Rules on EU doctors threaten patients’ safety, says House of Lords report

Authors: Clare Dyer 

Publication date:  21 Oct 2011


European Union rules allowing doctors and other healthcare professionals free mobility within the European Union pose an “unacceptable risk” to the safety of patients, says a report from the House of Lords.

The EU’s directive on mutual recognition of professional qualifications strikes the wrong balance between allowing professionals to work in all EU countries and ensuring the safety of patients, says the social policy and consumer protection subcommittee of the House of Lords’ European Union select committee.

The issue hit the headlines in 2009 when Daniel Ubani, a locum doctor from Germany on his first stint working for an out of hours service in Cambridgeshire, killed 70 year old David Gray, who had renal colic, with a 10-fold overdose of diamorphine. The coroner, William Morris, branded the death an unlawful killing and demanded a review of the EU rules (BMJ 2010;340:c1462, doi:10.1136/bmj.c1462).

Peers on the subcommittee hope that their findings will feed into the EU’s ongoing review of the 2005 directive, which is designed to ensure that EU states recognise each other’s medical qualifications and that clinicians can move freely across boundaries.

The peers call for a provision allowing the General Medical Council, the regulator of UK doctors, to test the language skills of all foreign doctors applying to work in the UK and not just—as at present—those from outside the EU. They also want an alert mechanism so that authorities can share information about doctors’ fitness to practise and can warn each other about practitioners who have been subject to disciplinary proceedings.

The subcommittee’s chairwoman, Lola Young, said, “It is absolutely unacceptable that current EU rules put patients in the UK and elsewhere at risk. From regulating bodies being forced to accredit candidates who may not meet UK standards to the fact that there is no way for prospective employers to check an applicant’s disciplinary history thoroughly, the EU is failing our patients.

“We recognise that mobility within the EU can bring significant benefits, but we have to make sure that this is not at the expense of patients’ health, care, and confidence. Employing doctors, nurses, midwives, pharmacists, and dentists from outside the UK can help to provide patients with the best possible treatment but may also expose them to unacceptable risks.”

Niall Dickson, chief executive of the GMC, said, “The committee is right: the safety of patients should always come first. Like us, they believe that current EU rules are putting patients at risk and that urgent changes are needed.

“In our evidence to the inquiry we set out the reforms needed to protect patients, which the committee has strongly supported. These include introducing a legal duty on regulators to share fitness to practise information about doctors and more powers for the GMC to assess the language and clinical skills of all doctors at the point they enter the UK.

“We are continuing to work with our partners in the UK and across Europe on the review of the directive to secure the changes we need to protect patients.”

Clare Dyer BMJ

Cite this as BMJ Careers ; doi: