An article in the Daily Mail on 2 April is inaccurate in suggesting that the EU is or ever will be “blocking vital checks on doctors’ qualifications” through the European Professional Card (EPC) system or in any other way.
A further article on 9 April saying the UK authorities “cannot check up on dentists” is also misleading.
Doctors are not currently covered by the EPC and no decision has been taken on whether or when the system might be extended to them – though doctors and dentists are covered by a rapid alert system whereby Member States share information on individuals subject to disciplinary action.
Any UK employer – in this case often the NHS – can check the aptitude, performance or language ability of any doctor, dentist, nurse or other medical professional who applies for a position or who is already practising, whether British, EU or non-EU.
This was the case even before the recent revision of the European Directive on the recognition of professional qualifications.
Furthermore, if the UK authorities or an employer have serious concerns about the performance of any medical professional, they can of course prevent or suspend that person from practising, while matters are clarified.
First, EU rules have never stopped UK employers from checking doctors’ language skills. Changes to the Professional Qualifications Directive – agreed, like the original Directive, by EU Member States and not somehow imposed by “Brussels” – took on board some legitimate criticisms and clarified existing rules but did not fundamentally change them. Former Commissioner Michel Barnier explained all this back in 2013, including in this piece in the Daily Telegraph:
Following those clarifications, UK rules – which previously had not taken full advantage of the possibilities under the Directive – were reformed to allow the General Medical Council and other health regulators to check language skills more systematically.
Second, the European Professional Card (EPC) procedure is available to nurses, pharmacists, physiotherapists and certain other professionals, but not to doctors, or indeed dentists.
It is simply not the case that the Commission has taken a decision to extend the EPC to doctors – whose qualifications tend to be more diverse and complex than those of other medical staff. Still less has a date been fixed for such a decision. This is clear from the legal text which states that further assessment is needed on this matter.
Moreover, any extension would require amendments to the relevant regulation and could only be achieved with the active support of a majority of Member States representing at least 65% of the EU population, after extensive consultations with stakeholders. “Brussels” cannot just decide unilaterally to introduce the EPC for doctors.
Third, the EPC is about the recognition of qualifications. It does not guarantee anyone employment.
Professionals may still need to register with professional bodies or undergo other controls before being allowed to practise independently.
The EPC itself and the systematic rapid alert mechanism introduced in parallel by the 2013 revisions to EU law are good for patients because they make it more likely that anyone from another EU Member State misrepresenting their qualifications will be weeded out by the competent authorities or regulators before they get a specific NHS job or contract.
Under the rapid alert mechanism, Member States warn each other through an EU-wide electronic platform about medical professionals – in this case including doctors – who have been prohibited or restricted from practice in one EU country, or those who have used falsified diplomas.
The bottom line is that the NHS, like some other European health systems, relies on being able to recruit appropriately qualified workers from across the EU.
The European Professional Card – for those professions where Member States have deemed it to be suitable – aims to combine further reinforcing safeguards with reducing the cost and time involved in screening those who want to work outside their home Member State.
Dentists from elsewhere in the EU must prove their qualifications directly to the UK regulator when applying for recognition in the UK. Subsequently, they can be required to prove their English language competences before they get access to work. Moreover, anyone proposing to employ an EU dentist or invite them to join a practice can test their competence in all respects – just as they can and do for any British dentist.
Of course, no process, however rigorous, can guarantee to identify in advance all of those, whether qualified in the UK or elsewhere, who later behave in an unprofessional manner. But as the cases mentioned prove in the Daily Mail article themselves prove, when dentists from elsewhere in the EU commit malpractice, they are struck off and the decisions are published by the General Dental Council. Exactly the same process applies to incompetent or dishonest dentists from the UK or elsewhere in the world.
Moreover, dentists are also covered by an alert mechanism like the one mentioned above for doctors and other medical professionals. So UK and other national authorities are warned when their counterparts in another Member State take measures to restrict or prohibit a dentist from practising.
Further background on the EPC
The rigorous process for obtaining the EPC is set out in this legal text introducing it.
Applicants will not get the EPC (which is an electronic certificate rather than a physical card) without demonstrating to their home country authorities – who are of course familiar with the system of qualifications in their country – that they have appropriate and genuine qualifications and that there are no outstanding disciplinary or professional competence issues. The home authorities have to ensure also that their application contains all documents that are required by the country of destination and that these documents are valid and authentic.
Before the EPC was introduced, these documents were just sent directly by the professionals to the UK authorities – who in practice may be less well placed to perform systematic checks and to detect anomalies – without any additional checks by the home Member States.
Equally, the UK will now be better placed to prevent British-based medical professionals avoiding – for example – disciplinary issues in the UK by seeking employment elsewhere.
The authorities in the applicant’s home Member State are required to clarify any questions or issues the host country may have. So if the UK is not happy with anything about an application, it can ensure further scrutiny.
The UK can also request translations where necessary.
Where a medical professional wishes to establish themselves long-term to work as a nurse, pharmacist, physiotherapist in the UK, at the end of the process, the decision on whether or not to issue an EPC allowing them to do that is taken by the UK.
Where someone wishes only to provide short-term or occasional services in the UK, two possible systems apply.
In both cases it is required that the professional remains legally established in his/her home Member State and thus continues to be subject to supervision there. In both cases also, having an EPC does not guarantee employment in the UK. It does not exempt the holder from being subject to professional rules directly linked to qualifications, including the rules on professional malpractice and disciplinary provisions in the UK.
The first type of situation for short-term or occasional work is for a) professions where the UK does not operate prior check of qualifications – for example for physiotherapists or b) where the applicant is covered by the EU’s longstanding automatic recognition of qualifications system, for example for generalist nurses with substantial practical experience, as explained in full here.
In these cases, the person can obtain an EPC from the home country. Under that process, however, the UK has access to all the documents and information that served as a basis for the issuance of that EPC. It can review that material and request further information either from the EPC holder or his/her home Member State. In justified cases it can ask for the EPC to be revoked.
In the second type of process, the decision on the application for the authorisation to provide temporary or occasional services is made directly by the UK authorities, which can accept or refuse, stipulate further testing or training, etc.
This piece was updated on 11 April to take account of the second article mentioned