Urgent review needed of out of hours service

THE company responsible for providing out-of-hours medical care in Suffolk yesterday moved to reassure patients as immediate improvements were ordered into the appointments of foreign doctors following the death of a patient.

The reassurances were offered after MPs yesterday said there must be “immediate changes” to the way overseas doctors working shifts in the NHS are vetted.

A damning report by the Health Select Committee called for rapid improvements to the way English language competency is checked among GPs who travel to the UK for work.

It comes after an inquest in February criticised Ipswich-based Take Care Now (TCN), the then out-of-hours provider, after German doctor Daniel Ubani administered 10 times the normal dose of diamorphine to David Gray in Cambridgeshire in 2008, killing him.

Dr Ubani admitted being exhausted after only having a couple of hours sleep before starting his shift in the UK, and said he was confused about the difference between drugs used here and in Germany.


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The new out-of-hours provider in Suffolk, Harmoni, said it did not use locums if at all possible and had “rigorous processes” in place to assure “the quality and competence” of any locums if they were called in.

Ruth Taylor, spokeswoman for the health provider, said: “Harmoni’s policy is not to use locums if at all possible, and we have in place rigorous processes to assure the quality and competence of them if we do.

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“We do not accept EU accredited GPs without assurance that they speak adequate English and have either been trained in the UK or have NHS and General Practice experience and a UK-based reference.”

Dr Ubani’s poor English meant he was refused work by the NHS in West Yorkshire but he was later accepted for work in Cornwall before working for TCN.

Matthew Hancock, Tory candidate for West Suffolk, said: “It shows what a mess our out-of-hours service has got into and how important it is to get to grips with it so people can feel safe in the knowledge that if they are ill outside of normal hours, they will be treated well.”

Giving evidence to the committee last month, Niall Dickson, chief executive of the General Medical Council (GMC), said there was a “gaping hole” in the registration system for doctors coming from the European Economic Area.

Although it regulates doctors, the GMC is prevented by law from checking the language skills of medics or fully assessing their competency.

The report said: “If the GMC had been able to check the language skills and clinical competence of EEA doctors wishing to practise as GPs, lives might have been saved.”

It said the Government, as a matter of “extreme urgency”, should make changes to the European Directive before it is due to be revised in 2012.

That would enable the GMC to “test the clinical competence of doctors and undertake systematic testing of language skills so that everything possible is done to lessen, as soon as possible, the risks of employing another unsuitably trained or inexperienced doctor in out-of-hours services”.

While the GMC has its hands tied, primary care trusts (PCTs), which commission out-of-hours GP services from a range of private firms, should be making proper checks, including those on a doctor’s language skills.

This is a legal obligation but “unfortunately, some PCTs have not done their job,” the report said.

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