House of Commons Library

Language testing for healthcare professionals

Published Wednesday, March 7, 2018

This House of Commons Library briefing sets out the English language controls for EEA and non-EEA healthcare professionals in the UK, including doctors, nurses, midwives, dental professionals and pharmaceutical professionals.

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In May 2010, the Coalition Agreement set out that the Government would “seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests” in order to assure patient safety and quality of care in the UK.

EU legislation does not allow the healthcare regulatory bodies to require evidence of a European applicant’s knowledge of English prior to registration, even when the regulatory body has cause for concern. The application of the Mutual Recognition of Professional Qualifications Directive entitles EEA and Swiss applicants to recognition of their qualifications in the UK, without testing whether an applicant has the necessary language skills to work in the UK. The regulatory bodies may however impose language controls to professionals from outside the EEA.

Following a 2013 consultation, in 2014 amendments were made to the Medical Act 1983 related to language controls for doctors. These changes:

  • Gave the General Medical Council (GMC) the power to refuse a licence to practise in circumstances where the medical practitioner is unable to demonstrate the necessary knowledge of English; and
  • Created a new fitness to practise impairment, relating to having the necessary knowledge of English.

In terms of language testing, this separated out the registration of doctors and the licensing of doctors.

In 2016, similar changes were introduced related to EEA nurses, midwives, dentists, dental care professionals, pharmacists and pharmacy technicians. In order to be compliant with EU law, the Order introduced a two-stage registration process, consisting of firstly the recognition of qualifications and secondly the granting of registration. This allowed the relevant regulatory bodies to request evidence of the EEA applicant’s English language capability after recognising their qualification, but before admission onto the register.

These changes also amended the regulators’ fitness to practise powers, to introduce a new ‘impairment of fitness to practise’ for not having the necessary knowledge of English, and introduced powers to allow an individual to undergo an English language test as part of fitness to practise proceedings.

Some regulatory bodies have argued that the changes to language controls for EEA professionals may have led to a reduction in applications to work in the NHS from EEA doctors and nurses.

Following the EU referendum, the Government has stated its intention to consider further regulatory changes on language controls for healthcare professionals, once the UK has left the European Union.

Commons Briefing papers CBP-7267

Authors: Elizabeth Parkin; Alex Bate

Topic: Health staff and professions

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