The 2005 EU directive on the recognition of professional qualifications enabled the free movement of clinicians around Europe, by requiring the GMC and other regulators to accept overseas medical qualifications. But it also bars them from conducting any formal language testing.

As a result, European clinicians may be registered with the GMC despite struggling to understand English.

The case of Dr Daniel Ubani, a German doctor who accidentally killed a patient on his first UK out-of-hours shift, highlighted the risks of hiring doctors whose English is not fluent.

Polly Kettenacker, EU and international officer at the Nursing and Midwifery Council, said the regulator had been lobbying the European Commission to change the directive ‘in the interests of patient safety'.

‘But we've established that's not going to happen,' she said. The NMC was now focusing on warning employers that professional registration does not imply fluency, she added.

But a spokeswoman for the GMC said that the regulator's ‘long-standing position' was unchanged. ‘We want to be able to systematically test doctors' English language ability at the point of first registration,' she said. ‘We continue to press for change both as an independent organisation and with other healthcare regulators.'

She reminded employers that they had a responsibility to conduct interviews, to ensure applicants' language skills were up to the job.

Read the full version of this story in this week's edition of GP dated 30 October