Foreign doctors need adequate English and better regulation, says BMA chief

Foreign doctors working in the UK must have the necessary language skills and be subject to the same regulation as British doctors, the head of the British Medical Association said today. Dr Hamish Meldrum, the chairman of the BMA, expressed his sympathy for the family of pensioner David Gray, who died after being given an overdose by a German visiting doctor working his first shift in Britain, but said sympathy was not enough to prevent a recurrence of such tragedies. "We must ensure that the doctors who treat our patients are competent to do so, that they have the necessary language skills, and that they are subject to the same regulation as UK doctors," said Meldrum in a speech on the opening day of the BMA's annual conference in Brighton. "The BMA will continue its work with the government, the GMC (General Medical Council) and others to make this happen." Daniel Ubani, 65, administered a tenfold overdose of diamorphine, a painkiller, to Gray and was found also to have treated two other patients improperly during a weekend of shifts in Cambridgeshire in February 2008. Ubani was struck off the medical register 10 days ago , so will not be able to practise again in the UK. The GMC has contacted the German regulatory authorities, but they will make their own decision on whether Ubani can continue to work there. Ubani has been convicted in Germany of causing Gray's death by negligence. Meldrum said: "It cannot be acceptable for poorly trained, badly regulated doctors whose knowledge of English is about as good as my knowledge of Chinese, to be able to practise, virtually unchallenged, in the UK." However, the BMA chairman rejected the contention that the Ubani scandal stemmed from the 2004 contract allowing doctors to opt out of providing out-of-hours care, which led to an increase in overseas doctors travelling to Britain to cover the shifts. "That is rubbish," said Meldrum. "It has been caused by under-funding and mismanagement of out-of-hours services by too many primary care organisations and by poor enforcement of, admittedly, inadequate regulations." An inquest in February into Gray's death heard Ubani had previously not been selected by Leeds primary care trust – part of a national network of organisations that commission emergency overnight and weekend care for millions of people – because he had failed a language test. But the GMC panel heard evidence that Ubani was competent in spoken English and his employers had no problems understanding him. He had flown into the UK the day before his 12-hour Cambridgeshire shift for the GP service provider Take Care Now, and had only had a few hours' sleep, the GMC panel was told. The panel last week ruled that Ubani had "presented a significant risk to patients as he failed to recognise and work within the limits of his own competence". It added: "It was unacceptable to prescribe and administer a controlled drug, diamorphine, with which he was not familiar." Ubani had failed to acknowledge the scale of his mistakes and, if left free to practise, could make similar errors again, the panel warned. His actions "brought the profession into disrepute and breached a number of the fundamental tenets of the profession", the GMC said. The health secretary, Andrew Lansley, has acknowledged the need for urgent reform in out-of-hours care. He said he was working with the GMC to ensure foreign healthcare staff are not allowed to practise in the UK unless they have proven their competence and language skills.