By Ian Quinn
Plans for a major regulatory crackdown on the fitness to practice of foreign GPs have been revealed in a GMC report.
The proposals, which would see significant new training hurdles put in the way of EU doctors qualifying outside the UK, have been mooted as a way for the body to protect patients against unsafe GPs while staying within European laws which currently limit the scrutiny regulators can apply.
The move comes with controversy over EU doctors to the fore, with the national spotlight on the inquest into the death of David Gray, a Cambridgeshire patient who died after being given an overdose of diamorphine by Dr Daniel Ubani, a German doctor on his first shift in the UK.
Commissioned by the GMC and the Post Graduate Medical Education and Training Board, the draft report, including 27 recommendations on improving the training and regulation of doctors, follows an independent review led by Lord Naren Patel.
The reports says it is vital that the public and employers have confidence in the in the fitness to practise of doctors, adding: ‘One factor militating against this is the lack of equivalence between the standards required of UK and EEA doctors entering the specialist and GP registers.’
While European law on the recognition of professional qualifications sets out the minimum training requirements for doctors across the European Economic Area (EEA), providing training satisfies those minimum requirements, member states are required by law to recognise the qualifications held by nationals of other EEA states.
It means the GMC has to treat EEA qualifications held by EEA nationals in the same way as UK qualifications and cannot carry out any assessment of the knowledge and skills of incoming EEA doctors who hold recognised qualifications.
The report claims patients are being put at risk because of ‘the shortcomings in current legislation’.
It says there is ‘significant variation between the training undertaken in different EEA countries,’ adding ‘as a result the GMC is unable to ensure that all new registrants are of an equivalent standard to UK trained doctors.’
‘This clearly limits the effectiveness of the registers and the ability of the GMC to protect patients,’ concludes the report.
It recommends the GMC brings in new regulation which means EEA doctors are no longer eligible to take up consultant and GP posts and be included on specialist GP registers, until they have been through the first revalidation following the completion of their training.
The move, it says, ‘could provide a mechanism for continuing to meet EC requirements in relation to recognition of training while ensuring greater equivalence in standards at the point of entry to the specialist and GP registers.’
The report comes with the Government reported to be planning to introduce a raft of new requirements for foreign GPs, including standard of English and medical competence tests, as part of a review of out-of-hours safety being headed up by Dr David Colin-Thomé, the Department of Health's director of clinical care, and Professor Steve Field, chairperson of the RCGP.
Niall Dickson, chief executive of the GMC said: ‘We have a great opportunity now to create a system in which every stage of education and training is fit for purpose, successfully prepares the doctor for the next one, where standards are constantly rising and which treats all doctors fairly, wherever they come from and whatever stage they are at in their careers.’