A proposed directive to enable health care professionals to freely move between European countries poses a serious threat to patient safety, writes the GMC's Matt Ball

Think of the most challenging human resource problem anywhere in the UK. An organisation like the National Health Service may well be top of your list. In the light of recent government pledges for national health improvements, recruitment of health professionals for the government has to be one of their principal challenges. The call of the public for more doctors, nurses, dentists and social carers has never been louder. Yet we hear in the press that health professionals are turning their backs on the profession year on year. We constantly read of the difficulty of recruiting health care students and the obstacles to retaining them once in the profession. If you were asked to come up with solutions, how would you face such a problem?

The obvious short term solution is to import the skills that the UK requires from abroad and this is one of the many solutions that the government is employing. A European Directive entitled "Mutual Recognition of Professional Qualifications" is being drawn up in order to support the freedom of movement of professionals between European countries. Such a solution seems like an easy fix, but as it stands the directive allows any EU healthcare professional to be resident in the UK, treating UK patients for up to four months without having to register. The UK's regulatory bodies are extremely nervous.

Ten of the UK's health and social care regulators have joined forces to raise awareness and support for their concerns regarding the draft EU Directive. The new Alliance, AURE (Alliance of UK Health Regulators on Europe), believes that the directive, as it stands, poses a serious threat to patient safety.

Under the current proposals, healthcare professionals from any EU country would be allowed to work for up to four months a year, every year, in the UK, without being registered with a UK regulator. In practice this means that if there was a problem with the care a person received, the UK regulators would have no power to take action.

The directive also proposes to water down existing public protection safeguards. Each regulator needs to be able to assure the public that everyone coming onto its register is able to practise safely.

To qualify as a doctor, nurse or dentist in, say, Greece or Portugal means taking different exams and undergoing different training than the UK. Although the directive permits the host Member State to apply compensation measures where there are substantial differences in training, in practice these are limited. In the absence of either common minimum standards to underpin the recognition of qualifications or the ability of regulators to apply adequate compensation measures, there is a risk of public protection being jeopardised.

Language requirements are another serious concern. Article 49 of the commission's proposal states that: "The Member States shall ensure that, where appropriate, the beneficiaries acquire the language knowledge necessary for performing their professional activity in the host member state." However the alliance believes it is unclear whether the article enables regulators to test the language proficiency of migrants at the point of registration. In order to guarantee the safety of UK patients, AURE believes that the ability to communicate effectively in the language of the host country must be a prerequisite to registration.

AURE also believes that the draft directive disregards Article 152 of the Treaty of Rome, which provides that a high level of human health protection shall be enshrined in all community policies. AURE wants to work with the Department of Health and with Brussels to change the directive to ensure high standards of practice in education, training and communication across the EU. The current proposals do not meet this need.

Everyone is agreed that health professionals from other EU countries can help address the shortfall of personnel in the UK. AURE welcomes the contribution made by health professionals from other EU countries but we have tabled amendments to the directive that will address our serious concerns for safety. The UK needs the professional capital of health care professionals in the EU, but the safety of UK patients must never be jeopardised in the interests of freedom of movement.