Are Patients ‘At Risk From Thousands Of EU Medics?’

On 24th September 2016, the Daily Mail headlined with the following:

This follows on from a number of previous articles published earlier in the year by the paper concerning doctors in the NHS who come from other EU countries.

Whilst the paper has never been overly fastidious with the truth, this arrangement of falsehoods and scare-mongering is not only irresponsible but immeasurably dangerous to the National Health Service.

As a doctor who works in the NHS, I fear to imagine how we would manage if my colleagues from Ireland, Italy, Greece, Poland or Spain left their jobs as consultants, clinical fellows, registrars or house officers. It would certainly expand the existing staffing voids to breaking-point. The straightforward issue of workforce numbers aside, we would also lose the countless continental talent who contribute so much to our hospitals and research.

I wonder if Sophie Borland, the Health Correspondent for the Daily Mail, could visit hospital for a few days and witness first-hand the contribution of the 10% registered doctors and 4% registered nurses from other EU countries working in the NHS.

But what of the central premise of the Daily Mail’s campaign, that EU doctors work in the UK without safety checks and constitute a risk to the public? The Daily Mail quoted the head of the UK’s General Medical Council, Niall Dickson:

“Some European doctors – because we haven’t checked their competency – may struggle when they practise here and that could put patients at risk. We are able to assess their language skills but we cannot check their competency to practise. That’s just a reality.”

The article curiously missed out the following from the GMC: “UK patients are more protected than they used to be and the European Commission deserves credit for bringing in the fitness to practise alert mechanism, which allows regulators across Europe to share concerns about the fitness of practise of health professionals, and for giving the UK and regulators in the rest of Europe the power to require health professionals to demonstrate their ability to speak the language of their patients before granting them entry to practice.”

The GMC goes on to say “it is important to remember that employers also have a responsibility to carry out thorough pre-employment checks and make sure that the doctor is qualified and competent to carry out the duties they are being given, including having the right language skills for their particular role.”

This states the obvious: that the obligation lies with the employer for ensuring a rigorous application and interview process and then monitoring a doctor’s practice, and this should be the same whether the doctor is from the UK, Europe or the rest of the world.

However, the obvious can be ignored when a vendetta is being waged, and so the Daily Mail not only overlooks this but contraindicates itself by publishing the GMC figures:

“GMC figures for 2011 to 2015 show that just 0.55 per cent of doctors who qualified in the UK were struck off, suspended or given a warning. This compares with 1.01 per cent from the EU and 1.1 per cent from elsewhere in the world”, In summary, there was more action against non-EU doctors than EU doctors (and still a small proportion).

In a riposte to the Mail, the European Commission states in its article at blogs.ec.europa.eu: “It is out of the question that EU rules would require the UK to let linguistically or medically incompetent doctors practise. In fact, the rules – recently further reinforced in agreement with the UK – expressly require Member States to prevent such people from being employed”

This headline brings two negative consequences – firstly, patients become needlessly worried about EU doctors, which may lead to delays in seeking appropriate and timely care. Secondly, an incorrect stigma is fostered against a large group of doctors and nurses. Since Britain voted to leave the European Union, there has already been a marked reduction in applications from EU healthcare staff to work in the NHS. If those who come here from Europe and work to save lives and cure illnesses feel that they are no longer welcome and leave, then patients will really be at risk.

My article was originally posted on the Huffington Post http://www.huffingtonpost.co.uk/nima-ghadiri/are-patients-at-risk-from_b_12224216.html?

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So… just who will be made accountable for this Brexit lie: “£350 million/week to NHS”

I just don’t understand how people or groups cannot be made accountable for such flat out lies (350 million /week for the NHS).

If the polls show that so many people voted based on that piece of complete fiction then a valid challenge needs to be made through all the available routes.

This isn’t just post-truth but the polar opposite of truth.  Medications have already become more expensive and Article 50 hasn’t even been invoked yet. We all know doctors, nurses and research staff in key positions who have resigned to return back to their countries or move to other countries in North America or the Antipodes. Rota gaps have become even worse over the last few months and the burden on service has had a tangible effect.

Just WHO will be made accountable for this?

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Studying The Kiwis: Could Britain’s Junior Doctors Learn From New Zealand?

