Foreign doctors need more training and the out-of-hours GP system is inadequate, according to a government-ordered report. GPs from other countries should prove they have the required skills and knowledge to work for the NHS, and be proficient English speakers, it recommended. The report made 24 recommendations for improvement, which the government is expected to accept before ordering PCTs to quickly comply. Study leaders David Colin-Thome, Clinical Director for Primary Care at the Department of Health, and Steve Field, Chairman of the Royal College of GPs, found the out-of-hours service is badly integrated with other urgent departments such as A&E. It is expected that the government will say some PCTs fail to meet safe care obligations, and instruct them to inform the General Medical Council whenever they refuse to hire a doctor, so a different trust does not unknowingly take on the same GP.

British nurses have to evidence that they are up to date and have the skills and knowledge to practice in whichever department they are in. It is an 'insult' to the profession to have poor speakers of the language with archaic practices to be able to work in the Out of Hours Service, the insult is made worse by the large salaries these foreign doctors can earn often much more than in their own country as well as their expenses such as hotel bills etc. I have worked in an Out of Hours Dept where this has happened. There were also newly qualified doctors also who in spite of a long training still did not have the experience to take on such a role. If it had not been for the support of experienced nurses I am sure there would have been a lot more 'mistakes' made. It seems ludicrous that a signature on a prescription in the form of a rubber stamp or guess work which happens! Thank heavens for nurse practitioners but there are not enough jobs for them! Many doctors fear that they could be a cheaper replacement which is true, but not if they are put in place of 'qualified inadequacy!