How was it that a doctor, who did not obtain his qualifications in this country, whose first language was not English, who was probably fatigued, who received a less than adequate induction and who was unfamiliar with the NHS system, and who did not know the area, came to be treating patients in Cambridgeshire, and treating at least some of them incompetently? How was this lamentable situation reached?
These were a few of the questions raised by William Morrison, at the inquest into the death of David Gray.
Mr Gray died as a result of an overdose of diamorphine by German doctor, Dr Daniel Ubani. Dr Ubani had come over from Germany to work as an out of hours GP. He had previously been refused work by Leeds NHS due to his poor English, but was later accepted by Cornwall who did not check his communication skills.
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. Unfortunately, this was the case for Mr Gray.
Mr Gray was suffering from renal colic in February 2008. His wife called the out of hours GP service and Dr Ubani attended. Mr Gray was administered 10 times the normal dose of diamorphine by Dr Ubani and sadly died four hours later. Dr Ubani prescribed the lethal dose on his first NHS shift.
Although there are no official figures for the amount of foreign doctors working in the out of hours service, I think it is fair to say it must be a large amount due to the deal negotiated with the Government in 2004, allowing GPs to opt out of the service.
With 9 out of 10 GPS’s choosing to opt out of the out of hours services in 2004, the PCT’s took over the running of the service.The Government’s primary care czar, David Colin-Thome, stated, in a report commissioned after the inquest: “We discovered that most providers did not make an assessment of the clinical skills or competence of their clinical staff.”.
This begs the question; with our GPs choosing to opt out of working out of hours services are foreign doctors our only choice?
It is not hard to see that urgent changes must be made to the system of vetting foreign doctors offering out-of-hours GP care, but do we now have to wait for the Election to see if anything will be done. The Tories have promised to review out-of-hours care if they win the next election – we shall now have to wait and see if any of the other parties are willing to make any promises in light of Mr Grays’ case.
By clinical negligence solicitor and Stephensons' Partner, Louise Griffiths
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