Immediate changes must be made to the system for vetting overseas doctors to protect patients from incompetent practitioners who cannot speak English, a committee of MPs says today.
Failure to implement the necessary checks on doctors who come to work in the UK led to the death of a patient, David Gray, who was given 10 times the correct dose of morphine by a German locum, Daniel Ubani, in 2008. At the inquest in February this year a coroner delivered a verdict of unlawful killing.
The case exposed gaping flaws in the system for checking overseas doctors from the European Economic Area (EEA) who are not subject to the same checks as medics from other parts of the world. Large numbers have sought work in the UK since the change to GPs' contracts in 2004, which resulted in 90 per cent of GPs dropping their out-of-hours work (at nights and weekends), which was taken over by commercial agencies.
Although the General Medical Council regulates doctors in the UK, it is prevented from checking the competence or language skills of EEA doctors under EU law. Had it been able to conduct the tests, "lives would have been saved", a report by the all-party Commons Health Select Committee says. The Government should press for a change to the relevant EU directive, which is due for revision in 2012, "as a matter of extreme urgency", it adds.
Mike O'Brien, minister for health, told the committee that the UK would face sanctions if it tried to amend the EU directive, although this was disputed by the GMC. But even though the GMC's hands were tied, primary care trusts (PCTs) who accept overseas doctors on to their "performers' lists" were required to make the checks, as were the employers who hired them. "Unfortunately, some PCTs have not done their job," the report says.
Daniel Ubani was admitted to Cornwall PCT's list, which gave him a ticket to practice anywhere in the country, but the PCT failed in its legal obligation to carry out the requisite checks. Despite this, no action was taken by the PCT or against it.
The report says the Department of Health should examine the merits of setting up a national database of doctors permitted to work in the UK. Strategic Health Authorities (SHAs), which oversee PCTs, must ensure PCTs are doing their job, and the Care Quality Commission should "use its powers" to deal with commercial organisations, it adds.
Labour MP Kevin Barron, chair of the committee, said: "It is tragic that it takes the death of a patient to expose the serious failings now evident in the current system for checking language and competence skills of overseas doctors. Everything possible must be done as soon as possible to ensure another life is not lost in this way."
Katherine Murphy of the Patients Association said: "The minister has admitted that the PCT did not meet its legal obligations, but what has happened as a result? Absolutely nothing. It's appalling. It's not good enough for the Government just to highlight the legal position and then wash their hands of it. If people aren't meeting their legal obligations without consequence then clearly there is little point in having them."
Niall Dickson, chief executive of the GMC, said: "While we will continue to work with the Department of Health and through the European Parliament to secure the changes we need, it is critical that employers ensure that the doctors they employ are fit to do the job. We have written to all PCTs and employers across the UK to remind them of their responsibility in this area."