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Locum GP from Germany is struck off medical register

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c3326 (Published 21 June 2010) Cite this as: BMJ 2010;340:c3326
  1. Clare Dyer
  1. 1BMJ

    Daniel Ubani, the doctor from Germany who killed a patient with 10 times the recommended dose of diamorphine on his first day as an out of hours locum GP in Britain, has been struck off by the General Medical Council.

    In the light of his “serious and persistent failings” in the clinical care of three patients on that first day, there would remain a serious risk to patients if he stayed on the medical register, the GMC’s fitness to practise panel held. David Gray, 70, who had renal colic, was pronounced dead four hours after Dr Ubani gave him the painkiller at his home in Manea, Cambridgeshire, in February 2008 (BMJ 2010;340:c550, doi:10.1136/bmj.c550).

    The case has prompted concerns over commercial out of hours services and over reciprocal practice arrangements that allow doctors practising in another European Union country to be registered by the GMC with exemption from the normal training requirements for general practice.

    The health secretary, Andrew Lansley, wants to make GPs responsible for organising evening and weekend cover, which he argues would encourage more of them to join together to provide the services themselves.

    Dr Ubani, 67, who was born in Nigeria, was taken on by Cimarron UK, which supplied doctors to the locum agency Take Care Now, on the basis of a curriculum vitae that showed no experience of general practice. His specialty in Germany was surgery.

    Cimarron based its assumptions about his experience and competence on the facts that he was registered with the GMC, was on the Cornwall & Isle of Scilly Primary Care Trust’s list of performers, and was classified by the GMC as exempt from UK training requirements, said the panel’s chairman, Brian Alderman.

    Yet the GMC is not in a position to test either the medical competence or language skills of EU doctors, he pointed out.

    On his first stint as a locum Dr Ubani flew into Stansted airport the day before he began work. After computer training and induction to familiarise him with local procedures and practices, he checked into bed and breakfast accommodation after midnight, before an 8 am start the next morning. In a letter of apology to the Gray family he explained that lack of sleep meant his “nerves were overstretched” and that he was “too tired and lacked concentration.”

    Mr Lansley said, “There is no doubt that out of hours care needs urgent reform. GPs are best placed to ensure that patients get the care they need, when they need it. If GPs are responsible for commissioning out of hours care, I believe many will also decide to play an enhanced role in providing these services themselves.

    “In addition, I am working closely with the GMC to ensure that foreign healthcare professionals are not allowed to work in the NHS unless they have proved their competence and language skills. We are currently exploring a number of options to put a stop to foreign doctors slipping through the net.”

    The GMC’s chief executive, Niall Dickson, agreed that there was a “gaping hole” in its procedures that needed to be plugged, to allow it to assess the language skills and clinical competence of doctors from other EU countries. “In the meantime it is all the more important that employers exercise their responsibilities and ensure that the doctors they take on are competent, proficient in English, and fit to do the job they are being given,” he said.

    Notes

    Cite this as: BMJ 2010;340:c3326