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Changes to EU law are a patient safety risk

Incompetent doctors could be allowed to work in the UK if changes to EU legislation designed to make it easier for doctors to move around Europe are approved, the GMC has warned.

Revisions to the Recognitions of Professional Qualifications Directive which came into force in 2007, contain a “tacit authorization” clause which could result in doctors working in UK without being registered with the GMC.

The directive gives doctors “tacit consent” to practise in the UK if the GMC does not process their application within two weeks.

The two-week timescale would apply even if a doctor had failed to provide the right documents backing their application. A doctor who received tacit authorisation would not have a GMC number but could set up in private practice.

“Patients in the UK would have no access to redress were they treated and harmed by doctors that are not registered with the GMC,” says the regulator in a position statement.

It warns that the concept of tacit authorisation represents a serious risk to patient safety. The GMC is asking that tacit authorisation should not apply to doctors who are some of the most mobile professionals within Europe.

Under the proposed changes doctors wanting to work in the UK would be required to apply to the “competent authority” or regulator in their own country who would then forward their application on to the GMC.

But the GMC warns that regulators in a migrant doctor’s home country would be burdened with the increased administrative costs of checking these applications. “As we continue to see certificates and documents issued in error and without due care, home member states will have little incentive to assess the documentation at the point of departure with the same rigour as the host competent authority, especially in light of the tight deadlines proposed,” says the regulator.

Another concern is that the directive, as it currently stands, does not require migrant doctors to keep their skills and competence up to date. “In some cases we have had to register migrating doctors who have not practised for many years since qualifying,” warns the GMC.

GMC chief executive Niall Dickson, said: “Although we support the freedom of movement of doctors, patient safety must always come first when making laws in Europe. We welcome many of the proposed changes including the introduction of a duty on regulators to share information and the recognition of the importance of language skills for doctors to practise safely. But there are some areas where we still need further clarity.”

Ahead of the changes in legislation NHS Employers has published new guidance stressing that NHS trusts should ensure that staff have the English language skills they need to provide safe care for patients.

The European Parliament will debate the changes to the directive in the coming months with a view to approving the revised legislation by end of the year. The proposals are likely to come into force in 2013.

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7 Responses to “Changes to EU law are a patient safety risk”

  1. wmcc says:

    This arguement seems to be based on the premise that the GMC is more effective and better than all the other european medical regulators. IO suspect most UK doctors would not agree with this

  2. Malcolm Morrison says:

    This has always been a problem since the UK joined the EU (or ECC as it was then). Many warned the GMC and MPs then; but the legislation was pushed through. It would seem to be pretty obvious (to me and others) that the standards and methods of teaching and traing in medicine are very different in many European countries – particularly in Eastern Europe; and that the ability to ‘communicate’ with patients is very important. Thus, it is vital that doctors who wish to work in a country, other than the one in which they qualified, should have to PROVE that their knowledge and skills equate to those demanded in the ‘new’ country to which they will travel; and that they should be competent in the language of that country.

    So, I hope that the GMC, and the Royal Colleges, are all telling the Priime Minister, the Minister for Europe, all MPs in Westminster and all MEPs that any moves to make it easier for the ‘free movement of people’ CANNOT apply to doctors who want to practise in a different country. They should warn them that, if they allow such restrictions on ‘regulation’ of the medical profession, then they, the politicians, must be responsible for any harm that comes to patients.

  3. Dr Helen Bright says:

    The whole point of self regulation is to eliminate competition

  4. joshek says:

    this is pure hypocrisy: personnel with NO medical degree, NO gmc regsitration and not even eligible for it such as nurse-specialists and physician assistants practising medicine is supposed to be all right but european doctors are supposed to be a risk to patient safety … ridiculous.

  5. Laura says:

    The delusions of the English about the quality of their health care system are making me laugh. Last week, my little girl needed to be hospitalised (I now live in Geneva) and the experience was like being on a different planet from the NHS. A spotlessly clean hospital (despite the building being from the 1970’s ‘ the difference is called “maintenance”), no wait in the ED, immediate attention by a paediatrician, decent size, clean room with bed and shower for mom, nurses who actually nurse patients and the doctors: competent, friendly, calm, multi-lingual … The notion that european doctors without gmc reg are a risk to patient safety is ludicrous. The contrary is the case: a brit in Geneva would be a risk to local standads!

  6. Malcolm Morrison says:

    I (and I don’t think others) were saying that ALL European doctors are of lesser quality than British doctors. I worded my previous comments ‘with due care’! There is no doubt that the standard of health care in SOME European countries is excellent; but it is less so in others. The question of ‘nurse practitioners’ is irrelevant; they are not representing themselves as ‘registered medical practitioners’. My point is that ANY doctor who ‘migrates’ to work in another country MUST be able to prove to the ‘regulating authority’ in the country to which they are moving that they are competent (in medical knowledge and language) to do so. And this should apply to ALL doctors entering the country, regardless of where they have come from (Europe or elswhere).

  7. joshek says:

    to declare the question of nurse practitioners (and all other personnel that are not gmc registered but de facto practice medicine!) as “irrelevant” is meant to be a joke, right? the gmc is supposed to regulate the practice of medicine in the uk – their guides are called “good medical practice”. it does not get more fundamental than making sure that everyone who actually practices medicine is registered and regulated by the gmc. the new “physician assistants” are de-facto taking the role of the SHO in the emergency department, yet they are not regsitered with the gmc. have you ever seen one of these physician assistants and their attitude in real life malcolm? i guess not because, contrary to what you write, they bloody well do present thremselves as medical practitioners!

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