Page last updated at 07:12 GMT, Thursday, 8 April 2010 08:12 UK

System of vetting foreign medics 'needs improving'

By Nick Triggle
Health reporter, BBC News

Committee chairman Kevin Barron: "I hope it won't happen again"

Urgent changes must be made to the system of vetting foreign doctors offering out-of-hours GP care, MPs say.

The Health Committee warned NHS trusts "were not doing their jobs" by failing to check language and medical skills.

That meant patients risked being treated by doctors who were incompetent or were not fluent in English.

Lives were at risk due to a reliance on overseas doctors in weekend and night GP shifts, the MPs said. The government said improvements were being made.

Poor English

The MPs said ministers should push for changes to EU rules to allow checks by the General Medical Council.

European regulations which allow free movement of labour mean the GMC is unable to carry out clinical or language checks on doctors from EU countries as it does for those from elsewhere in the world.

As employers, NHS trusts can carry out their own tests, but the MPs said this was not always happening.

There are no exact figures for how many foreign doctors are employed for out-of-hours work, although ministers said in evidence to the committee that it was a "limited" problem.

GPs were allowed to opt out of providing weekend and night cover in 2004. Nine in 10 did so
Responsibility for the service then passed to NHS managers working for primary care trusts
They have mainly contracted out the service to firms or not-for-profit groups of doctors
These tend to employ locums, some overseas medics, to cover shifts

The MPs looked into the issue after a coroner criticised the system in February following the death of a patient, David Gray, in Cambridgeshire two years ago.

He was killed by German doctor Daniel Ubani who administered 10 times the normal dose of diamorphine on his first NHS shift.

Dr Ubani's poor English meant he was refused work by the NHS in Leeds, but he was later accepted in Cornwall, which then led to work in Cambridgeshire.

Committee chairman Kevin Barron said: "Everything must be done as soon as possible to ensure another life is not lost in this way."

The committee's report said the government should lobby Europe about changing the law - it is due to be reviewed in 2012 and ministers have already promised to bring up the issue in the coming years.

But the report also raised questions about the UK's interpretation of the rules - the GMC believes regulators in other parts of Europe are still carrying out language checks.

The MPs said the issue was particularly pressing as GPs in the UK tended to have much more responsibility than their European counterparts.

Dr Stuart Gray, the son of Mr Gray and a GP himself, said the changes proposed must be made "urgently".

'Urgent review'

Professor Steve Field, chairman of the Royal College of GPs, co-wrote a separate review of out-of-hours service for the government.

He told BBC Radio 5 Live that European rules prevented the GMC from assessing the language skills of GP coming from Europe, although that could be done at a local level within the UK.

Professor Field said: "Ministers have accepted all of our recommendations, and gone further, but there needs to be an urgent review of the European legislation to make sure doctors are assessed at a national level as well as locally."

Liberal Democrat health spokesman Norman Lamb said checks should be allowed.

He added: "Labour has known for some time that the current safeguards in place are not working but has completely failed to take action."

And Conservative shadow health minister Mark Simmonds said the report had highlighted "significant failures".

But the Department of Health said it was already making changes to improve the regime.

A spokesman said it had recently reminded NHS trusts of their obligation to assess doctors they were putting on their employment lists.

And he added the organisations in charge of providing out-of-hours care - mainly firms and not-for-profit groups of doctors, both of which use overseas medics to do shifts - would be facing tougher regulation in the future.

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