EU: Recent Developments

Lord Kakkar Excerpts

Thursday 16th February 2012 Lords Chamber

[Lord Kakkar]

My Lords, as is quite right, this debate has focused principally on questions related to the economic crisis facing the eurozone and on questions concerning the negotiation of the ongoing treaty. I should like to seek further information and guidance from Her Majesty’s Government on how they are currently dealing with the unintended consequences of previous European regulation as it applies to the delivery of healthcare in our country. In so doing, I remind noble Lords of my entry in the declaration of interests as professor of surgery at University College, London, consultant surgeon at University College Hospital and an active biomedical researcher.

There are three important areas where there is consensus with regard to concerns about the application of European regulation and its incorporation into United Kingdom domestic legislation. The first is with regard to the ability of our national regulator, the General Medical Council, to assess the competence and language skills of doctors registered elsewhere in the European Union who come to work here in the United Kingdom. The General Medical Council currently has on its register 22,542 doctors registered elsewhere in the European Union who automatically have the right to be registered in our country by the General Medical Council because they have been registered elsewhere in the European Union.

The General Medical Council is not entitled to make any assessment of their competence, their skills to practise medicine and their ability to communicate in the English language as a result of the way in which the European regulation has been interpreted and incorporated into UK domestic legislation. Clearly that is not appropriate. We have seen unintended consequences with the result that doctors have come to practise in our country, have been unable to communicate appropriately and have not been subjected to the same tests and safeguards as any other doctor would be prior to registering with the General Medical Council. As a result, patients in our country have been put in jeopardy and their safety has been compromised.

I had the privilege of introducing a Question for Short Debate on 11 January in your Lordships’ House when this matter was discussed at some length. Following that debate and the subsequent media coverage, the European Union Commissioner for Internal Market and Services wrote an article for the Daily Telegraph in which he stated that it was an overinterpretation of current European regulation, with regard to the position which previous UK Governments have taken, that had resulted in an inability of the General Medical Council to perform the language, competence and skills testing that our citizens would reasonably expect our national regulatory body would perform for any doctor registered to work in our country.

I ask Her Majesty's Government what plans they have to redress that issue. In particular I know it is not normal practice or convention to pre-announce any measures that might be dealt with in the gracious Speech, but is there an opportunity in the forthcoming Session to redress that issue and to deal with an amendment to the legislation to ensure that, in the future, the General Medical Council is able to undertake this type of competence, skills and language testing that is so very important to ensure that all doctors and healthcare professionals in our country practise to a high standard? I emphasise healthcare professionals because there is a similar problem with regard to the ability of the Nursing and Midwifery Council to undertake such competence and skills testing.

The second area is the application of the European working time regulation with regard to certain disciplines and specialties in the broader area of medicine. Here I speak to the craft specialties, such as my own of general surgery, where it is generally agreed that a 48-hour working week is an insufficient period in which to provide appropriate training for our young doctors who wish to go on eventually to practise as independent consultant practitioners in our healthcare system. Very recently, two narrative verdicts by coroners in London identified the application of the working time regulation as a contributory cause to the deaths of two patients, one after an elective surgical procedure.

The imposition of the Working Time Regulations with the restriction to a 48-hour working week has made it impossible for our healthcare system, in the way in which it is currently delivered, to organise rotas that allow continuity of care for patients in hospitals. Clearly, that cannot have been an intended consequence of the working time directive when it was adopted into UK domestic legislation. It is vital that we overcome that problem and ensure that our patients remain safe and properly cared for in our hospital system.

The third area is the adoption of the clinical trials directive into domestic legislation. When the clinical trials directive from Europe was originally proposed, it was proposed with very good reasons to try to improve the standards of clinical research across Europe. An unintended consequence of the clinical trial directive has been excessive bureaucracy, which has undermined the competitiveness of clinical research in our country. In 2000, 6 per cent of all patients in the world who entered into clinical trials came from the United Kingdom. The clinical trials directive was adopted in our country in 2003, and by 2006 that level of participation fell to just 2 per cent of all patients entered into clinical trials coming from our country; in 2010, the figure was 1.4 per cent.

That has had a serious impact on the competitiveness and the standing of our life sciences industry and our academic contribution to biomedical research globally. That is hugely important because research drives innovation in our healthcare system; it improves standards; and it allows us to become more effective and more efficient in terms of delivering higher standards of healthcare. However, the Prime Minister announced on 5 December last year a life sciences strategy for our country, recognising that life sciences represent the second most important industry to our economy after financial services. It is well recognised that unless the problem of our competitiveness in terms of being able to undertake clinical research is addressed, the broader ambition of promoting our country as an inward investment centre for life sciences will not be achieved.

It cannot be right that unintended consequences of European regulations, and the way in which they have been interpreted and incorporated into UK domestic legislation, should be allowed to undermine the training of our young doctors, which ensures that future generations of healthcare professionals provide the highest standards that the people of our country have rightly come to expect; that that incorporation of regulation is allowed to undermine such a vital area of economic and academic activity as life sciences and biomedical research; and, most importantly, that it puts the safety of patients in our healthcare system unintentionally in jeopardy. I very much hope that in the coming Session, and in answering the debate, the Minister may be able to provide some reassurance that, despite all the other problems and challenges that Her Majesty's Government face with regard to negotiations in Europe currently, they will continue to address actively these three important areas.