Medical training review granted

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THE DEPARTMENT of Health was ordered by a judge yesterday to break its silence over junior doctors' claims of restrictive practices in the medical profession that breach EC laws.

The High Court ruled that the Government must answer allegations that it has failed to implement EC directives intended to ensure that fully qualified medical specialists can practise in any member state.

An application from Dr Anthony Goldstein, a Harley Street rheumatologist, for a judicial review of laws governing specialist medical training was granted by Mr Justice Popplewell. The review, opposed by lawyers for the department, will be heard by the High Court later this year.

The EC directives were drawn up in 1975 to bring about a single EC-wide certification system governing specialist medical training and qualification to foster the free movement of doctors throughout the Community.

However, the European Commission complained last May that the UK medical authorities were discriminating against doctors with EC certificates in favour of those holding the UK specialist accreditation from the medical Royal Colleges. It said the UK was acting unlawfully by running the two systems in tandem.

Virginia Bottomley, Secretary of State for Health, responded by establishing a working party, headed by Kenneth Calman, the Chief Medical Officer, to begin an overhaul of training and promotion and appointment practices. Although Department of Health lawyers accepted the EC complaints in June, ministers have repeatedly refused to respond publicly and in detail to junior doctors' demands for an explanation and early remedial action.

Dr Goldstein told the court yesterday that the Government's failure to enforce the directives had led to unnecessary shortages of qualified medical specialists practising in the UK and patient waiting lists that were among the worst in Europe.

Moreover, the British public had no way of knowing who was treating them. 'Under the present system, they cannot know if their doctor is a fully qualified specialist or a charlatan,' he said.

Last December, the High Court ruled it was 'perverse' of the UK medical authorities to grant Dr Goldstein EC specialist certification yet to deny him the UK accreditation. Most doctors are refused promotion to NHS consultant posts unless they have accreditation - denounced by many juniors as more of a work permit than a qualification.

The court yesterday rejected technical arguments from Eleanor Sharpston, the Department of Health's barrister, that Dr Goldstein's application was invalid because he had never practised as a doctor outside the UK.

Ms Sharpson said the department had introduced regulations on medical qualifications in 1977 in the belief that these implemented the EC directive.