Following the death of a patient treated by German locum Dr Daniel Ubani, MPs called on senior health officials to explain measures being taken to prevent another tragedy.

NHS Worcestershire chief executive Paul Baker said the trust had a 'powerful body of GPs' performing spot-checks on out-of-hours providers.

RCGP chairman Professor Steve Field said the college was developing a three-month induction for EU doctors hoping to work in the UK.

Meanwhile, GMC chief executive Niall Dickson said the regulator wanted changes to the Medical Act 1983 to give it the legal right to check the language skills of EU doctors wishing to work in the UK.

GMC deputy chief executive Paul Philip said a DoH working group was considering legislation that could make indemnity insurance obligatory for GPs working for non-NHS providers, such as out-of-hours firms, amid fears many overseas doctors are not insured.

But Dr Fay Wilson, chair of the BADGER out-of-hours co-operative, and Mike Farrar, chief executive of NHS North West, said PCTs had failed to assess the quality of out-of-hours providers. 'Because of the way the internal market works, we have taken reliability for granted and looked for cheap and quick services,' said Dr Wilson.

Mr Farrar added that 'PCTs still have some way to go' to ensure quality through out-of-hours providers' contracts.

Health minister Mike O'Brien said NHS Cornwall 'breached the law' by failing to assess doctors' language skills. He called for legislative changes and a new model contract for out-of-hours providers.

Antek Lejk, director of commissioning and primary care at NHS Cornwall, admitted the PCT did not attempt to assess Dr Ubani's language skills. 'We had no reason to think he wasn't competent,' said Mr Lejk.

'You had no reason to think he was, either,' said Dr Howard Stoate, GP and Labour MP for Dartford, Kent.