Failure to test English language skills of overseas GPs has cost lives

Can anyone explain to me how it’s possible for a GP to fill out a registration form and pass an interview if they have poor English skills? A damning report conducted by the GMC reveals that patients have died because ministers have failed to ensure that foreign GPs can actually speak fluent English. The Commons’ health committee report has described the situation ‘as a matter of extreme urgency’ and rightly states that English language tests for overseas GPs that provide out of hours care, must be revised. David Gray, a 70-year-old man from Cambridgeshire would still be alive today if tests on foreign doctors were stricter. His German doctor, Daniel Ubani administered more than ten times the correct dose of Diamorphine – a painkiller while he was being treated for renal colic in 2008.  Working for Cambridgeshire PCT, he was on his first shift as a locum, covering for GPs out of hours. This tragic incident could have been prevented had the UK in place effective measures for assessing English language skills. How can a patient communicate their needs, and a doctor their advice and treatment instructions if neither can understand the other? This isn’t something that you can pretend your way through, people’s lives are at risk and they listen to what doctors tell them. So how did this happen? How was Dr Ubani able to pass interviews and practice in the UK without being able to speak proper English and communicate to his patients and staff clearly?

Britain has been sticking rigidly to EU rules, made law in 1983, which prevent the GMC from checking the English of doctors on the grounds that this would hamper the freedom of doctors to practice. It must accept qualifications from within Europe and cannot do further exams or risk facing a hefty fine, despite being able to conduct language and competency tests on doctors from the rest of the world. Meanwhile other countries such as France have managed to evade this ban by interviewing potential GPs from abroad instead and then deciding if they can take the French test or go away to learn French, and then come back for another interview before being tested. The UK now needs a similar more rigorous testing system or we will continue to put the lives of patients at risk.

The Commons’ health select committee attacked the Government for agreeing to GP demands for a lucrative contract which makes it easier for them to opt out of responsibility for out-of-hours care. This act has forced the NHS to bring in doctors from abroad, contributing to a bigger problem. Now, if the hurdle of such a law preventing us picking up on Dr Ubani’s skills had been passed, the system fails yet again. PCTs have a legal duty to check the language skills of GPs, however many fail to do so and this could have been a vital opportunity to check qualifications. It amazes me that Dr Ubani’s poor English resulted in him being refused a job at West Yorkshire PCT but allowed him a place in Cornwall. It’s shocking to see that, even when there are regulations in place to ensure GPs are of the standard the UK requires, healthcare organisations are failing to make proper checks. These rules need to revised, but the issue of language holds many barriers to communication and isn’t just about whether or not a doctor can speak proper English. What will be defined as proper English? Will all foreign doctors be tested on their vocabulary skills too and what about accents? The latter brings in some serious questions because doctors from the UK would have to be tested too. Come to think of it, the issue of accent will apply to all healthcare professionals in the country not just GPs; that’s consultant, nurses, carers etc. For patients such as the elderly and those with hearing difficulties how will we ensure communication between patient and professional is smooth? Just how will we ensure compliance and understanding is not going to be risked?

Pawandeep K Kahlon

2020health researcher