Two senior paediatric pathologists say they have discovered vitamin D deficiency in a significant number of children who have died of Sudden Infant Death Syndrome (SIDS)- cot deaths.The two doctors, Dr Irene Scheimberg and Dr Marta Cohen, say that vitamin D deficiency and associated diseases such as the bone disease rickets could also explain deaths that are often thought to be suspicious.

Both doctors believe their findings merit further investigation and research.

The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.

Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly tell tale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.

In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.

Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had rib fractures.

In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.

Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.

Dame Sally Davies Chief Medical Officer was quoted as “We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.

“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”

Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.

Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.

“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.

“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.

“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”

Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.

“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.

“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.

From: http://multi-vitamins.eu/vitamin-d-deficiencies-linked-to-cot-deaths-sids

Penny pinching NHS managers have introduced new viagra prescription guidelines which could limit thousands of couples to having sex once a fortnight.New policy documents advise GPs in parts of the country that patients in need of Viagra or similar drugs should be limited to two pills per month, down from the normal prescription of four.

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

There are a host of challenges looming for the NHS in the next 12 months.After 139 days of public hearings, the Mid Staffordshire Public Inquiry closed on 1 December. There is no date yet for the publication of the final report. But already Robert Francis QC, the head of the inquiry, has said the issue threatens to unleash a “tsunami of anger”.

The inquiry has been looking at what happened at Stafford Hospital from 2005 to 2008 during which hundreds of patients died needlessly and why it went undetected for so long. In particular, the findings promise to have major implications for regulation of the health service.

In recent months, the Care Quality Commission, which now regulates quality in the NHS after taking on responsibility for it from the Healthcare Commission in 2009, has come under criticism from the House of Commons health committee for losing sight of what it should be doing. Ominously for the quango, the prime minister was quick to give his backing to the findings.

What is more, during the inquiry the culture and vision of the regulator came under attack from its own officials, prompting the health secretary to order an investigation himself. It seems unlikely that the CQC will survive unchanged.

Politically, the government’s reform of the NHS in England may be over the worst hurdles, but that does not mean it will be an easy ride from now until the big bang in 2013 when GPs finally get control over the purse strings.

There is growing frustration among doctors who are getting involved in the new clinical commission groups. In many ways, they should be the greatest advocates of the plans as they are supposed to be getting more power than ever before.

But the Clinical Commissioning Coalition, which represents the GPs who are piloting the new arrangements, has started reporting that they are being bullied by senior managers in the health service. They say they are interfering with their structures and decision-making process – and this in turn is threatening the whole project. Expect another 12 months of arguments and controversy.

Although it is not part of the NHS, the social care system is closely linked to the fortunes of the health service. Whether it is arranging discharge from hospital or preventing falls in the home, when social services are not working as they should, the effect is felt in the NHS.

When Tony Blair came to power in 1997 he talked about improving social care. But at the end of Labour’s 13 years in power, ministers were still arguing about the best way forward.

After 13 years of labour’s dithering the system is suffering from chronic under funding.

While the NHS enjoys a budget in excess of £100 billion, adult social care has to get by on about £14 billion.

This is topped up by individual contributions – the system is means-tested – but nonetheless councils across the country are cutting back on what they can offer. And so reform will require extra money – something which is of course in short supply at the moment.

It is also likely to require cross-party consensus, but there is still some bad blood between the health secretary and his Labour opponent Andy Burnham over the death tax row which effectively scuppered the shadow health secretary’s plans to reform social care when he was in power.

The budget is increasing by an average of 0.1%, but as inflation in the health service is rising at a much quicker rate to cover costs associated with the ageing population and rising levels of obesity, savings are having to be made.

The NHS has a target of £20 billion by 2015, the equivalent of about 4% a year. That means there is pressure on jobs – unions say tens of thousands are being lost – and front-line services.

In particular, hospitals are coming under pressure. Advances in medicine and the nature of illnesses in the 21st century – many more people are suffering from chronic conditions like diabetes – means more and more can be done in the community.

It has meant an increasing number of hospitals are piling up debts because they are not getting enough patients through the door.

This in turn means managers and ministers are having to make difficult decisions about closing departments and even whole centres. The process will continue in 2012, particularly in and around London which was recently described as being in a “shocking” state by a committee of MPs.

Under Labour, an 18-week waiting time target was set for non-emergency hospital treatment, such as knee and hip operations. Within months of the coalition being formed, ministers said it was being relaxed to move away from the tick-box culture that they say had developed.

