveness of the registers and the ability of the GMC to protect patients,’ concludes the report.
It recommends the GMC brings in new regulation which means EEA doctors are no longer eligible to take up consultant and GP posts and be included on specialist GP registers, until they have been through the first revalidation following the completion of their training.
The move, it says, ‘could provide a mechanism for continuing to meet EC requirements in relation to recognition of training while ensuring greater equivalence in standards at the point of entry to the specialist and GP registers.’
The report comes with the Government reported to be planning to introduce a raft of new requirements for foreign GPs, including standard of English and medical competence tests, as part of a review of out-of-hours safety being headed up by Dr David Colin-Thomé, the Department of Health's director of clinical care, and Professor Steve Field, chairman of the RCGP.
Niall Dickson, chief executive of the GMC said: ‘We have a great opportunity now to create a system in which every stage of education and training is fit for purpose, successfully prepares the doctor for the next one, where standards are constantly rising and which treats all doctors fairly, wherever they come from and whatever stage they are at in their careers.’
Readers' comments
About time!
This will now regulate the many 'specialist' clinics which has sprung around the UK targeting ethnic minorities with doctors claiming every speciality under the sun
Makes sense to at least check linguistic skills or provide a translator service
This is very welcome news, though, I am afraid, lamentably late. Many experienced GPs saw the problem, years ago, to be met with, 'it's the EU ruling - end of matter'.
You have to be pretty stupid not to understand the problem caused by non-English speaking doctors. How the GMC can ignore this issue, I never understand. Always blame EU rules.
It is not right to generalise matters totally. I have been trained in the Netherlands mainly, but did my GP training in England. Some EU countries do have proper GP training (the Netherlannds is one of them) whereas in other countries any doctor can decide to do GP work as well, without official GP training. I believe this used to be the case in Germany in the past, but this may well have changed in the meantime. I would think that there is a mixture of good, good enough, excellent and very poor doctors in whichever country you go to, whether that is England, the Netherlands or any other country. As long as the training that has been done is sufficient to be able to practice as a fully qualified GP, there should be no other hinderance than ensuring as far as possible that there are no concerns about the doctor in question. This should be no different for UK or EU or overseas doctors. It is however necessary for foreign doctors to have a sufficient understanding and knowledge of the English language to be able to communicate well with his or her patients.
Terrific. What about some of UK trained doctors who as far as I am concerned do not meet essential criteria? What a silly perception of ill borne superiority. Well known from UK history.
And how interesting it is to see comments about English language from doctors with 'typical' English names!
Checking language skills is absolutely necessary but please don't exaggerate your UK GP skills. You only cook with water too and training on the continent is not bad at all. Concerning the Diamorphine case a doctor truly has to check before giving meds but carrying a dose of 100mg(!) in the drugs box - enough to anaesthetize an elephant - is clinical negligence. Made in UK!
We have all worked with excellent doctors that have qualified and originated from the EU. We have all also had experiences where their understanding of English was a cause for concern. I am afraid this feels like too little too late but it's better than nothing and could be considered a start.
At last, the rules will be applied to ALL medical graduates who wish to work in the UK! Having worked for over 45 years in the UK, I feel that non-European doctors have at LAST got the recognition they fully deserve!! Well Done! Ram
I refer to MW's comments in response to this article and feel the editor should be more selective and not allow inflammatory coments. Talking about UK history and personalizing this matter is not helpful. This is an issue of patient safety and minimum standards of clinical care - not an opportunity for someone to have a dig at unrelated matters.
Thanks for the comment - while we will obviously intervene where necessary, we're keen to allow debate to flow as freely as possible on this undoubtedly contentious issue.
With regards to MW's comment, with all due respect, if a UK trained doctor does not meet the required criteria, they won't be given the CCT to practice! Also, I do feel you are mistaking what an English name is. Mohammad Kabir is as much an English name as mine and yours in modern England, maybe the word you were looking for was 'caucasian'.
I have seen so many english doctors struggling with local dialects: do they have to pass an english test as well ? Dear colleagues, please come down to earth, as Mark Mikus already wrote: 'you cook with water too'. As in every place, there are good ones and some which are not so good