In September 2016, Niall Dickson, chief executive of the General Medical Council (GPC), set out the possible impact for doctors and regulation as a result of the UK withdrawing from the European Union.

He said: ‘There is no doubt that withdrawing from Europe will have implications for the way that we regulate doctors. However it is far too soon to tell what those implications will be. Whatever happens, we want to protect the position of European Economic Area (EEA) doctors who play such a vital role in the UK’s healthcare system’.

European Professionals Card

The European Professionals Card (EPC) aims to simplify the recognition process and to introduce cost and operational efficiencies to benefit professionals and competent authorities.

As of 18 January 2016, regulatory bodies across Europe are required to operate a warning system to alert each other when a professional is banned from practising in one country, to stop them posing a danger to patients in another EU country. At the same time general care nurses, pharmacists and physiotherapists will be able to apply on line under accelerated procedures for an EPC, which will cut down on bureaucracy and enable them to provide services more easily in other EU countries. Further professions may become eligible for the EPC in due course, but the warning system will apply to all regulated healthcare professionals.

The EPC is expected to be applied to doctors from 2018.

Patient safety issues

The issue of doctors being able to speak English to a high standard has been prominent since the case of Dr Daniel Ubani, a German citizen who in his first GP locum posting in the UK unlawfully killed a 70-year-old man with a lethal dose of diamorphine.

He was allowed to treat patients despite having a poor grasp of English, leading to the death of pensioner David Gray in 2008.

The UK’s response to the EPC

The UK Government (in 2011) and the GMC (in 2014) were able to comment on the proposed EPC. The UK Government’s response was largely favourable to the wider endeavours of the EU to promote professional mobility and to improve and extend the IMI but was more reserved about the value of the EPC. The Government’s statement questioned the value of the EPC in professions where it is already easy to verify qualifications, as well as insisting the EPC must be voluntary. The GMC had more specific concerns about the application of the EPC to doctors for a variety of reasons. Whilst the GMC generally supported the free movement of doctors, it questioned whether the EPC would bring specific value and stressed the importance of patient safety.

GMC announcement following Brexit

The GMC have always argued that it should have the right to test the competence of European doctors, like it does for international doctors, with rigorous assessments of their knowledge and clinical skills.

Currently, European law restricts the GMC from doing that and it has made it clear that it considers this a weakness in the system.

However, Niall Dickson, GMC chief executive, stresses that 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. These checks have been a great step forward for patient safety - since 2014 more than 1,100 doctors from Europe have not met the GMC English language requirements and cannot practise in the UK until they do so.

The GMC language requirements are among the toughest in the world and are kept under regular review so that they continue to be effective.

The possible way forward

The GMC recognises that medicine is an increasingly mobile profession and they must have systems in place which make sure that all doctors practising in the UK have been examined and evaluated to the same high level. They are therefore proposing that there should be a medical licensing assessment for entry to the GMC register that everyone could rely on.