Monday, 23 March 2015

How to deal with immigration from the EU - make everyone pay - a lesson from the General Medical Council.


In 2008, a locum GP doctor injected David Gray, a patient with typical excruciatingly painful kidney stones, with a fatal (10 times normal) dose of morphine. This act was not intentional but a tragic mistake and it occurred because the doctor who was a German national and whose command of the English language was not good, for want of a better description, screwed up - badly.

This sad story highlighted an anomalous and fatal effect of free movement of workers within the European union - a sacred immutable right in the eyes of Angela Merkel and Brusselocrats. Ever since the inception of the National Health service in 1948 and quite possibly before then, foreign doctors working in England have come predominantly from the Indian subcontinent, part of the post war mass immigration of anglophonic ex colonial subjects.  Prior to being registered all these doctors had to take and pass the PLAB exam, an assessment of linguistic skills.
When the internal market within the European Union was liberated in the 1990s and free movement of goods and peoples became a possibility, the number of European doctors coming to work in the UK began to increase. The first were the Dutch, all of whom can speak impeccable English. Then came the Germans, most of whom can also speak good English. This account of the sequence of nationalities who migrated to the UK is based on personal memory rather than an forensic examination of Home Office migration records (which probably don't exist or have gone missing) or of NHS human resources records (which also probably etc etc..). In 2008, after the onset of the worst recession affecting Europe, the numbers of doctors coming from southern Europe started to rise sharply. By the end of last year, the number of doctors coming to England for work from non English speaking Southern European countries outnumbered those coming from English speaking (and educated) India and Pakistan. I found this fact, when reported in the media, to be quite extraordinary. But after a moment's thought, and recollection of the effects of the recent recession, the rights of EU citizens and changes to immigration brought in by the current government, then maybe such a fact should not surpise anyone.
The problem with this change is that most of the doctors in the EU do not have the command of the English language that previous medical immigrants did. Initial plans to apply a test of English to European doctors (modified PLAB) before gaining access to the medical register, was deemed as being contrary to the free movement of EU citizens - irrespective of the fact that in this case failure to understand and speak the language could prove fatal.
The General Medical Council to their credit (although I suspect they may have been nudged by the government in this matter) have come up with a cunning plan. If EU law says that incoming Europeans cannot be treated any differently to British citizens or graduates of British medical schools, then test everyone, Brits, EU and non EU doctors  - genius!
So now after slogging through 5 years of medical school, racking up a enormous debt and enduring endless assessments and exams, British graduates ( and all those who apply to go onto the medical register) will have to complete and pass a National Licensing Exam.
Genius  - maybe
Unfair - probably
Template for management of welfare applicants - unlikely.

Anyway, post 2017 when Britain votes with its feet and says au revoir/arriverderci/Auf Weidersehen etc etc, it may all end up as being redundant and unnecessary.