But when the government was knee-deep in criticism over its reforms the prime minister made the specific pledge that waiting times would not be allowed to slip. This has resulted in more attention than ever being given to waiting times.

And signs are emerging that hospitals are beginning to struggle to keep up with the 18-week goal. Overall, the NHS is still meeting the target – they only have to achieve it for 90% of patients to reflect the fact there are valid reasons why some wait longer.

But that masks the fact that there is a rising number of places where it is being breached, leaving the best-performers to bring the national figure up.

It means there could be growing dissatisfaction with the waits patients are facing, although it must be remembered a return to the 1990s when waits of six months and even a year were the norm for many patients is still a long, long way off.

The controversial NHS medical records database system would allow patients to check their medical documents online and raise any inaccuracies or problems with their doctor, however concerns have been raised over the security.The announcement was buried in documents released with the Chancellor’s Autumn Statement ahead of the results of a public consultation due to be published next year.

Patients should be given greater access and control over their medical information, the consultation said.

However, there are worries over the security of the system and that the information will be passed on or sold in so called ‘technology and data markets’.

Patients could be pressured into giving third parties, such as insurers access, to their record or to disclose details contained in it, it was warned.

In documents released with the Autumn Statement, it said: “All patients in the NHS will have online access – where they wish it – to their personal GP records by the end of this Parliament.

“GP practices that can already provide online access are encouraged to do so as soon as possible.

“These measures will help to position UK companies in the development of a personal information market, which is likely to be the next stage of development on from the growth of social networks.

“Online access to one’s own personal data enhances personal control and participation in public services. It also fuels innovation and growth in the supporting technology and data markets.”

Concerns were raised last year that the Summary Care Record was being rolled out too fast with patient records being uploaded to the national system unless people directly opted out.

The roll-out was halted but it now appears that it is to be restarted again and all patients who have already been contacted will have an online record by 2013.

The summary care record is part of a wider online medical records database to allow NHS staff to access brief medical records of patients they may treat outside their home area. However, in pilots, it was found that staff were passing access ‘key cards’ to each other breaching security rules.

Guy Herbet, general secretary of the campaign group No2ID, said: “The problem is this is a Trojan horse for the continuation of the Department of Health’s continuing centralisation of all medical records, and its seeming desire to share them with its friends in the pharmaceutical and medical technology industries.

“That’s a real threat to privacy and medical confidentiality. And the government has continued the previous administration’s work of taking records out of the hands of clinicians who have a direct duty to you.”

Gus Hosein, Executive Director of Privacy International, said: “In theory, this system is a positive development; everyone should have access to their own information.

“The problem is that the NHS is insisting on building a multi billion pound computer system to store records containing our most intimate and potentially compromising information.

“At best, it will fail, as large government IT systems have historically tended to do. At worst, it will create a data protection nightmare. The benefit of giving patients access to their medical records is vastly outweighed by the huge expense of the system and the significant threat to privacy.”

Chaand Nagpaul, the British Medical Association’s GP IT lead, said: “The BMA does believe that patients should be given the option of accessing more information online so that they can make informed decisions about their care.

“However, take-up has been very slow in those areas where patients have been offered access to their records online.

“It is essential that further work is undertaken to assess the level of demand amongst the public before further investment is made. With the NHS being asked to make efficiency savings of £20 billion, we must not waste money on expensive systems that patients will not use. It is also important any electronic system has built in confidentiality and data security safeguards.

“The UK’s research base and wider NHS could benefit from plans to publish datasets more widely and open up new channels of communication between different parts of the health service. It is important though that confidential data is not inadvertently disclosed. Proper safeguards must be put in place to stop this from happening. “

From:  http://www.telegraph.co.uk/All-patients-to-be-given-online-access-to-medical-records

Complaints against doctors have soared by almost 40 percent in just three years, according to official figures.The number of complaints to the General Medical Council (GMC) – which has the power to strike doctors off the medical register – has hit a record high, with more than 7,100 last year.

Patients’ groups said the figures were a “devastating insight” into a lack of public confidence in the health service, with more and more people feeling so alarmed by the behaviour of those treating them that they had asked regulators to investigate.

The watchdog found that among all groups of doctors, GPs, psychiatrists and surgeons attracted the highest rates of complaints.

The grievances covered allegations of medical failings but also rudeness and sexual misbehaviour.

A second set of figures, from the NHS’s in-house complaints unit, the National Clinical Assessment Authority (NCAA) also showed that the older a doctor was, the more likely they were to be referred to medical authorities because of concerns.

