Thursday, April 08, 2010

The NHS Language Barrier

Have you ever been to see a doctor when feeling unwell who had little or no comprehension of the English Language? I have, and though fair to say I do not enjoy visiting doctors or feeling unwell, mine were not experiences which endeared the NHS to me.

One such time with a twisted ankle I hobbled in on crutches which I had been loaned from a hospital visit a few days earlier and with my injured leg raised, slightly extended and in the absense of a shoe visibly wrapped; the doctor "read" my notes whilst I stood (not being sure if I should sit in the chair or climb aboard the examination table), the Doctor then stood behind me and lifed my shirt from my trousers.... He could not read English and had wrongly assumed from my limp that I had a back problem - at least that was the nature of the misunderstanding as I read it and I am sticking to that. An angry exchange followed, and I left as promptly as my crutches and good leg would carry me. I tried to warn (in a civil tone) the handful of people who remained in the waiting room that stood between myself and the outer world that the doctor did not seem to understand English, and failed in a visual diagnosis that I had a bad leg.  They looked on with the same vacant glare that is nationally recognised of a UK GP's waiting room where we preparing to take leave of our senses, go into a trance and "make do" with the service we are to receive.

Luckily for me, no harm done, I went to the chemist and simply purchased some pain-killers which I assumed would have been the end result if my trip to the doctors surgery had of been resulted in me leaving with a prescription. That was my first and last experience of that particular GP surgery.  This particular experience was the first of a few, because as we all know the NHS is staffed with a number of people in different positions from around the world with varying comprehensions of English. It is our own fault that we do not have enough home-grown, English Speaking front-line staff, but if we weren't poaching them from abroad we would on the current size of the NHS have a massive shortfall.

However, this experience has always left me cautious to the potential pitfalls of Doctors and Nurses who quite frankly can't communicate and as such are a danger to all of us, be it a through Nurses not being able to read and understand a medical chart, or through the inability of a Doctor to understand a patient describing potentially life threatening symptoms. There are other dangers of course when you set of down the road of setting out why it is dangerous not having a satisfactory level of communication between patients and NHS staff, and of course between two or more members of NHS staff.

The case in the public eye today relates to Dr Daniel Ubani who administered a lethal dose of a drug (Diamorphine) to a pensioner resulting in his death during his very first out-of-hours surgery. Dr Ubani's poor grasp of English is at the root of the case, and he had already been turned down for work by one NHS trust because of it. The Health Select Committee has reported in the wake of this case:

"If the General Medical Council had been able to carry out language and competence checks on EEA (European Economic Area) doctors wishing to practise as GPs, lives might have been saved. As a matter of extreme urgency, the Government should press for change to the relevant EU Directive to enable the GMC to test the clinical competence of doctors and to undertake systematic testing of language skills."

That's right, we are testing Doctors and Nurse's who come from abroad to work here for their grasp of English, but not if they come from other EEA countries because EU Law forbids it on the grounds that it inhibits free movement of people across the EU. What's more, people are dying as a result.

To me, it simply beggars belief that we allow people to work in the NHS who cannot write perscriptions in English, or potentially understand such simple phrases as "nil by mouth". You do not need me to rant about the insanity of it, it is clear. What's more, in my company we routinely test UK based EEA staff for their grasp of French and German when they are dealing with customers based in France and Germany; to not do so would be disastrous for our revenue.

So why no public outrage when it comes to our beloved NHS and people winding up dead?

What this case does highlight is how subservient the UK to the EU, and more importantly by our own initiative. Do you think that the French allow Doctors to work who can't adequately speak French?  Of course not!

The General Medical Council has addressed this particular concern with Health Secretary Andy "Lashes" Burnham to request an end to the ban on language tests. Mr Burnham's response was to point out that the ban stems from an EU Directive and has primacy in our law, and as such there is absolutely nothing at all the Government of the UK can, or will do about it - to do so would result in the UK being fined by the EU.

Understand? We can't test Doctors and Nurses travelling here from other countries in the EEA/EU for their comprehension of English even though it is resulting in the deaths of patients because the EU says so, and to go ahead and do it was to risk getting fined... even though this particular law is flouted in other EU countries, such as France. Andy Burnham additionally points out that the EU directive cannot be reviewed until 2012.

The Government and the Opposition Parties cannot do a thing about this issue, so they just will not talk about it. That, right there is our modern politics. We are supine to the real government in Brussels and as I said the other day, the reason all of the parties (or collectively, "the Westminster Party") seem the same these days is because they are; they are governing in the wastelands that the EU has left for them or just not got around to yet, which is not a whole lot in the grand scheme of things.

There will rightly be much talk during this General Election about the NHS but you will not get a policy or a commitment from any of the main parties on the issue if testing NHS Staff to ensure an adequate level of English because they know that they can't do a damned thing about it; not that they want you to know this of course, these kinds of issues might have people questioning whether in that case we should be in the EU at all, and that is an issue they definitely do not want to talk about between now and election night.


Harry Hook said...

Agreed Daniel1979, this EU lunacy has got to stop. I bet that an EU directive, lies at the heart of most, if not all, of our problems.

Daniel1979 said...

Absolutely Harry, I just wish the political debate could be more open about it.

If people dying in the NHS centred on a twist of UK legislation or on the amount of funding the media and LIB/LAB/CON would be all over it. But because it is the EU, virtual silence.

I too reckon at the heart of nearly all our woes is an EU Directive.