English language test for foreign doctors in EU “a matter of extreme urgency”

By Dr. Ananya Mandal, MDApr 9 2010

The European commission is working on changing the existing EU laws that allow the free movement of labour especially regarding health care personnel since the regulators have raised the issue of patient safety. The issue here is mandatory English language tests for all foreign doctors working in the UK.

In the 2005 revision of employment laws there were clauses regarding acceptance of foreign professional qualifications. This new development has come about after the senior MP’s in Britain have reported that the next Government must demand changes to the present rules "as a matter of extreme urgency" because lives are being put at risk. This report supports the General Medical Council view that patients are at risk because the GMC cannot test EU doctors on their knowledge of English or medical competence.

According to a statement made by a spokesperson for Michel Barnier, the relevant EU commissioner in Brussels, "The evaluation will specifically look at the language issue. The report has to be concluded by 2012 at the latest but we are considering whether to bring that date forward. On the basis of the report the commission will consider whether any further action is necessary or not, as it always does."

This issue was raised after a case of Daniel Ubani, the German doctor in Cornwall who killed a patient on his first shift in Britain. "It should also be noted that in the course of the evaluation of the directive, the need for a possible rapid alert system will be looked at," said the Brussels spokesperson.

This announcement from the commission should be a wake up call for the Department of Health, which made no reference to the key recommendation of the health select committee in its official response to the MPs' report. According to them there was a legal mandate that primary care trusts (PCTs) would not allow a doctor to work for them if they were not satisfied about the doctor's knowledge of English. Mike O'Brien, Health Minister said, "I am making absolutely clear that PCTs should have been, by law, since 2004 looking at language skills. They had no discretion on this; it was a legal obligation. They should be doing it now. If they have not been doing it, and we know Cornwall was not doing it, then they were in breach of the law."

Katherine Murphy, director of the Patients Association said, "It's not good enough for the Government just to highlight the legal position and then wash their hands of it. If people aren't meeting their legal obligations without consequence then clearly there is little point in having them..."

The EU Directive is due to be reviewed in 2012. Meanwhile the commission urges UK health authorities to look into the issue and if possible screen doctors for their knowledge of English. EU rules do not stop national authorities carrying out language tests on foreign doctors working in the UK, the European Commission has said. The level of public interaction in practice is also a factor that needs to be considered. Those working directly with people need a more stringent English language testing says the commission than those working in the laboratories. "The Professional Qualifications Directive says that language requirements can be imposed, but they need to be proportionate and on a case-by-case basis. The competent authority cannot impose a general test regardless of a doctor's situation; they have to give the doctor an opportunity to demonstrate their level of English… If the competent authority is not convinced that the doctor has the right level of English they can then impose a language test. So the EU Directive does not forbid the competent authority from imposing tests in such circumstances."