Referrals to regulators were just the tip of the iceberg – for each complaint lodged with the GMC, six more were made to local health services, with more than 43,000 such reports last year.

Katherine Murphy, chief executive of the Patients Association, said: “I think we have got a huge problem with falling public confidence in the health service; these findings are a devastating insight, and they mirror our own experience as a charity, with increasing numbers of people calling us because they do not know where to turn.”

Mrs Murphy said many members of the public felt doctors were still inclined to defend each other, rather than to admit patients had been let down.

The figures show the number struck off the medical register has also risen over three years, but by just 18 per cent.

However, many cases which end up with a doctor being removed from the register take far longer than a year to be investigated, meaning that it is too early to know whether the increase in complaints will mean to record numbers of doctors being struck off.

Last year 92 doctors were erased from the register, while 106 were given a suspension of up to a year.

The dramatic rise in the number of complaints follows a period in which pay for doctors has risen substantially, while workload fell.

GP income rose by more than 50 percent in the three years ending in 2006, with average earnings now around £105,000 per year.

At the same time, nine out of ten family doctors stopped providing care at evenings and weekends – reducing their workload by an average of seven hours a week.

A new contract for hospital consultants increased pay by 27 per cent over the same period, with average earnings now at £118,000, while working hours fell, in an attempt to meet European rules limiting the number of hours worked per week.

Niall Dickson, GMC chief executive said: “I don’t regard these findings as a cause for despair. I don’t think there is evidence that standards are falling, I think in some ways the system is getting better at identifying problems, and doctors are more willing to identify colleagues who are not performing well.”

He said that despite a “rising tide” of complaints from members of the public, surveys on the NHS suggested overall satisfaction remained high.

Some complaints were closed quickly, because regulators felt they were not suitable for investigation, either because they were not felt to be serious enough, or related to matters outside the GMC’s remit.

Of those which went on to full investigation, 60 per cent were complaints about medical care, with allegations about misdiagnosis and substandard treatment.

Another 26 per cent concerned respect and communication with patients, including accusations of verbal abuse, failing to listen to patients and basic rudeness.

Separate figures held by NCAA – an organisation set up a decade ago, in an attempt to resolve concerns about doctors more quickly, by retraining some, while referring others for investigation – show that older doctors were the most likely to attract complaints.

Those above the age of 60 were seven times more likely than those below the age of 40 to be referred to the NCAA.

The rate among those in their 50s was four times that of those below the age of 40.

Male doctors were far more likely than women to be the subject of such a complaint – with almost three times the chance of referral to the organisation, according to the figures, which cover the eight years ending last year.

From: http://www.telegraph.co.uk/Complaints-against-doctors-rise-by-40-per-cent

Drinkers should have three days a week off alcohol to avoid slipping into a cycle of binge drinking and risking liver disease, leading doctors have warned.The Royal College of Physicians (RCP) claims the Government’s current policy on healthy drinking limits is misleading, as it implies that it is safe for people to have alcohol every day of the week.

Official guidance on sensible drinking suggests that men should have no more than 21 units of alcohol a week, while women are restricted to 14 units.

But experts at the RCP said the policy does not take account of the fact that drinkers should have two to three days a week without any alcohol to let their bodies recover.

Drinking alcohol every day causes a “significant health risk”, doctors warned, increasing the chances of developing liver disease and other life-threatening illnesses.

“People should have two to three alcohol-free days every week to reduce the risks of long term damage from binge drinking, including liver disease,” a spokesman for the RCP said.

“After a day of drinking there is a need for a time to recover and that is why we need rest days in between our alcohol consumption.”

Younger drinkers are particularly at risk, the physicians warned, with daily drinking also common among middle-class women who often have a glass of wine after work.

As well as urging people to restrict their drinking to four days a week, the doctors recommend introducing lower limits for elderly people, as their bodies are more likely to suffer lasting effects from alcohol.

Speaking to the House of Commons Science and Technology Committee, Professor Sir Ian Gilmore, special adviser on alcohol at the RCP, said Britain’s binge drinking culture was creating a “tide of harm” in hospitals across the country.

“Given the burden of harm that we’ve got, it’s vital that levels are not increased at this point,” he added.

“We recommend a safe limit of 0 to 21 units a week for men and 0 to 14 units a week for women, provided the total amount is not drunk in one or two bouts and that there are two or three alcohol-free days a week.  At these levels, most individuals are unlikely to come to harm.”

The RCP’s warning comes after Professor Nick Heather, a lecturer at Northumbria University, urged MPs to increase daily drinking guidelines to include a “binge drinking limit” for maximum consumption in one day.

