Health Professionals: EEA and Non-EEA Citizens

Baroness Young of Hornsey Excerpts

Thursday 8th September 2011 Lords Chamber

[Baroness Young of Hornsey]

My Lords, I, too, am grateful to the noble Viscount, Lord Bridgeman, for securing this debate, as it gives me an opportunity as chairman of EU Sub-Committee G on Social Policies and Consumer Protection to let your Lordships know of the some of the aspects of the inquiry the committee has just completed. I very much look forward to seeing the noble Viscount, Lord Bridgeman, on our committee in the near future.

We launched this inquiry into the mobility of healthcare professionals in June and received a substantial amount of written and oral evidence which has informed our response to the Commission’s Green Paper—mentioned by the noble Viscount—on the modernisation of the directive which governs intra-EU mobility of professionals. The report has not yet been debated by Select Committees, and we anticipate publishing it some time in early October. I am going to draw on some of the evidence we have received to point to the particular aspect which the noble Viscount has drawn to our attention.

The inquiry heard from the major regulators of healthcare professions in the UK, including the General Medical Council and the Nursing and Midwifery Council. They expressed serious concerns that discrepancies in a number of areas were forcing them to admit to their registers individuals who did not meet what they considered the necessary standards for safe practice, thereby putting patients at serious risk. For example, the Nursing and Midwifery Council said it had concerns about the decisions it was forced to take in favour of certain EU applicants, and that it was absolutely certain that many of these would not have been admitted to the register if they had been UK applicants. Similarly, the GMC pointed out how countries joining the EU changed the requirements for doctors applying to work in the UK. Whereas previously applicants would have had to take an exam, which many of them failed, once they were from member states, the GMC’s ability to question their language, knowledge and skills was severely restricted.

It is right that there be some differences between EEA and non-EEA applications. For example, automatic recognition of professions is based on the fact that there are harmonised, minimum training requirements for these professions which do not exist for third countries. The majority of witnesses felt that the problem was not one of differences per se, but that the system lacked the necessary flexibility to take account of the specific nature of the healthcare professions, and did not reflect the nature and requirements of modern practice.

In certain areas, regulators argued that they should be able to apply the same standards to EU and non-EU applicants—for example, systematic language testing, as has already been indicated—at the point of registration. Others simply wished for greater freedom to decide what was appropriate in each case; for example, the ability to test more widely when they had doubts.

The fact that the Commission is looking at the issue is clearly welcome. However, there will need to be some far-reaching changes to ensure that intra-EU mobility of healthcare professionals maintains the confidence of patients and professionals alike. Mobility can bring significant benefits: exchange of ideas, new treatments, and so on. But as has been emphasised by all the witnesses, patient safety is the most essential thing and should be the priority over mobility.