Brexit, the NHS, and the English language
Foreign doctors are a massive bonus to the NHS. What is dangerous and unfair to all concerned are EU migration rules which mean a European doctor who speaks poor English is given easy access to working in the NHS while a Nigerian doctor who speaks fluent English has a dozen hoops to jump through. Brexit will cure this illness
Doctors in this country clearly must be able to speak English fluently. This should be basic common sense.
In hospitals and GP surgeries, doctors not being able to fully understand the English language is putting patients’ lives at risk.
Take the case of David Gray, who died in 2008 after being given ten times the normal dose of diamorphine. He had been given the overdose by a German doctor, Dr Daniel Ubani, who was on his first NHS shift.
Dr Ubani, who admitted he had confused the diamorphine with another drug, had originally had an application to practise medicine rejected by the NHS in Leeds due to his inadequate understanding of the English language. He then applied to the NHS in Cornwall, which accepted him... without testing his language skills.
Changes have been made since 2008 to ensure all doctors’ English language skills are up to scratch. However, despite these additional tests, it is clear some doctors with poor English are still in the system, with more arriving every month.
Information acquired by Get Britain Out as a result of Freedom of Information requests has revealed that between 2012 and 2016, 63 disciplinary cases were opened against doctors for ‘inadequate knowledge of English language’.
Stunningly, 46 of those 63 cases involved doctors who were EU nationals, compared to just 7 where the doctor was British, and 7 where the doctor was a non-EU national. In 3 cases the doctor’s nationality was unspecified. This means in 77 percent of cases where the doctor’s nationality was specified, the doctor was an EU national.
EU nationals are only 10 percent of registered doctors in the UK. They make up 19 percent of doctors who faced disciplinary action for ‘fitness to practise’ in general. Compare this to how 77 percent of doctors who have had cases opened against them for poor English are EU nationals.
Clearly there is a problem here. Inadequate English is disproportionately a problem among EU doctors who come here to work.
Why is this the case? The EU’s free movement of people must be the main suspect. Doctors who come here from further afield face vigorous hurdles to even get into this country, including, of course, the need to prove good comprehension of the English language.
Due to the EU’s principle of free movement of people, EU nationals face no such hurdles. In essence, there is an extra safety valve ensuring doctors with poor English coming from non-EU countries, such as China, Brazil, or South Africa, so we cannot get to the point where they practise medicine here, potentially endangering life or causing medical problems because of a lack of understanding of our language.
Due to the European Professional Card, the NHS (including individual hospitals, GP surgeries and the like) is also unable to properly check an EU doctor’s qualifications – or any marks on their records – before hiring them.
There are much more stringent regulations in place before potentially hiring immigrant doctors from outside the EU, as many more checks are required. Foreign documents, including those from the EU, can be difficult to find in the first place, especially when translation is an issue.
But the European Professional Card requiring the NHS to ‘trust’ nobody has slipped through the cracks of the relevant EU Member State’s system – simply because these applicants are coming from EU Member States.
Once we are out of the EU, there are safety valves we can put in place, which will help protect patients, but which we are currently unable to apply to doctors coming from EU.
It is true the number of cases deemed worthy of investigation is small, and Get Britain Out has no objection to good foreign doctors coming to work in the NHS. The vast majority of EU nationals who practise medicine here do have excellent English and make a very valuable contribution to the NHS.
But this is yet another case of how our EU membership stops us from taking a blatantly common sense step to ensure the wellbeing of the Great British Public. We must take back control of who comes to work here, and how we ensure those coming here are qualified to work here.
It would seem sensible, when creating an immigration policy from scratch for those who wish to work and settle here, to require proof of adequate English, particularly for those working in professions where this need is vital.
It is a requirement for a visa to move here for work or study. However, this does not to apply to the citizens of the 27 mostly non-English-speaking EU countries, who get a free pass, whatever their understanding of English.
Nor, for that matter, would anyone devise a system where, as last year, British universities were only allowed to recruit 6,000 new medical students, rejecting hundreds of straight-A students, even though 13,000 new doctors are registered each year. This is ironic considering the shortage of doctors here last year, which led the NHS to hire almost 6,000 foreign doctors.
We need to start training more of our own doctors and medical staff here in Britain, and divert some of the money we currently send to the EU towards this effort. We could also use this money to make working in the NHS a more attractive prospect for English-speaking nurses.
This, combined with the changes to our immigration policy, is how we will solve the staffing shortage in our NHS, without sacrificing patient safety. It would be a much better alternative to the dangerous efforts by some to relax the English language requirement for foreign nurses.
Brexit, thankfully, presents an opportunity for the Government to establish a fair and sensible immigration system, with one rule for all whether you come from Australia, Bangladesh, Belgium, Bolivia, India, Poland – or wherever else. Anybody who wants to settle here should have to prove they have adequate English and the right qualifications – a policy which would not only be fair, but would also help protect NHS patients.
Those who say relaxing English language rules even further is the only way to solve the staffing shortage in the NHS are wrong. We can use the money we currently send to Brussels to resolve these issues while keeping patients safe.
As we Get Britain Out of the EU, we can finally put these common-sense policies into practice.
Joseph Hackett is a Research Executive at grassroots, Eurosceptic campaign group Get Britain Out
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