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Peer issues warning over language skills of 'Eastern Bloc' nurses

Fertility expert and television presenter Lord Robert Winston has courted controversy by warning about the potential risks to healthcare posed by nurses with poor command of English.

In the House of Lords lat week, he pointed to particular problems with nurses coming from some Eastern European countries.

“Communication between the patient and the professional is of vital importance,” Lord Winston told peers.

“We run the risk of losing it with this issue of nurses who can’t speak the English language and have been trained in a different way. I’m particularly concerned about nurses coming from the east bloc of Europe. For example: Romania and Bulgaria.”

He urged ministers to fight for better communication standards in its dealings with other European states.

“I hope we can make the strongest case possible to make sure we get proper communication between patient and carer,” he said.

His comments came in a Lords debate on different training standards for health workers coming to work in the UK from within the European Economic Area and outside it.

At present, European union directives prevent the Nursing and Midwifery Council from testing EU nurses and midwives on basic language competency. Additionally, nurses and midwives with qualifications from an EU country are granted “automatic recognition” of their competence to work in the UK – a rule based on minimum EU training standards that were set in the 1970s.

This contrast with those from outside the EU who must take the International English Language Test and are required to undertake the overseas nurses (or adaptation to midwifery) programme – a 20 day course with a three to six month period of supervised practice.

In a statement released ahead of the debate, the NMC said: “The current process presents a risk to patient safety, with concerns over EU nurses and midwives’ language competence and knowledge of modern nursing standards.”

In response to Lord Winston’s comments, health minister Earl Howe acknowledged the problem was an issue of major importance for care quality, but said local measures had been strengthened.

He said: “In the UK we have implemented a system of checks at a local level through duties on primary care trusts and guidelines to local NHS employers.”

But Royal College of Nursing chief executive and general secretary Peter Carter said regulators, such as the NMC, should be able to test for language competency and that it should be a requirement “anchored in European law”.

He said: “UK nurses are required by the NMC to re-register every three years and must demonstrate that their skills are up to date. Conversely, if a nurse from the EU has not kept their skills up to date or worked for a number of years as a nurse, the NMC is still required to register them.

“Equally, there is a responsibility placed on employers to ensure that the language skills of all staff are of a high enough level to allow them to communicate effectively with patients and colleagues. Therefore, we would like to see checks in place to ensure continuing levels of competence for all health professionals.”

He added: “This is not to discriminate against nurses from any particular country, but rather to ensure that the highest standards of care and patient safety are maintained and that any barriers to that effect are removed.”


Readers' comments (57)

  • Why is this controversial? He is absolutely right? It isn't just Eastern Bloc workers though, India, Pakistan, Asia, any number of countrys, I have worked with many bank and agency staff from a variety of country's, mostly HCA to be fair, who cannot literally (with no exaggeration) not speak a single word of English. This doesn't just make the job itself more difficult for me and other staff Nurses, as information cannot be passed on, etc, but also how can they possibly communicate with patients?

    And let me get this straight before all the idiots come out with 'racist', this is not about race, or not accepting workers from other countries, I have also worked with many Doctors, Nurses and HCAs from many, many countries who are excellent.

    This is about ensuring that those who come to work here have the fundamentally basic skills that would allow them to do so, language skills being one of them. Australia have a mandatory English test (even for native English speakers) for those who want to go there to work, why can't we?

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  • All that is required is for a Trust to have the balls to put a minimum requirement for literacy and verbal communication skills into the job description or person spec and we're laughing.

    Shouldn't we be asking that Joyce Robins of Patient Concern what she thinks about this seeing as how she rates nurses being verbally accessible by patients during drug rounds so highly?

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  • The Lord speaks fairly. I have worked with numerous white British nurses who speak in 'chav' styles and are incomprehensible to all but their peers.

    The Czech and Polish nurses speak wonderful English in contrast....

