Language controls for nurses, midwives, dentists, dental care professionals, pharmacists and pharmacy technicians – proposed changes to the Dentists Act 1984, the Nursing and Midwifery Order 2001, the Pharmacy Order 2010 and the Pharmacy (Northern Ireland) order 1976.
A four country consultation report
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Ministers from the four UK health departments are firmly committed to improving public protection by ensuring that only healthcare professionals who have a sufficient knowledge of the English language are able to work in the UK. Language controls have already been introduced1, where appropriate, for European2 doctors wishing to practise in the UK.
This is why we have recently consulted on proposed amendments to the Nursing and Midwifery Order 2001, the Dentists Act 1984, the Pharmacy Order 2010 and the Pharmacy (Northern Ireland) Order 1976 which will allow the Nursing and Midwifery Council (NMC), the General Dental Council (GDC), the General Pharmaceutical Council (GPhC) and the Pharmaceutical Society of Northern Ireland (PSNI) to apply language controls, where appropriate, for European nurses, midwives, dentists, dental care professionals, pharmacists and pharmacy technicians3. These language controls will ensure that all healthcare professionals seeking entry to their registers have a sufficient knowledge of the English language to enable them to practise safely in the UK.
At the next available legislative opportunity, and subject to Parliamentary approval, we plan to give similar powers to the Health and Care Professions Council (HCPC), the General Optical Council (GOC), the General Osteopathic Council (GOsC) and the General Chiropractic Council (GCC). Due to the scale of the task, it was not possible to include all of the regulatory bodies in this current Parliamentary session. In choosing the professional regulators we did, we considered a range of factors such as the complexity of the legislative changes involved and the type and number of registrants affected.
The Department consulted on a UK wide basis, on behalf of the four UK Health Departments. The consultation document was available on the gov.uk website and the Department of Health’s Citizen Space website and comments were invited over a six week period between 3 November and 15 December 2014. We received 71 responses to the consultation.
This report sets out the findings and our conclusions following the analysis of these responses and sets out the Department’s proposed way forward.
In May 2010, the Coalition Agreement set out the Government’s intention to “seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests” in order to ensure patient safety and quality of care in the UK. This is an issue that the Government remains firmly committed to and a view that is supported by all four UK health departments.
Current legislation does not allow the NMC, GDC, GPhC and PSNI to require evidence of a European applicant’s knowledge of the English language prior to registration even where the regulatory body has cause for concern. They are however, already able to carry out language controls on non-European applicants who wish to practise in the UK.
Recent changes negotiated by the UK to the Mutual Recognition of Professional Qualifications (MRPQ) Directive4 have clarified the ability of national authorities to carry out language controls on European applicants where the profession has patient safety implications.5 Any language controls must be fair and proportionate, for example, there cannot be automatic testing for all European applicants and any controls must not take place until the applicant’s qualification has been recognised by the regulatory body.
We have been working with the NMC, GDC, GPhC and PSNI to ensure that they have powers to assess the knowledge of the English language of nurses, midwives, dentists, dental care professionals, pharmacists and pharmacy technicians seeking to work in the UK, in a way which is compliant with European law and does not impair free movement of healthcare professionals.
The consultation document set out the Government’s proposals to amend the Nursing and Midwifery Order 2001, the Dentists Act 1984, the Pharmacy Order 2010 and the Pharmacy (Northern Ireland) Order 1976 to strengthen the relevant regulatory body’s powers to introduce proportionate controls and require European applicants to provide evidence of their knowledge of the English language following recognition of their qualification, but before registration and admission onto the register. We also proposed corresponding amendments to the fitness to practise powers of the NMC, GDC, GPhC and PSNI, so that they can take fitness to practise proceedings in cases where a healthcare professional’s knowledge of the English language may pose a serious risk to patient safety.
More specifically, the main policy aims we are seeking to achieve are as follows:
the removal of any current restrictions on a regulatory body imposing English language controls on European applicants for registration;
including a new definition of the ‘necessary knowledge of English’ requiring regulatory bodies to publish information about the evidence information and documents which will demonstrate the necessary knowledge of English;
imposing requirements as to the English language controls that the regulatory bodies can impose on European applicants for registration, so that the regulatory bodies must first request and consider any available evidence before requiring a test;
requiring the regulatory bodies to issue a letter recognising the qualifications of European applicants in cases where registration cannot proceed because the language knowledge of such an applicant needs to be investigated further;
amending certain time limits in relation to giving a decision on an application by a European healthcare professional for registration, so that it is clear as to how the time limits will operate when further investigations as to language knowledge need to be carried out;
ensuring that there is a right of appeal where appropriate against certain decisions that can be made in respect of applicants as regards language controls;
adding a new ground for fitness to practise proceedings of not having the necessary knowledge of English;
providing for knowledge of English assessments in connection with fitness to practise proceedings, and certain restoration cases which are being considered by a fitness to practise panel or committee;
when applying for restoration to the register, applicants will have to demonstrate that they meet the requirements for original registration which will include in future having the necessary knowledge of English; and
the requirement to ensure that language controls are compliant with the MRPQ Directive in order to act as a competent authority.
The Department believes that the additional powers outlined above will enable proportionate checks to be carried out on nurses, midwives, dentists, dental care professionals, pharmacists and pharmacy technicians where there is concern around their English language capability, therefore providing an improved level of public protection and confidence in regulation. The consultation has confirmed this view.