Sunday, 29 January 2012

Calling for EU doctors to sit PLAB and IELTS to ensure NHS patient safety

20,000 EU doctors work in the UK and are registered with the GMC. There are a total of 232,000 doctors on the GMC register. We must ensure patients are safely treated in the NHS.

European Union doctors must sit an English Language Test (IELTS) before treating UK patients
Why are they exempt from sitting the IELTS English language test that the GMC submits all doctors who have trained outside the UK to (except for EU countries)? This means a Harvard medical school graduate who has completed a family medicine residency programme and has worked as a GP in America and only speaks English, albeit with an American accent, has to sit an English language competency test before he can work in the UK as a medical doctor! Yet a Polish medical school graduate can register with the GMC and never have his or her English language tested and go to work immediately in a NHS hospital or GP surgery.

Patients may be put in harms way if doctors from European Union countries are permitted to work in the UK as medical doctors and GPs, without any language test.

European Union doctors must sit a GP knowledge based test before working in NHS GP surgeries or walk in centres.
I question why only EU doctors are exempt from sitting the UK MRCGP licensing exam or equivalent exam testing NHS GP knowledge? EU doctors do not undergo a 3-year 'GP specialist training scheme' or 3-year US 'family medicine residency programme' but may travel by train to the UK, put their name on any PCT performer's list and work in any NHS hospital or GP surgery because they can 'call' themselves a 'GP' straight after medical school as is the case for any doctor who has qualified from medical school in Italy. In Germany there are no GPs. There is no GP training. The role of GP does not even exist in Germany. Chronic diseases are managed by hospital specialists. Women's health is seen by obstetrics and gynaecologists. Children are seen by paediatricians. So how may we accept 'any' German doctor to come work as a NHS GP? Are patients safe when they are being treated by a doctor with no formal GP specialist training or GP testing?

Yet all International Medical Graduates (IMGs) including countries like USA, Canada, S Africa, India, Pakistan, SE Asia, etc. have to sit and pass both an IELTS English language competency test and a medical exam PLAB which tests medical knowledge of UK drugs, diseases and NHS management and treatment of patients. Why do we only exempt doctors who have attended medical school in any European Union Country (France, Germany, Poland, Bulgaria, Italy, etc.)


Detrimental consequences on patient care of exempting only EU doctors from an English and a medical knowledge test
Sadly we have seen the consequence when both language and knowledge of NHS medicine has not been tested and these doctors are put straight to work in our NHS hospitals and GP surgeries.

Case of Dr Ubani, a specialist in cosmetic medicine from Witten, Germany, covered an out-of-hours service as a 'NHS GP' but who had undergone no formal GP specialist training or sat a GP licensing exam (MRCGP) or equivalent GP exam which we subject all our UK GP graduates too before they cover OOH services for NHS patients.

Case of Dr Werner Kolb, a 51 year old German orthopaedic surgeon, hired by the local Primary Care Trust to cover a UK consultant's annual leave, because his CV stated 'consultant' grade. Little did the NHS PCT management know that a German 'consultant' is the equivalent of a training UK 'senior house officer or registrar' grade, and that the German equivalent of a UK consultant is actually a 'Professor' grade. Both his English and surgical knowledge had not been tested at UK consultant level yet we subject our own UK graduates to a 7-year specialist training scheme in orthopaedics and a fellowship exit exam in orthopaedic surgery, before they can be given a CCT certificate of completion of training to operate at NHS consultant grade.
Click Grandmother-died-mumbling-German-doctor-botched-hip-operation-tribunal-told


With the onerous burdens of more paperwork bureaucracy of CQC registration, revalidation of doctors, austerity gatekeeping role of GP, need to find £20 billion efficiency savings in a NHS which is starting from a place of debt,  drastic pension cuts and changes to the length of service from 65 to 68 years old, our UK doctors and GPs are retiring early or immigrating to Australia, New Zealand and Canada, countries whose economies are thriving and have no CQC registration or revalidation but allow doctors to focus on 'patients and not paperwork'.

So instead we will see more EU doctors entering the UK to work in our NHS and cover walk in centres, GP surgery sessions, locum for NHS hospitals and Accident and Emergency departments. If your doctor does not speak fluent English, you as a NHS patient have a right to ask to be seen by another doctor who does.

Safety-netting
It is imperative that a medical doctor be able to communicate with you so that both parties are mutually understood to ensure you are safely treated for your medical condition, else NHS mistakes will and have occurred. As economies in Greece and Italy face potential bankruptcy, doctors from Greece and Italy may consider immigrating to the UK. Please bear in mind, NHS employers, that you do not just accept a CV but actually interview prospective employees to ensure they can speak English fluently and check all references  to ensure they are clinically competent and up to date. Until the government and GMC change the rules and remove the 'EU exemption' to testing English language and NHS medical knowledge, our NHS patients may still be at risk of harm.

Lansley pushes for language testing for EU doctors Clinical-competence-checks-for-eu-trained-doctors-not-against-rules and suggests PCT responsible officers ensure EU doctors can speak fluent English. Would also like to push for medical competency testing too.