The Government has published its Response to the House of Commons Health Committee report into the use of overseas doctors in providing out of hours services, (the response) which was commissioned following the death of David Gray, a patient of Dr Ubani from Germany who was working as an out of hours doctor, despite having previously failed a language test to work in this country. Dr Ubani administered diamorphine to Mr Gray which was twenty times the recommended dose.

The response recognises that as the law is governed by the European Directive 2005/36/EC on mutual recognition of professional qualifications, any changes to that legislation will need to be effected as part of the European Commission’s review of the implementation of the Directive. There is no guarantee that the review will result in changes to the EU law and in any event any changes are likely to take several years to implement.

There is therefore a need to focus on what can be done to strengthen language checks with the current law. The response confirms that the Government is working with the GMC to jointly explore a strengthened system of language checks.

The response also confirms that the Government is considering the possibility of the NHS commissioning board taking over responsibility for ensuring that there is a more effective process for undertaking language knowledge checks on primary care practitioners.

From April 2012, out of hours providers will be required to register with the Care Quality Commission (CQC) and as the response points out, from that time they will be required to meet CQC registration requirements which include a requirement that staff are suitably qualified, skilled and experienced. In its guidance on compliance, the CQC confirms that this includes a requirement of being able to communicate effectively with patients, the inference being that they are able to speak the patient’s language.

With regard to the contractual arrangements for out of hours care generally, the response stresses that those commissioning out of hours care should ensure that contracts with providers detail rigorous standards in respect of recruitment, induction and training of doctors and that this will apply to future commissioners including GP commissioning consortia.