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zoom RSS 外国人医師に依存する時間外診療の改善を/英国医療事情

<<   作成日時 : 2010/04/08 20:39   >>

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 時間外の一般診療を外国人医師に依存している状況は至急改善されなければならない。NHSトラストは英語や医学的技能をチェックできておらず、本来の仕事ができていない。十分な能力がなく英語も堪能でない医師による診療は患者を危険に曝すことになる。週末や夜間の診療が外国人医師に依存しており、命が危険に曝されている。労働力の移動の自由を認める欧州規則は、世界中からだけでなくEU諸国から来る医師の臨床的言語的能力をチェックできていない。NHSトラストは雇用者として自らテストできるはずなのに実行していない。時間外診療のために外国人医師が何人雇用されているのかも正確な数値がない。
 2年前にケンブリッジシャー州で患者デイビッドグレーが死亡し、検死官が2月にシステムを批判した後に、問題が調査された。ドイツ人医師 Daniel Ubani が最初のNHSシフト勤務でdiamorphine を10倍量投与し患者は死亡した。英語が下手なためにリーズでNHS採用を断られたが、その後コーンウォルで採用されたという。
 同じ過ちを繰り返さないために速やかに実行に移さなければならない。
 委員会報告で、政府は法律変更をEUに働きかけるべきだとしており、大臣も約束をした。しかし報告では、規則の解釈に問題があるともしている。
 GPの時間外診療は、2004年に週末と夜間を免除され、9割がそうしている。診療の責任はプライマリケアNHSに任され、非営利グループなどに主に契約され、外国人医師が採用されるといった形をとるようになっている。
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外国人医師に依存する英国医療
http://kurie.at.webry.info/200707/article_8.html
英国医学会総会で、厚生省の責任者の辞任を要求/英国医療事情
http://kurie.at.webry.info/200706/article_81.html
政治への医師の怒り/英国医療事情
http://kurie.at.webry.info/200706/article_75.html
混乱する医師研修システム/英国医療事情
http://kurie.at.webry.info/200708/article_39.html
小児外科医不足 必要数の半分以下/英国医療事情
http://kurie.at.webry.info/200707/article_55.html
外科医の不足/英国医療事情 週48時間労働規制
http://kurie.at.webry.info/200901/article_43.html
医師研修制度改革と労働時間48時間制限による若手医師の不足/英国医療事情
http://kurie.at.webry.info/200812/article_49.html
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Page last updated at 00:26 GMT, Thursday, 8 April 2010 01:26 UK
System of vetting foreign medics 'needs improving'
By Nick Triggle
Health reporter, BBC News
http://news.bbc.co.uk/2/hi/health/8608010.stm

画像Stethoscope
The majority of GPs no longer offer out-of-hours care

Urgent changes must be made to the system of vetting foreign doctors offering out-of-hours GP care, MPs say.
The Health Committee warned NHS trusts "were not doing their jobs" by failing to check language and medical skills.
That meant patients risked being treated by doctors who were incompetent or were not fluent in English.
Lives were at risk due to a reliance on overseas doctors in weekend and night GP shifts, the MPs said. The government said improvements were being made.
The MPs said ministers should push for changes to EU rules to allow checks by the General Medical Council.
European regulations which allow free movement of labour mean the GMC is unable to carry out clinical or language checks on doctors from EU countries as it does for those from elsewhere in the world.

GP OUT-OF-HOUR CARE
GPs were allowed to opt out of providing weekend and night cover in 2004. Nine in 10 did so
Responsibility for the service then passed to NHS managers working for primary care trusts
They have mainly contracted out the service to firms or not-for-profit groups of doctors
These tend to employ locums, some overseas medics, to cover shifts

As employers, NHS trusts can carry out their own tests, but the MPs said this was not always happening.
There are no exact figures for how many foreign doctors are employed for out-of-hours work, although ministers said in evidence to the committee that it was a "limited" problem.
The MPs looked into the issue after a coroner criticised the system in February following the death of a patient, David Gray, in Cambridgeshire two years ago.
He was killed by German doctor Daniel Ubani who administered 10 times the normal dose of diamorphine on his first NHS shift.
Dr Ubani's poor English meant he was refused work by the NHS in Leeds, but he was later accepted in Cornwall, which then led to work in Cambridgeshire.
Committee chairman Kevin Barron said: "Everything must be done as soon as possible to ensure another life is not lost in this way."
The committee's report said the government should lobby Europe about changing the law - it is due to be reviewed in 2012 and ministers have already promised to bring up the issue in the coming years.
But the report also raised questions about the UK's interpretation of the rules - the GMC believes regulators in other parts of Europe are still carrying out language checks.
The MPs said the issue was particularly pressing as GPs in the UK tended to have much more responsibility than their European counterparts.

Urgent

Dr Stuart Gray, the son of Mr Gray and a GP himself, said the changes proposed must be made "urgently".
Liberal Democrat health spokesman Norman Lamb said checks should be allowed.
He added: "Labour has known for some time that the current safeguards in place are not working but has completely failed to take action."
And Conservative shadow health minister Mark Simmonds said the report had highlighted "significant failures".
But the Department of Health said it was already making changes to improve the regime.
A spokesman said it had recently reminded NHS trusts of their obligation to assess doctors they were putting on their employment lists.
And he added the organisations in charge of providing out-of-hours care - mainly firms and not-for-profit groups of doctors, both of which use overseas medics to do shifts - would be facing tougher regulation in the future.

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