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  • I work in Cyprus with Romanian, bulgarian, polish, Russian and one Cypriot nurse. I am British. All of them speak English and Greek in varying degrees however, it is their difference in nursing education that bothers me! However not to digress. In the Republic of Cyprus, to become registered, all non Greek nurses have to pass an interview in Greek with the ministry of health.. EU member or not. To work in a government hospital, we need to pass written and verbal exams equivalent to A level Greek.

    I believe this should be the same in the UK. I left the NHS dissallusioned by many things but my very last shift was with a team of nurses of whom I was the only native English speaker and the patients as well as the other team members could not communicate effectively.. No one could read or write care plans or the reports..Dangerous!

    There really should be language exams put in place both written and verbal as part of the registration and employment proceedure.

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  • Listening to the News today it sounds like lets have a pop at Nurses.
    Lord Winston you are absolutely wrong, Nurses and Patients have often been struggling to understand Doctors ever since I can remember. Doctors often have a language barrier and Patients always ask the Nurse what was said.
    More often than not we can't understand Doctors writing including prescriptions.
    My Nurse colleagues where English is a second language are absolutely fantastic, superb clinical skills.

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  • I currently work with nurses of many nationalities and have found in my personal experience that eastern block nurses have an excellent command of the English language both written and verbal, work well with their peers. On the other hand I work with Chinese and Fillipino and Indian nurses with poor language skills and those with excellent
    and those with excellent language skills. But I also work with English nurses and health cares who equally are excellent and abysmal. So I really don't think it has anything to do with nationality at the end of the day !

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  • They must have degrees in something and 'b----r' the rest of us. How do these people, British or otherwise, even get through an interview?

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  • If nurse managers had the balls. These nurses would not even get to interview, yet alone, appointed.

    However, if a nurse is found to be lacking in verbal and or written english ability then that is an area of unacceptable incompetance.

    We have all had to reach a professional level of competance to practice, if nurses fall below this level then it is the easiest thing in the world to dismiss them and not end up at a tribunal.

    It all goes full circle with nurse managers and their balls...

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  • UK London teaching hospital trained nurse, pure white British, born in London of British parents, grandparents, ancestry traced back to 11th century, brought up in England, English mother tongue, etc. with MSc from English university and 20 years clinical experience working autonomously and as part of an interdisciplinary healthcare team in a multinational, 1000 bedded, modern, state of the art university hospital in Europe. has excellent communication skills and flexiibilty to nurse patients of many different cultures, speaks two other European languages fluently and can communicate at basic level in a third, cannot get job in the UK as there is a lack of places due to recruitment of foreign labour although some have inadequate communication skills in the English language and their employers seem to have little knowledge of their training!

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  • Anonymous | 11-Sep-2011 7:44 am well said. That is another huge issue but I absolutely agree. Whilst I would argue that Nursing is one of the few professions that should always be open to anyone from any country because it is a desired skill, there is something terribly wrong when trusts have huge quotas to fill with foreign nationals and there are many British Nurses struggling to find work.

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  • mike | 11-Sep-2011 9:08 am

    from 7.44 above. we have had this conversation before Mike, and I am no longer offering my services to the UK market. but having returned from so many years abroad and full of enthusiasm to carry on in the UK with so much experience under my belt I was shocked and totally deluded at the attitudes of employers and the poor working atmosphere and relations in the workplace which I was so unused to.

    I just felt it was a total waste of my qualifications and with so much to offer them, as with many others in a similar situation, and I know you are included in this group, who have had the experience of working abroad and in my case in a health system which delivered care par excellence and knew how to recruit the very best staff and retain them (also with an excellent employment package and benefits), often from leaving their training school, for the whole length of their career.

    I also remember at the time the RCN encouraged nurses to go and work abroad and said in their literature that the NHS should welcome the experience of those who had!

    the NHS aren't in the slightest interested listening to any fresh ideas of those who have worked abroad as though they are afraid it might upset their status quo.

