Hospitals appointing doctors from outside EU without assurances of English language skills and police clearance

The HSE is appointing doctors from outside the EU to work in hospitals without having assurances about their competence in the English language or that they had no criminal records in Ireland or abroad, internal auditors have said. These deficiencies reduce assurance that all staff engaged met required regulatory and governance standards when they were taken on “and give rise to potential regulatory, patient safety and operational risks”, the auditors said in a report published yesterday.Nearly 28 per cent of doctors in active clinical practice in 2024 held a basic medical degree from outside Ireland, the UK or the EU. More than 2,300 doctors had graduated in Pakistan and 1,200 qualified in Sudan.Apart from work permits, doctors with qualifications from outside the EU being appointed by the HSE must have the appropriate visa, registration with the Irish Medical Council, independent references, Garda vetting and clearance from the relevant police force overseas. They must also have authorisation from occupational health authorities in Ireland and evidence of competency in the English language. READ MOREThe HSE internal auditors examined the cases of 20 international consultants and non-consultant hospital doctors working across seven hospital sites in the Dublin-Midlands and Dublin-North East regions.“Overall compliance was low for mandatory checks relating to evidence of English language competency and occupational health clearance,” they found. “Evidence of English language competency was not available for 13 employees across the two regions, including two consultants who were assessed as fluent at time of onboarding but for whom no documented evidence was retained on file.“In addition, one site accepted an English language certificate that did not meet the minimum HSE required score and one other site accepted a certificate a year after onboarding.”The audit report said evidence of occupational health clearance of staff being appointed “was low in one region, and varied between sites within that region, while the other region demonstrated high compliance”.[ Radiologists concerned over patient scans reviewed by unregistered doctors abroadOpens in new window ]“Deficiencies in completion and/or retention of evidence of these mandatory checks reduce assurance that staff meet baseline fitness and competency requirements before commencing duties, creating potential patient and employee safety risks,” the auditors said.The report also notes “inconsistent evidence of pre-employment vetting checks”.“Overall compliance achieved for Garda vetting was moderate while compliance achieved for overseas police clearance was low. Evidence of Garda vetting clearance was not available in one region for two employees (while) for a further five employees, Garda vetting clearance was obtained after commencement of employment.”In a statement the HSE said patient safety was its foremost priority. “The HSE has a comprehensive, standardised process for the recruitment of non-European Economic Area doctors to ensure compliance with legal, regulatory and professional requirements and to verify that doctors are appropriately qualified and credentialed for their roles,” it said. “The HSE is committed to ensuring that these requirements are consistently applied across all services and that the audit recommendations are fully implemented through established governance and oversight mechanisms.”