Doctors from overseas provide a vital service by working in fields that UK graduates avoid ( their choice ).


About 80% of UK GPs qualified here, compared to 60% of hospital doctors.


There is an A & E crisis in the UK :-


1. Increased demand by patients who are attending with conditions which are neither accidents or emergencies, but can’t / won’t seek treatment elsewhere ( family doctors, dentists, walk in clinics, pharmacies, self-help ).


2. Staff shortages – most work could be done by more junior doctors and nurses, rather than consultants.


3. Alcohol. Many patients in A & E, especially on Friday and Saturday nights are there because they’ve drank too much. They need to be supported and monitored, but most don’t need the resources of a casualty doctor, A & E cubicle, or ward bed.


4. “Bed-blocking “ patients on wards. They don’t require to be in a hospital ward, but can’t be discharged because of social care problems. The minority of patients in A & E who need to be admitted have to wait too long for a bed to become available.



Of course “ routine competency tests “ should not be waived in this country’s desperation to recruit doctors from India ( or anywhere else ) to prevent A & E units from closing.


The planned GMC review of how foreign doctors’ knowledge is assessed may also help. All overseas medical qualifications should meet the same standards as those in the UK. It’s the GMC’s responsibility to make sure they do.


The fact that doctors trained in India are more likely to be struck off partly reflects the sheer number ( over 25,000 ) on the GMC Register. A glance at the reasons for disciplinary procedures also shows that they appear to be valid and not unduly harsh.


The Medical Practitioners Tribunal Service / MPTS runs hearings for doctors whose fitness to practise is called into question. It’s accountable to Parliament and the GMC ( which sets the standards ). The 300 or so panellists are a mix of medical and non-medical people, appointed through open competition. Most of their hearings are held in public. The MPTS is independent in its decision making and the panellists - identifiable to the public - must give reasons for their decisions.



Some would view an ideal NHS as having ONLY UK medical graduates. That way standards could be tightly controlled. There are enough applicants from the UK for UK medical schools. But our graduates don’t want ( and can’t be forced ) to enter unpopular specialties in undesirable areas. At present these essential posts are filled by foreign graduates.


“ Scrutiny of doctors trained abroad “ is not just a function of the GMC ; it’s up to local appointment committees ; and the UK can’t afford to do without the third of its doctors who are foreign any time soon. Without them services like A & E could not survive.