doubling in cases of serious disciplinary action taken against doctors from other EU states.

Fears over safety of foreign doctorshttp://www.richimag.co.uk/nhs2009/page12.html

The number of doctors who have come to work in Britain from other parts of Europe without undergoing safety checks or extra training can be revealed for the first time.

By Laura Donnelly, Health Correspondent
Published: 9:00PM BST 05 Sep 2009

Of more than 20,000 EU doctors registered to practice in this country, 4,061 have arrived since safety checks were removed five years ago.

The figure comes amid increasing concerns about the lack of scrutiny of medics who migrate to this country.

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Figures from the General Medical Register show that among the foreign doctors registered to work in the UK, more than 5,000 are from former Eastern bloc countries.

Of those, the greatest exporter was Poland, which trained 1,800 medics now on the British register, followed by Hungary, which sent more than 1,000. More than 700 came from the Czech Republic and almost 800 from Romania.

Under an EU directive passed in 2004, doctors who qualify in any EU state can move to work in any other member state without tests of their language skills or clinical competence – even though experts last night warned that there is little consistency in the medical training, treatments and medications used across Europe.

This newspaper's investigation reveals that since then, the number of EU doctors registered to work in Britain has risen by 4,000 – an increase of 25 per cent – at a time when the number of UK-trained doctors on the register has fallen.

Meanwhile, there has been a doubling in cases of serious disciplinary action taken against doctors from other EU states.

Regulators warned that British lives were being put at "unacceptable risk" by the lack of safety checks covering doctors who come here for permanent work, as well as those flying in to work lucrative shifts at evenings and weekends.

Senior doctors expressed particular fears about the quality of training in some parts of Eastern Europe.

They warned that other countries exporting high numbers of medics to this country were not familiar with the same medications, and had different education systems.

More than 3,500 doctors came from Germany, the figures disclose. Last year, Dr Daniel Ubani killed a pensioner during his first shift working in Britain after flying from Germany to work as an out of hours doctor.

David Gray, 70, died as a result of a massive overdose of the drug diamorphine which is rarely used by family doctors in Germany.

Under the Brussels rules on freedom of labour the General Medical Council, which regulates doctors, cannot force its counterparts abroad to reveal whether a doctor has been previously struck off, or had restrictions placed on their practice.

Instead it relies on voluntary sharing of information, which its officials warn is unreliable.

The GMC has pleaded with the Government and European Union to re-examine the rules, which it believes put patients at risk.

Paul Philip, the deputy chief executive of the GMC, said: "If a doctor applies to go on the register here and they have previously been struck off in France, Germany or Poland we would not necessarily be able to find that out.

"We can try to get as much information as we can – and we do – but there is no legal obligation for regulators to pass on information to us. We think that creates an unacceptable level of risk."

Professor Sir Donald Irvine, former president of the GMC, criticised the Government for failing to block the original EU laws which had created dangers to the public, or to adapt British regulation systems to assess every doctor more rigorously.

While he was GMC president he argued that any medic who wanted to work in this country should undergo a national examination first, using a system which has been used for more than 60,000 doctors who have come to the UK from foreign countries beyond EU borders.

Sir Donald said he feared the risks to patients were being increased by an influx of doctors trained in Eastern Europe.

"I am particularly worried about some of the more recent entrants to the EU – there is huge variation in the quality of training in Europe," he said.

The latest figures from the GMC show that one in 10 doctors registered to work in Britain was trained elsewhere in Europe.

Last year, 30 EU doctors were struck off in the UK, suspended, given a warning or had conditions imposed on their practice, compared with 15 in 2005.

Ray Montague, from the NHS Alliance, which represents GPs, said the current system assumed that medical training in every country was similar, when it is not.

He gave the example of medical training in Italy, which involves little practical experience until after a doctor qualifies, and highlighted the case of Ubani.

Dr Montague said: "Medical education takes years, and it is not something that any employer can assess in an interview. In the Ubani case there was a fundamental hole in the doctor's knowledge, which had fatal consequences.

"But if a doctor is on the medical register, turns up for an interview, sounds charming and talks convincingly about a few medical subjects, specific gaps like this would be unlikely to be picked up".

One in three primary care trusts is flying in foreign GPs because of a shortage of doctors in Britain willing to work in the evenings and weekends.

As "temps" they earn up to £100 an hour, with one Merseyside trust spending £267,000 on nine Polish doctors and two Germans last year.

Since the Ubani case became public, GP leaders have called for a radical overhaul of the system of out-of-hours care.

Dr Steve Field, head of the Royal College of GPs, said doctors should not be allowed to "waltz in and out of this country" without any safeguards for the public.

Other cases to cause concern include a French surgeon who was suspended for 18 months after botching nine of 15 orthopaedic operations he performed.

Roland Istria returned to Paris after the cases at the Nuffield Private Hospital in Cambridge in 2005.

Dozens of elderly patients were left requiring operations to correct botched surgery carried out by Scandinavian doctors flown in to work as locums in Somerset, as part of an NHS initiative which promised to cut waiting times between 2004 and 2006.

A spokesman for the Department of Health said the UK was required to recognise professional qualifications of European Economic Area nationals.

He said NHS organisations had a responsibility to ensure any individual recruited was fit for their role.