Audit Commission Briefing published in April 1999: Cover Story - The Use of Locum Doctors in NHS Trusts (click here to read).
It made a series of recommendations making life for locum doctors very difficult based on Department of Health wish not to pay locum agencies their commission fees. £110 million was spent on agency locum doctors (1996/1997). Audit Commission recommended that those in permanent jobs should provide the cover for absent colleagues, because, of course, doctors in permanent jobs are quite simply super-human. If the only way to provide the cover was to cancel own clinics NHS managers accepted that. Patients can always wait even if they die in the process.
Audit Commission recommended NHS trust to scrutinize locum staff the way they do not their permanent staff and where they thought they could get away with it. Senior doctors-consultants were told that they would be given support by the named NHS Trust consultant when the true purpose of the exercise was spying and supervison of senior colleagues who did not need it. Notes of such "support meetings" with locum doctors were destroyed by consultants who provided "support".
Frenzy of complaints to GMC against locum doctors followed, helped by GMC's own discriminatory policies against locum doctors. GMC decided that complaints that would not have impact on doctors registration (called Stream 2 complaints) in the case of locum doctors would be taken up by GMC Fitness to Practice as Stream 1 (serious complaints that GMC must investigate and that could have impact on doctors registration).
Locum doctors were essentially, described as dangerous and in need of supervision by Audit Commission in 1999 for political motive against private enterprise (locum agencies).
Audit Commission stated that 35% of those who responded to their survey about locum doctors (and we do not know total number of the responders), directors of personnel, reported adverse events are associated with locums.
Medical Protection Society (MPS) carried their study and found that 49% of doctors who answered their survey had complaints made against them (over 700 doctors responded).
MPS sample would be doctors in permanent posts. Click here to read.
Most locum doctors are ethnic minority doctors and racial/ethnic discrimination is rife in NHS. 35% is less than 49% . I conclude locum doctors could be a threat to incompetent or insecure doctors/staff in permanent jobs but because their performance is actually better overall based on 32% being less than 49%.
Audit Commission in their report failed to recognize that doctors can have problems when they are excellent. Prejudice is blindness.
Willful blindness is the title of the book written by Margaret Heffernan. She could be endlessly inspired if she lived in UK Click here to find more about it.
Canadian and USA studies did not find that their foreign doctors are worse. In fact, the opposite.