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EU rules come before patient safety

Posted by Richard Monday, July 04, 2005

Picked up by the BBC today is a report about concerns expressed by the General Medical Council about doctors' English language skills. Patients' lives, says the GMC, are being put at risk because thousands of doctors working in the UK may not have sufficient skills.

What this boils down to is that all medics from outside the European Economic Area are tested by the GMC before being allowed to work in the UK, but those from within these areas are exempted. That means that English-speaking New Zealanders have to pass an English language proficiency before being allowed to practice, while Germans, Spaniards or Greeks, with not a word of English, cannot be tested. This is to prevent, or so the EU believes, national discrimination.

Now, concerned by the poor language skills, The BMA is seeking legal opinion on whether this principle – enshrined in the original Treaty of Rome - can be overturned.

There are more than 230,000 doctors registered with the GMC, of which 162,000 are UK nationals, 12,000 from the European Economic Area - the EU countries plus Norway, Iceland, Switzerland and Liechtenstein - and 60,000 from the rest of the world.

Dr Surendra Kumar is president of the British International Doctors Association and a former member of the GMC's registration committee, which determines the requirements doctors need to fulfil to show they are fit to practise. She says: "Quite often doctors from outside Europe have better language skills than those from within Europe because they may have trained in English. But the problem is that we cannot test those from Europe."

Dr Edwin Borman, chairman of the BMA's international committee added: "It's essential that all doctors, whether from Europe or outside Europe, can communicate effectively, both with patients and colleagues. We know that hasn't always happened under the present system."

Needless to say, our communautaire government does not share the GMC's concerns. At the moment, it says, NHS trusts have responsibility for ensuring the doctors they employ are proficient in English and department of health's code of practice recommends that foreign doctors demonstrate a level of English language proficiency "consistent with safe and skilled communication with patients, clients, carers and colleagues".

That rather evades the point that the trusts cannot actually test doctors' language skills and neither – as it law is currently understood - can a citizen from an EEA member state be refused a job on the basis of poor language skills.

The same applies, incidentally, to veterinary surgeons, many of whom are employed under contract to work in British slaughterhouses. For a long time, abattoir owners have suffered the extraordinary situation of being forced to accept supervision from Spanish and other EU country veterinarians, with extremely poor English language skills, so bad that they cannot adequately perform their duties – which also include law enforcement.

We had exactly the same problem with the government when we pointed this out, meeting a wall of indifference. Now that patients' lives are actually at risk, we might see something done about doctors, but it is still a pretty weird situation that the government, up to press, is prepared to put EU rules above the safety of its own people.