He argued that the Government should issue separate guidance on upper limits for daily and weekly drinking, without increasing recommended overall alcohol levels.

Guidlines from the Chief Medical Officer say men should not drink more than three to four units of alcohol a day, while women should limit themselves to two or three.

One unit is 8g of alcohol, roughly equivalent to half a standard glass of wine, half a pint of beer or a pub measure of spirits.

From:  http://www.telegraph.co.uk/Avoid-alcohol-three-days-a-week-doctors-warn

Paramedics are to be told if a patient does not wish to be resuscitated or wants to die at home, under plans backed by ministers.Adults in Britain can legally refuse medical treatment, even if it leads to their death but doctors cannot undertake treatment to a patient if it clashes with any clinical judgment.

Patients should, however, be given an opportunity for a second opinion wherever possible.

While the General Medical Council (GMC), the doctor’s watchdog, said last year there was no absolute obligation to prolong life, the medical profession does have a final say about whether resuscitation is in the patient’s best interest.

This has led to accusations from some critics who believe doctors are “playing God” and ignoring vulnerable patients’ right to life.

It has also prompted fears that as hospitals face deeper budget cuts, not resuscitating patients will become a cost-cutting option. It is thought that four in five people who die in hospital are the subject of “do not resuscitate”(DNR) orders.

Cardiopulmonary resuscitation (CPR) attempts to restore breathing or blood flow to those whose heart has stopped beating or who have stopped breathing.

It can include using electric shocks to try to correct the rhythm of the heart, repeatedly pushing down firmly on the patient’s chest and inflating the lungs with a mask or tube inserted into the windpipe.

While television medical dramas suggest it is often successful less than a fifth of those who have had such treatment actually go home, according to the British Medical Association (BMA). Inevitably, the young and fit are more likely to survive than the frail and elderly.

In 2007 the BMA, together with the Resuscitation Council (UK) and the Royal College of Nursing, issued joint guidelines on the issue in a 25 page document titled “decision relating to cardiopulmonary resuscitation”.

Legal experts say the “do not resuscitate” advice is essential where a “patient or their family disagree with doctors about whether a particular treatment is futile, a burden rather than a benefit, or inappropriate”.

Roger Goss, the co-director of Patient Concern, has raised concerns previously that “do not attempt resuscitation” orders are being misused.

“We are concerned that patients are having “do not resuscitate” written on their notes without they or their relatives knowing,’ he said earlier this month.

‘Bearing in mind NHS budget cuts over the next few years, it is not far-fetched to foresee that “do not resuscitate” orders will proliferate to the point where everyone over a certain age — perhaps 65 or 70 — gets one stuck on them.”

In England, Andrew Lansley, the Health Secretary, has stopped short of a national policy.

From: http://www.telegraph.co.uk/Paramedic-patients-resuscitation-advice-focus-on-current-rules

Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, analysis by the polling firm Gallup has found.Overweight and obese workers with no chronic problems take twice as many days off as comparable workers of a healthy weight, found the survey of almost 9,000 people.

Those who were overweight or obese and had three or more chronic health problems took 12 times as many sick days as healthy weight individuals with no health problems, or 18 compared to 1.5.

The survey was conducted by Gallup and Healthways, a firm that runs fitness centres.

It also found obesity alone counts for six lost work days per worker each year – or over £1,200 in lost productivity.

Ben Leedle, president and chief executive of Healthways, said it showed that the level of chronic disease in the UK workforce was at “alarming levels”.

He said: “Employers who recognize the importance of improving well-being at the workplace are most likely to gain a competitive advantage.”

From: http://www.telegraph.co.uk/Obesity-and-chronic-disease-cost-UK-PLC-20bn-a-year

Fair skinned people who are prone to sunburn may need to take health supplements to ensure they get enough vitamin D, say experts.It appears that those with pale skin, while not deficient, may still be lacking in the essential vitamin that the body makes from sunlight.

The Cancer Research UK charity say that even with a lot of sun exposure, those with fair skin may not be able to make enough vitamin D.

And too much sun causes skin cancer.

Clearly, for this reason, increasing sun exposure is not the way to achieve higher vitamin D levels in the fair-skinned population, say the researchers. But taking supplements could be.

Their work examined 1,200 people.

Of these, 730 were found to have “lower than optimal” vitamin D levels – and many of these were people with very pale, freckled skin.

