“Tighten laws allowing European doctors to enter UK”

Doctors’ leaders have urged the European Commission to update laws allowing doctors to work anywhere in Europe to protect patients.

The BMA told the EC that existing rules covering the free movement of medical professionals are no longer fit for purpose.

The EC is considering revisions to its directive on the mutual recognition of professional qualifications. Under the directive, European Economic Area medical qualifications are valid across Europe, and EEA doctors can seek work in any country in the area.

The BMA submission says: “It is essential that EEA doctors who exercise their right to free movement are able to demonstrate regularly to the host competent authority that they are fully qualified and fit to practise.”

The following is a summary of the BMA’s response:

1. Simplification

It is vital that any simplification of the directive on the mutual recognition of professional qualifications does not dilute the checks and balances that enable authorities to regulate doctors effectively and to ensure patient safety.

2. Code of conduct

Some of the provisions in the code of conduct produced by the European Commission in April 2010 need clarification. Most notably, the code prevents authorities from requiring original and officially translated copies of documents and from requiring applicants to verify their identity.

3. Partial access

Under no circumstances must ‘partial access’ to the medical profession be granted to a doctor whose training or qualifications do not merit full recognition.

4. Mobility for graduates

The scope of the directive should not be extended to include professionals who hold a diploma but have yet to complete a remunerated traineeship of supervised practice.

European medical graduates can apply to enter the UK Foundation Programme without discrimination under law. The FY1 is currently oversubscribed. The BMA believes professional registration should take place in the country in which the doctor completed their medical qualification before they can have this qualification recognised by another member state.

5. Professional card

The introduction of a professional card has been proposed as a tool for facilitating the free movement of doctors.

The BMA argues that the Internal Market Information System (IMI) should be strengthened and made compulsory instead of introducing a card, thus allowing authorities to exchange regulatory data on doctors.

6. Temporary and occasional practice

Standard fitness to practise checks cannot be made on EEA doctors who apply to work on a ‘temporary and occasional basis’ in the UK. This must not be seen as an easier route to enter the UK medical system.

The BMA questions whether temporary or occasional services that are provided online should be exempt from an annual declaration. Regulatory requirements should apply to both electronic and non electronic healthcare.

7. Minimum training requirements

A decision to allow a European doctor to enter the UK should not be based on the length of time individuals have trained for. It should be based on the skills they have acquired. Authorities must be able to satisfy themselves that that a doctor possesses all of the necessary clinical skills in order to undertake their job successfully.

8. CPD

The current directive does not allow authorities to satisfy themselves that a doctor has kept their skills and competences up to date in the years following their qualification.

There should be a way for verifying the CPD status of applicants and, if necessary, impose additional requirements before a doctor can take employment.

9. Proactive alert mechanism

The directive should be revised to introduce a legal duty on all medical regulators to share registration and fitness to practise information proactively with other regulators in Europe. This would act as an alert system. The IMI system must be made compulsory for EU authorities.

10. Language testing

There remains confusion, particularly in the UK, as to the extent to which authorities can verify the language abilities of EEA doctors.

It is essential that doctors are able to communicate appropriately with their patients and colleagues and that the regulatory authorities are able to assess the fitness to practise of each doctor in their jurisdiction.

It is currently the responsibility of employers. Some believe the dilemma of whether the regulator can verify the language skills of a European doctor lies at UK national level.

It is believed that the UK Medical Act 1983 ‘gold plated’ the 2005/36 directive and thus prevents the UK authority from language testing doctor where a concern over their ability is raised.

It is believe that by amending the Medical Act 1983 some degree of informal language testing would be permitted.

Further investigations need to take place at national level to verify this – the BMA encourages the government to address this issue as a matter of urgency.

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