Professor Tamara Hervey, University of Sheffield*
on 3 August 2018 claims that “EU regulations currently prevent doctors from
qualifying before five years of training. Just one of countless examples of EU
“market building” that do nothing of the sort, instead causing disruption and
impairing UK policymakers.” It’s citing Health Minister Steve Barclay, and a
This is yet another example of
pro-Brexit propaganda that sounds beguilingly simple and obvious but turns out
to be nothing of the sort.
It is so for four main reasons:
First: It is wrong about the
causal relationships between EU law and current UK practice. It forgets that
the UK has been a powerful and influential member state of the EU for decades.
As such, the UK has had important influences on the way EU law is in this area
– as in many other areas. Current UK law on medical qualifications does indeed
comply with EU law. But effects of EU law on routes to medical qualification
are limited, and mainly indirect. The vast majority of the detailed contents of
medical curricula are determined nationally. The length of time it takes to
qualify for a particular medical profession differs in different EU member
in the EU need to undergo a certain agreed amount of training: the UK agreed
those rules as an EU member state. If the UK wanted to make changes to the
rules on medical qualifications as a member of the EU it could. Indeed,
the UK already did, particularly in the reforms that led to the new
EU laws adopted in 2005.
So there’s no new opportunity
here, at least not in the sense implied in the minister’s statements.
Second: This kind of statement
vastly over-simplifies rules about qualifications of different types of medical
professionals. EU rules about doctors are on one model, where there is a set
amount of time and a broad brush agreement on the content of what they need to
learn in order to qualify. This isn’t the case for other medical
professionals. For them, there is significantly more control by the home
state, subject to the obligation to recognise equivalent qualifications from
other EU countries (and the corresponding duty of other EU countries to
recognise UK qualifications). The UK – along with every EU Member State – is
permitted to check linguistic competency of medical professionals working in
Third: The statement assumes that
quicker is better and cheaper. There is a good reason that it takes time to
qualify as a medical professional: medical professionals affect people’s
health, dignity and lives. Less well qualified medical professionals might not
necessarily be cheaper for the NHS longer term. I hardly need to elaborate
further here, surely?
Fourth: The idea that we could
gain a ‘Brexit benefit’ from shortening qualification periods for medical
professionals is wrong about who our doctors and other health professionals
are, and about how medical practice, and bio-science more generally, works in
today’s world. Bio-medical science is an international career. The UK does
well, at the moment, in attracting professionals from other EU states to the
UK. If we depart from alignment with EU qualifications, then we lose an
important group of collaborators, and people who could work in the UK as
It is inconceivable that the UK
could be ‘self sufficient’ in medical professionals – the numbers just do not
add up – as the Nuffield Trust has convincingly shown in its detailed research.
Even if UK were to invest an
unprecedented amount in educating medical professionals – and bear in mind that
there is no commitment whatsoever from this, or any other, government to
attempt to do so – it still wouldn’t give us access to the international
collaborations that we currently participate in through the EU.
In short, this kind of
misinformation that seems too good to be true is just that: too good to be
Parliament (both Commons and
Lords) is concerned about any worsening of health post-Brexit and will seek to
hold the government to account. The current government itself agreed in the
debates on the EU (Withdrawal) Bill that Brexit should ‘do no harm’ to health.
These kinds of statements about supposed ‘Brexit benefits’ need to be carefully
scrutinized against that standard.
Barnard & Peers: chapter 27
Photo credit: Royal Bournemouth