The Department of Health has indicated the Government’s intention to introduce new legislation to enable regulators
(including the General Dental Council, the Nursing and Midwifery Council, the General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland) to follow in the footsteps of the General Medical Council with regard to language testing for EU doctors. Language controls were introduced on a statutory footing for European Economic Area (EEA) doctors wishing to practise in the UK in 2014. It is almost inevitable that the GDC will introduce similar measures for dentists and dental care professionals (DCPs). The proposed changes are currently subject to a consultation process with the Department of Health.
The changing legal landscape was prompted in May 2010 by a Coalition Agreement which stated: “We will seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests.” This was in order to bolster the overriding duty of the regulators to ensure patient safety and quality of care in the UK.
Current legislation does not allow for regulatory bodies to demand evidence of English language proficiency of European dentists and DCPs prior to registration. Recent revisions to the Mutual Recognition of Professional Qualifications (MRPQ) Directive have provided some clarity, allowing for controls where patient safety implications apply. Of course, any changes introduced must be fair and proportionate. It appears from the Department of Health’s
consultation paper (November 2014), that the Department of Health has been working closely with the various regulatory bodies to ensure that any changes to the law operate within the parameters of European law and the MRPQ Directive.
Current system
Before outlining the proposed amendments to the Dentists Act 1984, it may be helpful to take a brief look at the current situation.
In a nutshell, the GDC is already able to carry out language controls on non-European applicants who wish to practise in the UK. However, if a European dentist or DCP applies to register in the UK, the GDC does not, at present, have powers to require evidence of the applicant’s knowledge of the English language prior to registration.
Consultation
The consultation paper was published by the Department of Health November 3, 2014. This document details the proposed changes to allow the GDC to put in place language controls for European applicants and impaired fitness to practise action where concerns arise regarding English language skills for those already on the register.
The closing date for consultation was December 15, 2014, and completed questionnaires on the consultation process were invited by post, e-mail or completion of an online document. Equally, any submissions made which did not follow the structure of the questionnaire were also considered.
The proposals – an overview
Essentially, any language controls introduced by the GDC must be fair and proportionate, and therefore cannot be introduced as automatic testing for all European registration applicants as this would impair the free movement of healthcare professionals within the EU. Further, any controls to test for English language competency must not take place until the applicant’s qualifications have been recognised by the regulatory body.
It is also proposed that there will be a new category of impaired fitness to practise. Interestingly, it is proposed that this new provision will apply to all professionals regardless of nationality, place of qualification or whether they
were required to provide evidence of English language skills before registration.
Registration
With regard to the registration process, it is proposed that there will be two distinct steps: qualification stage and
registration stage (which will include a language control stage). At the qualification stage, applicants will have the option, but not be required, to supply evidence of English language knowledge with their application for registration. The registrar will then assess this information and, if sufficient, the applicant’s qualification will be recognised. It is proposed that the registrar would send a letter to the applicant recognising their entitlement to registration, subject to meeting other registration requirements.
The language knowledge will then be examined and if it is felt that further evidence is required it will be requested at that point. This may include a number of opportunities to sit an English language test which, if failed, may result in rejection of the application, albeit with a right of appeal.
The proposed changes also include a definition of “necessary knowledge of English” which is intended to follow the definition already contained in the Dentists Act 1984. The GDC is also required to publish guidance, which the registrar is obliged to have regard to when considering applications. The three or four month period in which a registration application must be determined (depending upon whether it is an automatic recognition or general system application), will be suspended during the time that the English language knowledge investigation is undertaken. It is also suggested the regulator will be allowed to charge a fee for examination of applications.
Fitness to practise
In addition, it is proposed that a new ground for impaired fitness to practise be introduced to ensure that any case
based on allegations of inadequate English language ability is referred to a professional performance committee and dealt with in the same way as deficient professional performance cases.
This will include the power to direct a registrant to undertake an assessment of their knowledge of English in order
to decide whether fitness to practise proceedings are necessary. It appears that this power will be given not only to practice committees, but also to investigating committees.
In considering an application for restoration to the register of a dentist or DCP whose name was erased on the grounds that it was fraudulently procured, English language assessments may also be directed in this instance.
In conclusion then, it is clear that far reaching changes are afoot. It is anticipated the proposed new restrictions will broadly mirror those introduced for European doctors last year.