European leaders are under renewed pressure to fix systemic failures in the continent’s cross-border medical alert system after a sweeping investigation revealed that dozens of doctors banned for serious misconduct in one country have quietly resumed their careers in another. The findings – published in the Bad Practice series by the Organized Crime and Corruption Reporting Project (OCCRP), Norway’s VG, and the Times of London – have triggered alarm among medical associations, patient advocates, and regulators who warn that the loopholes pose a direct threat to public safety.

The Standing Committee of European Doctors (CPME), representing national medical associations across Europe, issued a strong and unusually direct statement urging the European Union to enforce stricter oversight. Their message was clear: the EU’s mechanisms for alerting member states about dangerous doctors are failing, and patients are paying the price.

According to OCCRP’s investigation, more than 100 doctors who had lost their licenses for serious professional violations – including malpractice, sexual assault, fraud, and gross negligence – were still legally allowed to practice medicine elsewhere within Europe. Under EU rules, member states are required to submit alerts on the Internal Market Information (IMI) system whenever a doctor faces disciplinary action, suspension, or a revoked license. These alerts allow national regulators to verify whether a doctor applying for work elsewhere has a history that would make them unfit to practice.

In reality, the system is riddled with holes.

The OCCRP reporters found that some countries rarely use the alert mechanism at all, despite its mandatory nature. Malta, Greece, Liechtenstein, and Estonia have reportedly issued zero alerts since 2016, when the legal requirement was introduced. Another ten countries have filed fewer than ten. In the meantime, many doctors sanctioned in one state have quietly moved to another where their past misconduct went undetected due to the absence of proper alerts.

For CPME, these revelations confirmed long-standing concerns about the uneven implementation of the IMI system. In its statement, the organization said it was “deeply concerned” and urged immediate reforms. “We call on the EU and the member states to take measures to ensure the alert mechanism is fully and uniformly implemented, with strengthened data exchange between competent authorities across Europe and at national level between responsible bodies,” the group said.

CPME emphasized that the issue goes far beyond bureaucratic inefficiency – it strikes at the core ethics of the medical profession. “Fixing the alert system is vital to uphold ethical standards and to maintain patient safety and public trust,” the organization stressed. Without a functioning mechanism, patients have no way of knowing whether the doctor treating them was previously disciplined or banned elsewhere.

But the problem is not simply that countries fail to send alerts. The investigation found that even when alerts are submitted, many national authorities struggle to access them, hindered by technical obstacles, unclear interface design, or internal regulatory fragmentation. Regulators in some countries told journalists they were overwhelmed with a large volume of alerts, many of which lacked clear definitions or consistent standards, making it difficult to determine whether an incoming warning required action.

These issues mirror concerns raised last year by auditors from the European Commission itself, who found widespread confusion over how warnings should be categorized, what constitutes serious misconduct, and how far a restriction must go before an alert is triggered. The auditors also criticized the overloaded nature of the IMI system, which sometimes drowns regulators in non-critical alerts while allowing major threats to slip through the cracks.

The consequences can be devastating. In one case highlighted by the OCCRP, a doctor who had his license revoked for gross negligence related to patient deaths successfully registered to practice in another EU country that had never been informed of the disciplinary action. In another case, a surgeon banned for sexual misconduct was later found employed at a foreign clinic, where patients had no knowledge of his past.

The cases illustrate how dangerous doctors can exploit the freedom of movement within the EU – a principle meant to empower qualified professionals, not shield those who have harmed their patients.

To understand the depth of the problem, it is necessary to consider how the IMI system is supposed to work. When a doctor is disciplined or banned, the regulator in that country must notify the IMI system within three days. The alert then becomes visible to all other member states, which are expected to check incoming applications against the database. If the system functioned properly, it would create a continent-wide safety net: once banned in one country, a doctor would be unable to practice anywhere else in Europe.

But as the investigation shows, this ideal system remains largely theoretical.

CPME’s renewed call for reform is therefore being seen as a turning point. The organization wants clear definitions, harmonized reporting standards, and better communication channels between national medical bodies and the EU. It has also urged member states to ensure that disciplinary decisions are immediately and accurately uploaded, and that regulators have the proper tools to review incoming alerts swiftly.

For their part, European Commission officials have acknowledged the severity of the findings. In response to the OCCRP investigation, the Commission said it would explore ways to strengthen and modernize the alert system to ensure patient safety across the continent. While they did not specify what reforms might be introduced, possibilities include mandatory quality checks on alerts, stricter penalties for countries that do not comply, and technical upgrades to improve accessibility and standardization.

Patient advocacy groups are also mobilizing. Many argue that the public should have access to more information about disciplinary actions, enabling individuals to make informed choices about their healthcare providers. Some are pushing for the creation of a centralized, publicly accessible EU-wide database of sanctioned doctors – similar to systems already in place in countries like the United States.

As the EU continues to expand cross-border mobility for workers and services, the stakes are only rising. Without robust mechanisms to track professional misconduct, dangerous individuals will continue to exploit regulatory loopholes – and patients will remain unwitting victims.

The OCCRP’s investigation has exposed a serious breach in Europe’s healthcare safeguards. The CPME’s forceful response underscores the urgency of the problem. Now, the question is whether European leaders will respond with decisive action or allow the loopholes to persist, leaving millions of patients vulnerable in a system that was meant to protect them.

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