Belgian registers are failing to stop professionals barred from practice in other European countries, even as the number of foreign doctors reaches a record high

Belgium has become increasingly dependent on doctors trained abroad, but the system meant to check whether they are entitled to practise has failed to keep pace. A record number of foreign doctors now work in Belgium, yet oversight remains fragmented. In practice, a specialist struck off in another European country for serious misconduct may continue to see patients in Belgium.

An international comparison bringing together more than 2.5 million names of healthcare professionals, both those authorised to practise and those struck off, has exposed a fundamental problem. Several doctors, dentists and psychotherapists who are no longer allowed to practise in other European countries still appear in the Belgian registers of the Order of Physicians, the federal health authority and the institution managing health insurance. In some cases, it has been established that these individuals are actually working with patients.

The conduct that led to their removal from professional registers in other countries is serious. It includes sexual assaults on patients, punishable sexual conduct, large-scale fraud involving social security funds, or dangerous incompetence. For patients in Belgium, it is difficult to distinguish a properly vetted doctor from someone who should have been barred from practice, particularly when their names may appear in official registers as though everything were in order.

The problem is not simply a lack of additional checks; it also concerns the way European systems communicate. The Internal Market Information System alert mechanism, created specifically so that Member States can notify one another of professional bans, is not being used to its full capacity. The Order of Physicians acknowledges that incoming alerts are not checked systematically and that its list of recognised professionals is not automatically synchronised with this system. In other words, a ban imposed in one country may have no practical effect in Belgium.

The authorities’ response points in the right direction, but for now it remains at the level of principle. The federal health minister says that providing quality care and protecting patients should be a given for every healthcare provider, regardless of nationality. He acknowledges the need for oversight mechanisms and a clear framework setting out the conditions under which every professional may and must work. The question is how quickly this will be translated into a system that automatically blocks a doctor struck off elsewhere.

Belgium does not need to shut its doors to foreign doctors; it needs to know exactly whom it is allowing to practise. An interoperable register, an automatic suspension procedure while a case is clarified, and systematic checks of European alerts would be a basic starting point. Until then, patients’ trust depends on a system that, in some cases, fails to see what it should.