    One Director of Nursing told me that my problem was that I lacked experience! With an MSc in healthcare management and 20 years of working on an acute and chronic general medical ward and often in charge of shifts or working alone, especially at nights. I think she really meant experience in the NHS but I wonder what her definition of experience was - I was so amazed and horrified that I left even without questioning her attitude!

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  • Anonymous | 11-Sep-2011 7:44 am:
    UK London teaching hospital trained nurse, pure white British, born in London of British parents, grandparents, ancestry traced back to 11th century, brought up in England, English mother tongue, etc.

    @ Anonymous 11-Sep-2011 7:44 am
    Are you for real?!?!?!?! What the hell is pure white British? I think the fact that you cannot get a job might be due to something else other than foreign nurses!

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  • @ Mike I have just noticed that you congratulated the anonymous poster for their racist rant- are you for real? Are you another 'pure white brit'

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  • @ Anonymous 11-Sep-2011 7:44 am

    nothing racist intended. I just wished to indicate that out as a British born and trained nurse I was unable to get a job in Britain and had to go and work abroad or remain unemployed whereas vast sums of money are spent recruiting nurses from abroad and some of whom are unable to speak English as well as someone whose mother tongue is English. If I was racist I would not have worked abroad in an international, multicultural society for so many years.

    I just coined the phrase 'pure white British' to point out that even those who come from the UK and trained there do not necessarily get a job before someone is recruited from abroad and apparently I am not the only one, it seems to affect thousands of nurses and maybe because those from abroad, in theory, are paid lower salaries.

    Judging by your remarks and those by NHS below, I would suggest that these are racist and not mine or Mike's! The problem probably lies in your interpretation of the comments and not what was actually said or intended.

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  • I'm relieved that someone picked up on that NHS Nurse, thankyou!
    FYI anon 7.44, pre 11thC were the Danes, the Romans the french, the celts.........

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  • te rog, ce-ai spus?

    ?? ?? ?? ????????.

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  • ?????????, ?? ?? ?? ????????.

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  • Anonymous | 12-Sep-2011 11:26 am
    Oh that's all right then you meant no offence with the term 'pure white' British! And of course you worked abroad so couldn't possibly be racist next you will be telling me you have friends of colour.......

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  • NHS Nurse | 12-Sep-2011 11:01 am

    I could equally well have said 'lily white British' if you prefer, it was just to illustrate the point that I am British and it is not acceptable that British nurses are out of work whilst vast sums of NHS money are being spent sending its employees abroad to recruit staff. in the present economic climate they can ill afford to do this and the money may be better spent where it is needed such as in direct patient care.
    Perhaps, without this expensive exercise, it might leave more financial resources available to engage increased numbers of front line staff.

    I think we have every right to object to this practice especially as it must also involve wastage through, for example, a potential lack of the skills required, costs of extra training and not remaining in post as long as their British counterparts might, then a need for further recruitment involving more costs.

    In the poorer countries, such as Bulgaria and Romania, cited in the article and many others as well, maybe they would not be too happy either if there was a large recruitment drive from abroad when their own qualified nurses are struggling for jobs.

    However, I am a great supporter of some of the more positive effects of globalization and the enrichment of living and working in a multicultural environment. It can be far more enriching and interesting and where there is so much to learn from one another, but I do believe in a country as small and overpopulated as Britain a quota system might be of help whereby more UK trained nurses are offered jobs as first priority, although ultimately they should be chosen for their ability to do the job and not their nationality or colour of their skin which to me is totally immaterial. I fail to understand why, in the UK, this has become such a big issue which leads to further stereotyping, lack of a willingness to understand others, discrimination and in some cases ostracism.

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  • Anonymous | 12-Sep-2011 11:26 am:
    whether you intended to be racist is beside the issue. Your words belie your intention regardless of your defence, do you really not see that?
    You're confused about regarding what you see as a 'pure bloodline', however ridiculous that might be, with your right of entitlement to a british job. How is that not racist?

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