Medical professionals from all over the world make a huge contribution to the healthcare sector in the UK. They bring with them unique experience and often second languages that the sector can call upon. That said, it's vitally important that overseas professionals working in the NHS are able to use English to a high standard so that they can deal with the often complex and varied communication situations.
This issue has been high on the political agenda for quite a while now and throws up some interesting challenges. At the Conservative Party conference earlier this month for instance, Health Secretary, Andrew Lansley pledged to extend English language tests to all overseas doctors. More recently, a House of Lords committeehighlighted the importance of English language skills for foreign medical professionals. So what are the current rules?
The General Medical Council (GMC) requires healthcare professionals from outside the EEA (European Economic Area) to demonstrate their language skills using the international English test, IELTS. This has proven to be an effective approach but EU rules impose restrictions on carrying out similar tests on professionals from within the EEA. A number of organisations are campaigning to ensure the law is amended. In the meantime, there are a number of common sense approaches Medical Authorities can take to ensure that all foreign doctors and nurses have a good command of English.
Table 1: The Common European Framework of Reference for languages can be seen here.
Set your standards
Firstly, it's important to set a benchmark of English language ability and the Common European Framework of Reference for Languages (CEFR) is a good place to start. The CEFR is an internationally recognised benchmark of language ability developed by the Council of Europe. Originally used by language assessment specialists, the CEFR is now widely used to measure language ability for immigration purposes and the workplace. The framework uses a scale ranging from A1 for beginners to C2 for those who have mastered or are considered fluent in a language. Broadly speaking, the framework describes the different levels of language ability as A (Basic user), B (Independent user) and C (Proficient User).
When setting a minimum language level, the first thing I would advise Medical Authorities to consider is how linguistically demanding the role is. For a frontline healthcare role such as a GP or nurse, then C1 would probably represent a minimum level for such a demanding professional environment. Individuals at C1 level can converse effortlessly in English and are easily understood by native speakers and learners from other countries (see Table 1).
Support existing staff
Whilst a minimum level of language proficiency is important for new staff, it is equally important to ensure that overseas professionals already in employment meet this level too. Carrying out a detailed benchmarking exercise using language assessment tools is a good way of achieving this.
If someone falls short of the required level, language support with achievable targets should be provided so that their progress can be accurately measured. Successful language learning is not just about understanding grammar and vocabulary - it is about knowing how to communicate in real-life situations.
A national scheme for a national health service
The responsibility for checking a foreign worker's language competence lies with the relevant Primary Care Trust (PCT). A national scheme for the health sector that encompasses all nationalities working within the Health Service could be the answer. For such a scheme to be effective, it needs to be linked to reliable, fair and internationally recognised and available qualifications.