Question marks over EU register of bad doctors

By Sabine Prokscha and Amelia Strzepek BERLIN

In recent years, cases of doctors who are guilty of malpractice and then migrate to other European countries to continue their practice have been causing public outrage.

Now, the European Commission wants to install a Europe-wide alert mechanism.

The European Commission wants to install a Europe-wide alert mechanism (Photo: BWJones)

But according to patient rights activists, the planned system does not ensure enough transparency.

In January 2013, when it was revealed that a 67-year-old neurologist, working in a hospital in Heilbronn, Germany, was responsible for “the biggest medical criminal case in the history of the Netherlands,” patient rights activists shook their heads in disbelief.

Between 1998 and 2003, he is said to have misdiagnosed patients with severe diseases, leading to the death of nine of his patients.

One of them committed suicide after being misdiagnosed with Alzheimer’s.

Back in 2006, after having been put under pressure by a hospital, the once drug-addicted doctor voluntarily gave up his licence, banning himself from a list of registered doctors.

He then crossed the border to Germany and continued practising in several hospitals.

It only came out in the open when a Dutch journalist confronted the German hospital administration.

How could this happen?
Current system is ‘profoundly unsatisfactory’

To date, the exchange of information on doctors among European authorities is not mandatory. It has to be specially requested.

In order to validate a foreign doctor’s licence, host country authorities need to contact the doctor’s home country and inquire about his or her work history.

European authorities are obliged to provide such information, but language barriers and differing national or even regional organisations impede efficient communication and the chances of finding the appropriate figure in authority.

For his part, Niall Dickson, chief executive of the General Medical Council, which maintains a register of medical practitioners within the UK, describes the extent of sharing information on incriminated doctors between European countries as “profoundly unsatisfactory.”

Its Danish equivalent, Sundhedsstyrelsen agrees.

In 2012, Sundhedsstyrelsen was not able to warn its German counterpart, Deutsche Aertzekammer, of a problem doctor because they did not know which of the 16 authorities was in charge.
EU process to continue until July

The EU commission has proposed to put a proactive alert system in place.

In future, regulators across Europe are to declare cases of health professionals, such as doctors, nurses or veterinary surgeons, who have been stripped of their right to pursue their professional activity.

All EU member states are to be informed within 48 hours of a malpractice decision via a centralised, confidential computer system – the so-called Internal Market Information System (IMI).

The plan falls under article 56 of directive 2005/36/EC on professional qualifications.

EU countries and the European Parliament are to give their decision on the proposal by July.

EU member states then need to give it life in national law.
Transparency vs. data protection

The main controversy on the bill is the question of transparency versus data protection.

In terms of EU countries’ positions, the issue of stronger monitoring of doctors often depends on the current legal system in any given country.

States with already high standards of patient rights such as Denmark, the UK and Ireland call for more transparency, while countries such as Germany, France and Poland insist on data protection.

According to the commission proposal, only formal disciplinary action will be recorded in the IMI.

Allegedly serious cases of malpractice and even judicial convictions will not be listed if the doctor has not been banned from practice.

Most patient rights organizations across Europe want more transparency in the new alert system.

Tomasz Szelągowski, a representative of the Federation of Polish Patients (FPP), finds it important to have “a public debate on a large scale on transparency that will lead to the implementation of a system solution acceptable by all stakeholders.”

Sophie Hankes, chairwoman of the Dutch-based Iatrogenic Europe Unite-Alliance, wants a public alert system, which already exists in the UK and Ireland.

“Patients should have direct access to information on whether doctors are licenced or not and whether they were struck off, and why,” she says.

Meanwhile, the issue of effective communication between European authorities is becoming more important as the movement of doctors in Europe increases.

In 2012, 43,919 doctors migrated to another EU state to practice, making it the second highest ranking of migrating professional groups in Europe.

This article was produced with support from by Sabine Prokscha, vice-chairwoman of the German Journalist Association, Section Berlin/Brandenburg and by research assistant and interpreter Amelia Strzepek