Major concerns have been expressed over plans for responsible officers to check the language competency of doctors working in England.
The BMA warns that the proposals could lead to a postcode lottery of language competency, and result in doctors with inadequate English entering medicine in one UK country and transferring to another without checks being carried out.
Doctors leaders say the proposals could have a significant impact on the workload of, and pose a conflict of interest to, the ROs overseeing revalidation.
They issue the warnings in their response to the Department of Health consultation Responsible Officers in the New Health Architecture, which became necessary after the Health and Social Care Act became law. The act will abolish PCTs and strategic health authorities, which had been due to host ROs.
The BMA welcomes the fact that the government is considering taking action on the issue of language competency, but says more detail is needed on how the proposals would work.
It says: ‘ROs will find it extremely difficult to fulfil this requirement effectively, given the time constraints that they are … under. Ensuring language competence is essential for patient safety, and must be done properly if it is to be done at all’.
The BMA also warns of possible conflicts of interest. For example, if a medical director is also an RO there could be times when their priority is getting a doctor into a post so that service needs are met, the association says.
Conflicts of interest
The BMA says: ‘This could conflict with the need to ensure that the necessary language competence assessments have taken place, placing the RO in a very difficult position.’
It also stresses that RO regulations need to state explicitly how language competency will be determined, to avoid different interpretations and a postcode lottery of competency.
The BMA is particularly concerned about the system being introduced in England alone. It says: ‘This would lead to a lack of consistency across the UK, and raises the possibility of doctors with inadequate language skills … gaining entry to UK medicine in one country and being able to transfer to another without checks in place.’
The BMA welcomes the proposal for the NHS Commissioning Board to nominate or appoint ROs for primary care doctors, but expresses concern about how locum GPs and those in academia will link to ROs.
It suggests locum GPs should be allowed to nominate their ROs based on the geographical areas where they do the majority of their work, rather than according to their GMC-registered addresses as the consultation proposes.
The association also recommends that individuals should not be ROs and be responsible for managing GP practice contracts or implementing commissioning policies at the same time.
It says: ‘The individual holding both offices will be presented with a conflict between implementing commissioning policies and independently making revalidation recommendations.’