Regulators to insist on ‘clear English’ for healthcare workers

Regulators will be able to strike off or discipline doctors, nurses and healthcare workers who cannot communicate clearly in English, under plans announced today.

A new draft Bill published by the Law Commission will unite the nine bodies currently covering healthcare, allowing them to work from one legislative framework.

At present, organisations including the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC) are bound by different rules on what they can do.

New powers would allow regulators to proactively investigate instances of suspected poor conduct and practice whenever they come to their attention.

At the moment, some can only investigate once they have received a formal complaint.

The sanctions regulators can impose will be extended and, for the first time, they will be able to discipline or strike off professionals who are not able to communicate clearly in English.

The Bill also allows regulators to reconsider cases that have been closed following a mistake or error, as recommended by the inquiry into the scandal at Mid Staffs.

A process of revalidation – where professionals undergo “MOTs” to ensure they are still fit to practise – will be extended from doctors to all health and social care professionals.

Schemes could also be introduced to bar unregulated workers from providing services, according to the UK-wide recommendations.

The nine organisations, including the General Dental Council, General Pharmaceutical Council and Health Professions Council, are responsible for around 1.4 million workers across 32 health and social care roles.

Nicholas Paines QC, the commissioner leading the project for England and Wales, said: “The professional regulators of the health and social care field operate within a wide variety of legal frameworks that have been agreed and amended by Parliament in different ways, at different times, over the past 150 years.

“Our recommended reforms place patient protection firmly at the heart of a new legal framework.

“If implemented, they will enhance the autonomy of the regulators, empower them to respond more quickly and effectively to emerging public health concerns and enable them to meet the demands of a modern, devolved health and social care sector.”

A joint letter signed by the regulators calls on the Government to support the new plans and asks for “urgent parliamentary consideration” of the Bill.

It said: ” The Law Commission was tasked with creating a single, streamlined legal structure covering all nine regulators which would enable us to provide better protection for patients, be more responsive, reduce the burden of regulation and to drive down costs.

“We were, and remain, committed to these aims. Realising them is essential if we are to retain the trust and confidence of the public, healthcare professionals and the health service in which those professionals work.

“The recommendations of Robert Francis QC following events in Mid Staffordshire highlighted the vital importance of effective regulation focused on promoting safe, compassionate patient care rather than, as too often in the past, intervening only after patients have suffered harm.”

A Department of Health spokesman said: “Following the Francis Inquiry, it is important for public and patient confidence that our professional regulation system is fit for the future.

“The Government is committed to legislate on this important issue when parliamentary time allows. We welcome the Law Commission’s report and will respond to their proposals in due course.”

The Bill will put all regulators on the same footing when it comes to being able to test the language competency of health workers.

According to the Law Commission, regulators have limited powers to remove workers with poor communication skills once they are registered.

Under the new plans, all regulators will be able to language test any person applying to be on the register if specific issues are raised about their lack of proficiency.

The regulators will also be able to remove from the register or discipline any professional specifically on the basis that their fitness to practise is impaired due to insufficient knowledge of the English language. No additional criteria will be needed.

The GMC is already receiving extra powers in the summer to test the language competency of doctors.

Niall Dickson, chief executive of the GMC, welcomed the Bill.

He said: ” Under the current arrangements we have to go through a bureaucratic and legalistic process to change our rules which serves no one – as the Law Commission and the Government have recognised there is a better way which will encourage reform and innovation in the interests of improving standards of medicine and patient safety.

‘In addition to this fundamental change in the legal framework, the Bill will also tackle critical issues which require attention now. These include granting us the right to appeal against fitness to practise panel decisions which we believe are too lenient.

“We also want to be able to strike off doctors who have been convicted of serious offences without the need for a panel hearing – there is no place for serious criminals in the profession.”