Doctor who fought illegal practices faces bankruptcy: Rheumatologist must pay litigation costs in excess of pounds 60,000

A DOCTOR who helped to expose illegal restrictive practices in the UK's system of medical training and qualification faces bankruptcy after the High Court in London yesterday refused him damages and rulings against the Department of Health.

Dr Anthony Goldstein, a London rheumatologist, was landed with legal bills in excess of pounds 60,000, even though the court accepted his arguments that criteria for awarding specialist medical accreditation in the UK were in breach of EC law.

Mr Justice Schiemann said the Department of Health was 'in some embarrassment' over EC complaints last year that Britain had not complied with directives passed in 1975. These were intended to bring in mutual recognition of specialist medical qualifications between EC states.

The EC's complaint came to light after Dr Goldstein led an attack on the rules governing the appointment of NHS consultants and restrictions on those able to carry out private practice. A working party headed by Kenneth Calman, the Government's chief medical officer, accepted in January that Britain had unlawfully been running two systems in parallel. UK specialist accreditation, awarded by the medical Royal Colleges, was run in tandem with the EC specialist certification scheme.

But most doctors find they cannot be appointed consultants without accreditation. The High Court ruled in December 1991 that it was 'perverse' of the UK authorities to award Dr Goldstein the EC certificate but not accreditation, since each should imply completion of specialist training. Yesterday Mr Justice Schiemann acknowledged that Dr Goldstein's EC certificate was of no practical use to him. The judge also accepted that accreditation involved a 'fair amount of subjective assessment of the candidate by his seniors'.

He said that the intention of the EC directives was to enable those such as Dr Goldstein to practise as a specialist only in other EC member states, not in the UK where he trained. Under the Treaty of Rome different standards could be set by an EC state for its own nationals, so long as nationals from other states were not disadvantaged.

The judge referred to the case of an Italian surgeon, Uccio Querci della Rovere, who came to the UK in the late 1970s. Although fully qualified, Mr Querci had to start again at the bottom of the ladder because the authorities would not recognise his qualifications. Mr Justice Schiemann said foreign EC specialists such as Dr Querci 'can legitimately complain' that the UK has failed fully to implement the directives.

In other words, if Dr Goldstein had been a national of another EC state, coming to Britain to practise as a specialist, the judgment would have been more likely to have gone in his favour. But because he had trained and stayed in this country, he was bound by the prevailing UK system.

Dr Goldstein, who must pay the Department of Health's costs, said he would appeal.

(Photograph omitted)