Foreign doctors who are neither clinically competent nor able to speak good English are being allowed to work in the NHS “virtually unchallenged” because of shortcomings in vetting procedures, the head of the British Medical Association warned today.
Hamish Meldrum used his keynote address to the association’s annual congress to call for tighter regulation of overseas doctors, particularly those from within Europe.
Concerns have been raised that while doctors from outside Europe face formal language tests before being accepted for an NHS post, the EU prevents such assessment because of laws on free movement of labour.
The General Medical Council (GMC), which regulates doctors, claims the Government’s interpretation of the law prohibits testing European doctors for clinical and language competence.
Citing the case of Daniel Ubani who killed a pensioner with an overdose of painkillers on his first and only shift in Britain, Dr Meldrum said the UK “seemed to be able to do little or nothing to check that doctors from overseas — especially from Europe — meet the proper standards of language and competence”.
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Dr Ubani, a Nigerian-born doctor, flew in from Germany and injected David Gray, 70, with 100mg of a pain relief drug — ten times the recommended dose. He was struck off the medical register this month after being found guilty of making “recurrent mistakes” in caring for Dr Gray and two other patients.
In his address to about 500 doctors, Dr Meldrum said Britain had benefited enormously from overseas doctors and would continue to do so but the Ubani case had “shocked us all”.
“It cannot be acceptable for poorly trained, badly regulated doctors whose knowledge of English is about as good as my knowledge of Chinese, to be able to practise — virtually unchallenged — in the UK,” he said.
The Government and the GMC are in discussion about EU rules which prevent the regulator from being able to test the language ability or clinical competence of overseas doctors.
Niall Dickson, chief executive of the GMC, has said it “remains extremely concerned that the current arrangements do not provide patients with the protection they need”.
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Health trusts can carry out their own tests but MPs said in April that this was patchy. The Commons Health Select Committee cautioned that NHS trusts “were not doing their jobs”, meaning patients risked being treated by doctors who were incompetent or were not fluent in English. The MPs said ministers should push for changes to EU rules to allow checks by the GMC.
Dr Meldrum insisted the situation had not arisen as a result of the 2004 GP contract, which allowed doctors to opt out of providing out-of-hours care in return for about a £6,000 drop in salary.
“That is rubbish,” Dr Meldrum said. “It has been caused by underfunding and mismanagement of out-of-hours services by too many primary care organisations and by poor enforcement of, admittedly, inadequate regulations.” His sympathy went out to the family of Dr Gray “but sympathy is not enough”, he said.
“We must ensure that the doctors who treat our patients are competent to do so, that they have the necessary language skills and that they are subject to the same regulation as UK doctors.”
Later this week the BMA is due to debate seven motions put forward by members on the risks posed by overseas doctors unable to grasp colloquial English and without sufficient clinical skills or knowledge of the operation of the NHS.
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Mr Gray, who was suffering from kidney stones, died at his Cambridgeshire home in February 2008 after being given the massive overdose of diamorphine by Dr Ubani.
Dr Ubani, 67, a specialist in cosmetic medicine based in Witten, Germany, admitted causing the pensioner’s death after confusing it with another drug. He was given a nine-month suspended sentence in Germany for death by negligence but still works as a doctor there.
Andrew Lansley, the Health Secretary, said setting up more effective assessment of foreign doctors was a key government priority. “We are working closely with the GMC to ensure that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language skills, and we are currently exploring a number of options to put a stop to foreign doctors slipping through the net,” he said.