Doctors’ performance is being scrutinised as never before, and too many of those trained abroad are either being found wanting, or treated unfairly. The General Medical Council does not know which, but patients and the doctors themselves deserve an urgent answer.

The number of official complaints to the GMC has quintupled in the past ten years, to nearly 100 a week. If this trend is alarming, the disproportionate number of foreign-trained doctors drawn into the disciplinary process is even more so: they are more likely than UK medical graduates to face an initial complaint from members of the public, fellow doctors or other “persons acting in a public capacity”; they are twice as likely to face a hearing as a result of a complaint; and they are at overwhelmingly greater risk of being struck off after the hearing. Two thirds of the 54 barred from practising last year were foreign-trained – three times as many as in 2005.

Were these doctors poorly trained, insensitive to patients, victims of “institutionalised NHS racism” (as the British Medical Association has suggested), or all three? Thankfully, the numbers are sufficiently few to lend themselves to a proper case-by-case analysis, which the GMC has undertaken. This study is important and must not be biased by political correctness towards the accused, or professional cosiness towards the accusers. But everyone involved should be clear as to the broader context: the NHS has relied heavily at times on doctors recruited from abroad because of its own glacial slowness in responding to demand for them at home. Like a clumsily steered supertanker, it has now overcompensated. The same doctors are likely to suffer as a result.

The expansion of British medical training to meet demand did not begin in earnest until the late 1990s. Only now are larger graduate numbers emerging from medical schools, but in the meantime EU enlargement has entitled doctors from ten more countries to register to work here. The NHS has also indulged in profligate hiring from Switzerland to Syria to plug gaps in a system starved for decades of frontline hospital personnel, but is now too timid to require GPs to work at nights or weekends if they do not wish to. The results are dismaying. They include absurd expenditure on locums flown in from Europe by booming doctors’ agencies to provide out-of-hours cover, and an equally lamentable glut of junior doctors, trained at a cost to taxpayers of £250,000 per head, competing for jobs with rivals trained abroad but under no obligation to reveal exactly where.

Within this category are some 16,000 doctors recruited from South Asia facing the nonrenewal of both contracts and visas now that demand for their services is no longer acute. The risk to them from the complaints on which we report today is that they may be used to support claims that foreign medical training, deemed acceptable when needed, is now somehow inadequate. The truth is that foreign-trained doctors have performed a vital service for the NHS, often forgoing career prospects to work here. But now that domestic medical training is at an appropriate level, there is a legitimate distinction to be drawn between UK and nonUK graduates. The former should have first call on jobs here. Whether that means fewer complaints to the GMC depends ultimately on the quality of British training.