'Warning system' proposed for overseas doctors and nurses

The European Commission this week put forward proposals for an updated directive on the recognition of professional qualifications.

Provisions for health include a system whereby UK professional regulators – in the case of nursing the Nursing and Midwifery Council – would be warned if a doctor or nurse had been struck off or suspended from the register in another EU country.

There is a proposal for a “professional card”, an electronic record for staff which could be sent easily between regulators, and speed up the approval process.

The proposals also potentially provide for a different approach to a country assessing the language skills of healthcare professionals. However, that would take place “only after host [country] has recognised a qualification”. It appears to prevent a regulator applying a test before allowing a professional to work.

UK health organisations have been pressing for greater language tests, and it has been an issue in several high profile cases – for example that of the German out-of-hours locum GP Daniel Ubani, who killed a patient in Cambridgeshire with a huge overdose of diamorphine.

The commission has also proposed new procedures for updating the list of qualifications recognised in the EU, to ensure they meet up to date standards.

General Medical Council Niall Dickson welcomed the proposed warning system but said: “The proposed changes on language requirements will however raise serious concerns for patients. We will study the detail carefully but it remains our view that the final directive should provide greater safeguards for patients.

“Over the coming months we will continue work with the UK Government, MEPs, other regulators, and EU institutions to ensure that the final version of the directive focuses on protecting patients.”

The NHS Confederation welcomed some of the proposals but said others needed clarifying or changing. The Confederation’s European office director Elisabetta Zanon said: “The European Commission has rightly recognised that healthcare workers are a special case and that stricter rules need to apply to them to protect patients.

“We have pushed hard for some of these changes, for example the introduction of an alert system so that countries can warn each other about dangerous health professionals.

“These proposals mean that regulatory bodies will be allowed to check that healthcare workers can speak good English. However, the details of the commission’s proposals are still unclear and we will need to ensure the final wording allows the NHS to introduce checks which are fair and workable.

“NHS employers still have significant concerns about other features of the proposals, such as the introduction of a professional card, and we will continue to push over the next few months to ensure that decision-makers in Europe seize this opportunity to update and improve these rules to the benefit of both patients and those who care for them.”

They Royal College of Nursing called for safeguards to go further. Chief executive and general secretary Peter Carter said: “We remain concerned about the lack of requirement to ensure professionals keep their skills up to date. It is surely a risk to patient safety that a nurse who has not worked for a number of years could, in theory, come to the UK from another EU country and register with the Nursing and Midwifery Council.”