Supplements are already recommended for groups at higher risk of deficiency. This includes people with dark skin, such as people of African-Caribbean and South Asian origin, and people who wear full-body coverings, as well as the elderly, young children, pregnant and breastfeeding women and people who avoid the sun.

Based on the latest findings, it appears that pale-skinned people should be added to this list.

Vitamin D is important for healthy bones and teeth.

A level less than 25nmol/L in the blood is a deficiency, but experts increasingly believe that lower than 60nmol/L are suboptimal and can also be damaging to health.

Most people get enough vitamin D with short exposures to the sun (10 to 15 minutes a day). A small amount also comes from the diet in foods like oily fish and dairy products.

But people with fair skin do not seem to be able to get enough, according to Prof Julia Newton-Bishop and her team at the University of Leeds.

Part of the reason might be that people who burn easily are more likely to cover up and avoid the sun.

But some fair-skinned individuals also appear to be less able to make and process vitamin D in the body, regardless of how long they sit in the sun for.

Hazel Nunn, of Cancer Research UK, explains how to increase vitamin D levels if you’re pale

Prof Newton-Bishop said: “It’s very difficult to give easy advice that everyone can follow. There’s no one-size-fits-all.  However, fair-skinned individuals who burn easily are not able to make enough vitamin D from sunlight and so may need to take vitamin D supplements.”

Hazel Nunn, of Cancer Research UK, said: “It is about striking a balance between the benefits and harms of sun exposure.

“People with fair skin are at higher risk of developing skin cancer and should take care to avoid over-exposure to the sun’s rays.  If people are concerned about their vitamin D levels, they should see their doctor who may recommend a vitamin D test.”

From:  http://www.bbc.co.uk/news/health-15151930

Foreign doctors who cannot speak English are to be banned from working in NHS hospitals and clinics, the Health Secretary will announce today.The NHS will introduce mandatory language tests for doctors moving to Britain after training elsewhere in the European Union.

The decision follows a series of cases in which patients have died or suffered poor care as a result of doctors speaking sub-standard English.

The issue was brought to national attention three years ago when Dr Daniel Ubani, a German-trained GP on his first out-of-hours shift in Britain, killed David Gray, 70, by giving him 10 times the normal dose of diamorphine.

In his speech to the Conservative Party conference today, Andrew Lansley will say that the Medical Act will be amended so that doctors must speak good English to practise in Britain.

“I am determined that doctors who come from overseas to work here in our NHS must not only have the right qualifications, but also the language skills to practise here,” the Health Secretary is expected to say. “We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients. This is not about discriminating; we’ve always appreciated how much overseas doctors and nurses give to our NHS. It is simply about our absolute commitment to put patients’ safety first.”

There are more than 88,000 foreign-trained doctors registered to work in Britain, including 22,758 from Europe. They account for almost a third of the total.

Under the proposals, local NHS trusts would have a duty to check the language skills of foreign-trained doctors before they can be employed. In addition, the General Medical Council would be given powers to take action against doctors when there were concerns about their ability to speak English. At present, only doctors from outside the European Economic Area are routinely scrutinised for their language skills before being registered by the GMC.

This means that doctors from Canada or Australia are routinely tested for their language skills while those from countries such as Poland and France are not.

It had previously been thought that European Union laws ensuring the freedom of movement of labour prevented language testing. However, the European Commission has recently stated that the language tests would be legal.

Dr Ubani, who admitted he had never heard of the drug he gave to Mr Gray, was struck off by the GMC in June last year but still practises in Germany. His poor English meant he was refused work by the NHS in West Yorkshire but was accepted in Cornwall and Camb-ridgeshire, where he saw Mr Gray.

Since the case, the GMC and other NHS leaders have repeatedly warned that some foreign doctors’ language skills are so poor that patients are being put at risk.

Compulsory language tests for foreign doctors will raise concerns that the NHS could be left short-staffed, such is its reliance on overseas medics. Ministers believe that the majority will reach the necessary standard of English.

Mr Lansley will today deliver a robust defence of the Government’s health policy, saying that money is being diverted from cutting bureaucracy to front-line services.

“Unlike Labour, we will make sure that every penny of our investment goes right to the patients who matter, not the huge Labour bureaucracy which we inherited,” he will say. “And all that is why, since the election, we now have 1,500 more doctors and 5,000 fewer managers in the NHS.”

He will also claim that hospital infection rates have fallen and the number of people being treated in mixed-sex wards has fallen by more than 90 per cent over the past eight months.

From: http://www.telegraph.co.uk/Conservative-Party-Conference-2011-doctors-from-overseas-must-speak-English-or-be-banned