Refugee doctors could boost NHS

AN "UNTAPPED pool" of refugee doctors could save the NHS hundreds of millions of pounds if they were permitted to work, say leaders of the medical profession.

More than 1,000 doctors are believed to be refugees in this country, but they face severe professional and financial barriers that make it virtually impossible to continue their careers in the UK.

Their plight has been taken up by the British Medical Association (BMA) which is calling on the Health Secretary, Frank Dobson, to create more accessible "pathways" for up to 1,000 highly trained refugee doctors to convert to work in the NHS, thereby easing the shortage of doctors, said to be at least 7,000. Doctors from overseas can practise in Britain only if they have passed the Professional and Linguistic Assessment Board (PLAB) examination, administered by the General Medical Council, to ensure they have adequate medical and language skills. Preparing for these examinations is costly. Even when they have passed, finding clinical attachments to polish their skills and acquiring a job can be a long, difficult process.

The PLAB test alone costs candidates pounds 415. Typical clinical attachments cost up to pounds 250 a week. For anyone living on income support on pounds 50.35 a week, such costs are prohibitive.

Fatima Sekkoum, a GP from Algeria, is a refugee who still hopes to practise medicine in Britain one day.

"We have something to offer, we want to give something back to this country," she said.

Dr John Eastwood, the former sub-dean at St George's Medical School, London, which helps to retrain refugee doctors, said: "The main reason for helping these doctors is a humanitarian one, but any doctor residing in the UK and unable to practise is a wasted resource. Indeed, they could make a significant contribution and each one will save Frank Dobson pounds 200,000 by not having to undergo a full medical school course in the UK."

A PLAB qualification allows for only a restricted GMC registration lasting a maximum of five years. The United Examination Board exam is the only non-university medical qualification available but that could soon be phased out by the GMC.

Along with doctors, there are also thousands of dentists, engineers, scientists, architects, teachers and other professionals whose skills could be utilised for the benefit of British society, said a spokeswoman for the Refugee Council.

One of their main difficulties, she said, is that job centres are not geared to meet the needs of highly qualified professionals and many refugees are forced to take menial jobs as cleaners, waiters and drivers or they face the penalty of losing their benefit.

Mrs Sekkoum, who is in her thirties, lives in a small, dank north London council flat with her husband, Mohammed, 47, and their three British-born children. Mr Sekkoum was once a leading vet in Algiers but he is also blocked from practising his chosen profession, bar some voluntary work at London Zoo.

The Sekkoums fled to England in the late eighties after Mohammed was arrested for writing an article warning that the Algerian government was passing off the meat of diseased cattle as fresh beef. He was arrested by the secret police and imprisoned for two months in Algeria's most notorious jail. A prison doctor advised him to get out of the country and influential friends helped him escape.

After his wife qualified as a doctor in 1989, she joined him in London and both have lived in professional limbo since. "I really appreciate what the British people have done for us in allowing us to come here, but now the system is letting us down," said Mr Sekkoum.

Mrs Sekkoum added: "One of my children said to me the other day, `I don't want to be a doctor - you have no job'." Both say their self-respect is rock bottom.

Dr Vivienne Nathanson, BMA head of health policy and research, said the reasons for seeking government action are manifold. "The NHS would benefit from their clinical expertise, from the experiences they bring from so many different countries and the unique insight into the human condition which they have gained as refugees."

Prejudice against refugees also counts against many qualified doctors, said a BMA spokeswoman.

Mrs Sekkoum has failed the PLAB once and cannot afford to take it again. But she still believes she will - somehow - be back in medicine. "I won't give up hope of working in my profession," she said. "I can't allow myself to think like that."

The GMC has now promised a swift review of all aspects of the PLAB test.

THE RULES

WHAT YOU need to practise your profession in the UK:

Lawyers

Qualified lawyers from within the European Union under the First Diploma Directive can, subject to certain safeguards, practise within the UK.

Those from outside may have to re-qualify completely. Some aspiring barristers will be eligible to go straight on the Bar vocational course, although they are subject to the same conditions as Britons. The professional bodies (the Bar Council and the Law Society) will judge each case on its merits.

Accountants

Various professional exams must be taken. There are certain areas of chartered accounting such as auditing where membership of one of the six professional bodies is required before being allowed to work in that area. Reciprocal agreements exist with South Africa, New Zealand, Australia and Canada to gain membership of professional bodies; work in special areas is restricted.

Civil engineers

The title of engineer is not protected as is the case with accountants, but to become a member of one of the institutions (such as the Institution of Civil Engineers) qualifications will be needed, usually a primary engineering degree.

Non-UK residents can work in the UK if their qualifications are accredited by one of the institutions, and these tend to be reciprocal agreements. The First Diploma Directive allows for EU residents to work in other member states without further qualifications, subject to certain safeguards.

Dentists

Dentists in the EU have an automatic right to practise in Britain, as do some dentists with Commonwealth dental qualifications (the General Dental Council should be contacted for complete details). Other dentists have to take a statutory exam set by the GDC or acquire a UK qualification.