As the British Medical Association (BMA) prepares for another meeting to discuss further industrial action against the government’s proposed junior doctor contract, the New Zealand Resident Doctor’s Association (NZRDA) has also announced a campaign for a better contract for junior doctors, with the threat of strikes on the horizon. Can British Doctors and their union learn from New Zealand?
Following a year-long stalemate punctuated by brief periods of attrition, Britain’s junior doctors remain locked in a dispute with the government over a proposed new contract, warning of “escalated” industrial action should the Government refuse to address concerns over patient safety and fairness. This is likely to encompass a rolling programme of strikes, starting in September. The BMA Junior Doctors Committee claim that worries have been repeatedly raised and not addressed, including concerns about weekend working and pay for those working less than full time.

JDC chair Ellen McCourt has said:

“Forcing a contract on junior doctors in which they don’t have confidence, that they don’t feel is good for their patients or themselves, is not something they can accept”.

Echoing events in Britain, New Zealand’s Resident Doctors Association (NZRDA) called for changes to junior doctor working patterns, including the number of potential consecutive 10-hour night shifts to be reduced from seven to four, and the number of consecutive day shifts to be reduced from 12 to 10.

The campaign is focusing entirely on patient safety and has centred on a strong social media presence with clear statements and images:

http://www.nzrda.org.nz/

Highly publicized figures from NZRDA’s survey of its 3600 members reported that 300 doctors had fallen asleep behind the wheel on the way back from work, and more than 1000 doctors had made a mistake which affected patient care due to exhaustion. The NZRDA has warned that if there are no changes to rosters, there will be industrial action for the third time after previous strikes in 1992 and 2006.

http://www.newshub.co.nz

The NZRDA was originally founded in 1985. In contrast to Britain’s BMA it represents only Junior Doctors, not all doctors. British doctors moving to New Zealand are often surprised about the power and proactive nature of the organisation. The face of the NZRDA for the last few decades has been the organisation’s National Secretary Dr Deborah Powell. She is perceived by doctors, media and public alike as a fiery and uncompromising battleaxe who persistently wields clout in negotiations.

http://www.nzrda.org.nz/

These negotiations have yielded a number of benefits over time for junior doctors in New Zealand, which have included: consistent increases in pay, final year medical students being given a salary, free canteen food during working hours, training and membership costs being covered, presence of cross-cover and relief doctors to cover short-term absences, ease in going out-of-training for family or travel. There is even a motivation for hospitals and clinics to ensure that their junior doctors claim all of their annual and study leave, as the amount not used becomes “cashed out” as a payment.

In the few instances when conditions have deteriorated, the NZRDA has been aggressive. In April 2008, they gave notice of a nationwide 48-hour strike over pay, conditions and ongoing issues of retention, as 40% of Kiwi doctors were moving to Australia. At the time, a first year house-surgeon in NZ earned 88,000 NZD (£40,000) on average. Junior doctors sought a 10% pay rise over three consecutive years (twice that of other health service workers) rather than two rises of 4% over two years.

The strikes were widely seen as a success which brought the desired outcome for the doctors, caused no harm to patients (indeed, emergency department waiting times were markedly reduced), has improved retention of doctors and made New Zealand a very attractive destination for British and other doctors. They have also underlined the power of the NZRDA to fight annually for better conditions.

http://www.saferhours.co.nz/
The success of these victories is reflected by a reversal in the exodus of Kiwi doctors to the United Kingdom, such that British doctors are now flocking to New Zealand at record levels. We can only speculate whether a single-minded force such as Deborah Powell may have challenged the various events which have taken place over the last decade and reduced morale of British junior doctors to such an extent: Loss of House Officer Accommodation, shortages of training posts, the ill-received Medical Training Application System (MTAS), pay increases below inflation, consistently increasing GMC and examination fees.

How would the NZRDA manage if metaphorically transplanted onto the negotiating table closer to home? Their use of punchy statements and images, peppered with some humour, has helped the public clearly identify the junior doctors’ argument. Based on their track record, would they have hesitated to legally challenge the UK government: particularly on Jeremy Hunt’s early assertion that we do not already have a seven-day emergency NHS, a proclamation which has already led to well-documented patient harm?

http://www.saferhours.co.nz/

Watching the British and New Zealand negotiations developing in parallel will be an interesting comparison of the relative power of government and employers’ union in both countries.

Also published here: http://www.huffingtonpost.co.uk/nima-ghadiri/new-zealand-junior-doctors-uk_b_11675406.html

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