Doctors trained in India and other non-EU countries are far less likely to face allegations of poor English skills than those trained in the EU, prompting Britain’s worried health leaders to seek language tests for EU doctors in Brexit-related negotiations.
Several recent cases in the National Health Service (NHS) suggest that patients’ lives are at risk when treated by doctors trained in European Union countries. Due to EU rules, they are not required to pass strict tests that Indian and other non-EU trained doctors need to clear.
Doctors trained in India constitute the second highest group in the NHS, after those trained in Britain. There are 25,503 doctors trained in India, amounting to 8.9% of the overall number of registered doctors, according to the General Medical Council (GMC).
The Royal College of Surgeons (RCS) said during 2014-2015, 29 EU-trained doctors faced allegations of “inadequate knowledge of English language” and four were suspended or had restrictions put on their practice.
By comparison, 10 doctors trained in non-EU countries faced similar allegations and none of them were suspended or faced restrictions. EU-trained dentists were “disproportionately likely” to face allegations due to poor communication, RCS said.
“This is despite the fact that there are more doctors from non-EEA (Euopean Economic Area) countries: 26% of doctors on the medical register are from outside the EEA compared to 11% from the EEA,” RCS said. In 2014, GMC prevented 1,000 doctors with poor English from practising in Britain.
Trained with a syllabus in English, Indian doctors rarely face issues related to their language skills, according to the British Association of Physicians of Indian Origin, which has long called for putting EU-trained doctors through similar tests.
A spokesperson for RCS told Hindustan Times: “Non-EU doctors and dentists are already required to demonstrate their English language skills in a clinical setting (unlike those from EU countries). For example, non-EEA doctors are usually required to take the Professional and Linguistic Assessments Board (PLAB) test. This is not permitted as a requirement for doctors from the EU.”
Raj Mattu, a senior Indian-origin doctor, said: “With public and patient safety being the primary concern of the NHS, it is a fundamental requirement for all clinical staff caring for patients to have sufficient skills in clinical English language so that the public is protected against mistakes and risk of avoidable harm.
“The increasing number of cases where patient safety may have been compromised by clinicians from Europe having inadequate command of the English language shows why the RCS is entirely justified in wanting Brexit negotiations to include the UK ensuring more stringent language tests for European clinicians.”
Mattu said the it was important that rules on patient safety being applied to non-UK clinicians wishing to work in the UK are “fairly met both from within and outside the EEA”. The Brexit negotiations with Brussels provide an opportunity to ensure that tests for those arriving in Britain from outside the EEA to “show they can communicate effectively in clinical English must be met by those arriving from Europe as well”, he said.
Nigel Hunt, dean of the faculty of dental surgery at the Royal College of Surgeons, said: “While the professional regulators are able to require proof of the clinical language skills of non-EU applicants, the same checks do not apply to EEA applicants and our fear is that this could be putting patients at risk. We want the same rules to apply to all non-UK professionals, regardless of where in the world they come from.”
He added: “Currently EU law makes it impossible to insist applicants demonstrate their English skills in a clinical setting. However post-Brexit negotiations offer an excellent opportunity to change this and ensure that testing is vigorous enough to ensure patient safety.”
The number of new Indian doctors registering with GMC has dwindled in recent years, mainly due to stricter immigration laws, but this trend is complemented by Britain recently seeking to fill a large number of NHS vacancies by recruiting in India.