Lack of clinical language tests for EU doctors ‘putting patient safety at risk’

Post-Brexit negotiations should strive to ensure that the UK can begin systematically testing the clinical English language skills of dentists, doctors and nurses from the European Economic Area (EEA) to ensure patient safety is no longer put at risk, the Royal College of Surgeons (RCS) has said.

The royal college argued that current EU rules mean EEA applicants are not eligible for these language checks like non-EU applicants are, since regulators are not allowed to put requirements on EU health professionals “over and above” what UK professions must achieve.

But this could be putting patient safety at risk, the RCS argued. Data from the General Medical Council (GMC) provided under a Freedom of Information request revealed that 29 doctors from the EEA, excluding the UK, have faced allegations related to ‘inadequate knowledge of the English language’ during 2014-15. Four EEA doctors were suspended or had restrictions put in place because of it, with a number of cases still yet to be resolved.

On the other hand, just 10 doctors from non-EEA countries, all of which can be subject to language tests, faced such allegations, with none being suspended. This is despite the fact that there are more doctors from non-EEA countries, with 26% of doctors on the medical register coming from outside the EEA compared to 11% coming from within it.

Professor Nigel Hunt, dean of the Faculty of Dental Surgery at the RCS, recognised that the NHS “would struggle to provide care” in hospitals, clinics and dental practices without skilled EU and non-EU professionals, therefore making it vital that the government “finds ways to ensure they can remain working in the NHS post-Brexit”.

But he added: “That said it’s unquestionable that such staff should be able to communicate clearly with patients in English about their clinical problems, illnesses and treatment.

“While the professional regulators are able to require proof of the clinical language skills of non-EU applicants, the same checks do not apply to EEA applicants and our fear is that this could be putting patients at risk. We want the same rules to apply to all non-UK professionals, regardless of where in the world they come from.”

Changes made in 2014 mean regulators can ask, but not systematically test, EEA applicants to demonstrate everyday English language skills. Since implementing these new rules, the GMC said over 1,000 EEA doctors seeking registration in the UK have not satisfied their English language requirements.

“The number of EEA doctors and dentists facing allegations relating to their communication skills is an issue we think the government should be taking very seriously,” Prof Hunt added. “Currently EU law makes it impossible to insist applicants demonstrate their English skills in a clinical setting. However post-Brexit negotiations offer an excellent opportunity to change this and ensure that testing is vigorous enough to ensure patient safety.

“It is also disappointing that the General Dental Council and Nursing and Midwifery Council do not match the GMC’s requirements on assessing EEA professionals’ general language skills. At the very least we would like to see all regulators copy the GMC’s lead.”

While the UK still remains in the EU or if rules continue to apply, the Faculty of Dental Surgery said the regulators should find ways to encourage applicants to demonstrate their clinical language skills – such as to ensure consent, describe a procedure or possible side effects – voluntarily.

A Department of Health spokesman said patient safety is “of the utmost importance” and that it expects all healthcare professionals working in the UK to have a “good command of the English language”.

“That is why we have tough rules, allowing the GMC and individual employers to test employees at and beyond the initial point of employment – and these cases represent just 0.002% of NHS staff,” he added.

Niall Dickson, chief executive of the GMC, agreed that the UK’s language requirements “are among the toughest in the world” and are therefore under regular review to ensure they remain effective.

“In the past we were not able to check doctors from Europe. Now we can and the difference is clear – this has been a huge step forward for patient safety. Since 2014 nearly 1,100 doctors from Europe have not met our English language requirements and cannot therefore practise in the UK,” Dickson added.

“We have always argued that we should have the right to test the competence of European doctors as well as language and that remains our position.”


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