Explaining action to be taken to improve out-of-hours care during a parliamentary debate last week, he added: 'That will be monitored by the SHA. Thereafter, PCTs need to take a higher level of responsibility for it.'

The RCGP and GMC push for a change to EU law, to ensure proper skills and language tests for doctors who wish to practise in the UK, will not be addressed directly by the government.

Mr O'Brien said: 'There are three checks on doctors from the European Economic Area. First, the GMC checks their medical qualifications. Secondly, since 2004 the PCT is responsible for checking that they speak English and that nothing is known about them that undermines their medical capability.

'Thirdly, the employers are responsible for ensuring that the GPs whom they employ not only speak English, but are clinically competent. In some cases it is clear that some of the PCTs have been a weak link. Some have not always complied with their responsibilities.'

Mr O'Brien added that the EU law restricting the checks the GMC can carry out will be reviewed in 2012: 'So the directive will be reviewed in any event. We must ensure that we examine the detail of that.'

But after the death of a patient treated by German locum Dr Daniel Ubani he pledged to implement safety checks as a matter of urgency to 'ensure that this year the lessons of that tragic death are learned'.