Dr Fox is having great difficulty making sense about foreign doctors

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If the Conservative leadership seriously thinks that what they need to win the next election is a shot of thinly-disguised racism, they are in deeper trouble than anyone thought. The initiative by the shadow Health Secretary, Liam Fox, calling for a tougher language test for foreign doctors working in the NHS, is deeply unpleasant. The cynicism of it is perhaps the most offensive aspect. Dr Fox protests that he did not think that his remarks would encourage racists.

If the Conservative leadership seriously thinks that what they need to win the next election is a shot of thinly-disguised racism, they are in deeper trouble than anyone thought. The initiative by the shadow Health Secretary, Liam Fox, calling for a tougher language test for foreign doctors working in the NHS, is deeply unpleasant. The cynicism of it is perhaps the most offensive aspect. Dr Fox protests that he did not think that his remarks would encourage racists.

Yet he decided that the most important thing the Conservative Party had to say this weekend about the NHS was that "the communications skills of many overseas-registered doctors are simply inadequate".

Of course, that is a problem, although "many" is a weasel word. Something ought to be done about the few foreign doctors who have difficulty making themselves understood by their patients. But something ought equally to be done about British doctors who have the same difficulty, despite sharing a common language with their patients. There are a few who regard patients as the enemy and the idea of discussing their treatment with them as a threat to their professional integrity.

Then there are communication difficulties the other way round, arising from patients who do not speak English well. Most hospitals in areas with large minority-language populations have translators, but more needs to be done to facilitate communications. Sadly, Dr Fox chose not to highlight this aspect of the problem.

There are broader issues of public confidence in the competence of doctors that could benefit from intelligent criticism by an Opposition determined to improve the NHS. The General Medical Council continues to be too lax in allowing doctors sacked from one job to practise elsewhere, or allowing doctors disciplined abroad (usually in English-speaking Commonwealth countries) to practise here.

Almost as depressing as Tory cynicism is the timidity of the Government. It was Nick Harvey for the Liberal Democrats who was first off the blocks in attacking Dr Fox for his nastiness and desperation. But the Government has a strong case to make. Why does the NHS rely so heavily on foreign doctors? What it needs is more money to train thousands more doctors. The Government set out a plan last month for doing that. The Conservatives have promised to match Labour's planned NHS spending but still have awkward questions to answer about where they are going to find the money for tax cuts.

Yet we know, from the Prime Minister's leaked "Touchstone Issues" memo, that the Government is running scared on the issues of race and crime. It need not do so. The next election will not turn on asylum-seekers, travellers or foreign doctors. If Tony Blair took a firm stand against Tory attempts to exploit xenophobia, he would gain more respect for his courage and principle - two qualities which he is in danger of seeming to lack - than he would lose.

The more serious criticisms, however, are reserved for William Hague and his front-bench team. If this is the best they can manage by way of a political initiative on the health service, a month after the Government has announced sweeping but possibly over-bureaucratic reforms to accompany the huge amounts of extra money to be pumped into the NHS over the next five years, the Conservatives deserve to fail.

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