Shadow Liberal Democrat health secretary Norman Lamb has made suggestions to improve out-of-hours care during the inquest involving German locum Dr Daniel Ubani which is expected to conclude on Thursday.

Mr Lamb was responding to comments from primary care minister Mike O'Brien in a parliamentary debate that there was an unacceptable variation in PCT-provided out-of-hours services.

Mr Lamb said: ‘The minister is right to admit that the system of out-of-hours care is a shambles. The scandal is that this Labour government has presided over this mess yet it's failed to make sure out-of-hours care in this country is up to standard.

‘We have inadequate safeguards to stop dangerous doctors from overseas from practising here and threadbare cover in many parts of the country.

‘I have put forward proposals to ensure every doctor working in this country can speak English, is familiar with our health service and is well trained.'

Mr O'Brien is expected to publish the recommendations of the out-of-hours review carried out by RCGP chairman Professor Steve Field and England's primary care czar Dr David Colin-Thome on Friday.

Editor's blog: Revealed: the contents of the out-of-hours review (my predictions, at least)