One in ten primary care trusts is flying in GPs from abroad to cover out-of-hours shifts because of a shortage of willing local doctors, an investigation by The Times has found.

Although there are often qualified GPs within the local area, trusts have spent more than £1 million in the past two years on GPs from all over Europe, including Germany, Poland and Lithuania.

Some of the foreign doctors were paid the same as local locum GPs while others were very well rewarded and received thousands of pounds for just a few days’ work. Last year alone 119 overseas GPs covered out-of-hours shifts in England and Wales.

Doctors, patient groups and MPs say that the reliance on GPs from other countries is a direct result of the revised GP contract produced in April 2004. This allowed family doctors to opt out of providing a 24-hour service in return for a salary sacrifice of £6,000 each – half what the service costs to provide. Most GPs seized this chance, leaving trusts responsible for care at evenings and weekends.

Michael Taylor, who chairs the Family Doctor Association, said: “Very few GPs want to do the antisocial shifts. I think overseas doctors are perfectly capable of handling emergency cover but for routine care cover they are not capable. When it comes to complex issues, such as mental health problems, family issues, addictions, it is more difficult for the patient to trust the overseas locum.”

The Times submitted freedom-of-Information requests to the 152 PCTs in England and Wales. In total, 17 PCTs, including North Lancashire, Dorset, Portsmouth City Teaching and Somerset, all said that they had employed overseas agency GPs at some point in the past two years. The amount spent in 2006-07 was £879,149, a rise of 244 per cent on the previous year’s total of £255,530.

Of all the PCTs, Halton & St Helens spent the most. According to the trust, the cost of providing eight Polish GPs for a 12-month period was £366,042.50. A spokeswoman said: “The decision to purchase the services provided by Devon Doctors [which provides the Polish GPs] was on the basis of a full and robust evaluation of their bid and their ability to provide a quality, safe and affordable service to Halton residents.”

About nine million patients require out-of-hours care in England each year, but the Department of Health claims that more than six million patients are currently unhappy with their surgery opening hours.

Roger Goss, co-director of Patient Concern, a watchdog, said: “These figures from The Timesprove that GPs couldn’t believe how lucky they were with the [2004] contract. They also show that continuity of care, which should be at the core of a GP service, has gone for good.”

While some PCTs were helpful, many were reluctant to disclose information. Initially, The Times contacted the ten strategic health authorities in England and Wales, which directed the paper to the 152 PCTs. Of these organisations, many provided only the contact details of the agencies employed by them to hire overseas out-of-hours GPs. So The Times called 40 agencies. A large proportion, including Primecare, did not return calls.

Last month it emerged that Piotr Robinski, a 40-year-old GP from Poznan, makes a 13-hour trip from Poland every other Friday to Aberdeen to provide cover for GPs. Dr Robinski can earn up to £200 an hour in Britain on Bank Holidays, though the normal rate is nearer £80.

A spokeswoman for the Department of Health said: “PCTs have a legal obligation to provide safe, high-quality out-of-hours care. They are free to recruit GPs subject to those conditions. The big increase in the number of UK-trained GPs should mean less need for recruiting overseas.”

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club