In some cases, hospitals have employed doctors attracted by the high pay who have been incompetent, negligent or violent. When background checks were made they were found to have lied about their age, qualifications and experience.
About 3,500 locum doctors are working in the NHS on any one day, at a cost of pounds 214m in 1996-97. They are widely believed to be of lower quality than permanent staff but despite this they are subject to few checks and get little support.
The report, by the Audit Commission, comes after a series of scandals involving locums. Last week, Helmi Nour, a locum obstetrician at Queen Charlotte's Hospital in west London, was struck off after he crushed a baby's head while trying to deliver it by forceps.
A consultant obstetrician, Richard Neale, who was sacked by Friarage Hospital in Northallerton, North Yorkshire, because of concerns about his judgement, obtained locum posts in Leicester and the Isle of Wight where he is alleged to have caused injury to several women. The General Medical Council is investigating.
Tougher rules for vetting locums were introduced in 1997, but the Audit Commission, which conducted a survey of 13 trusts, found most were ignoring them. Almost a third of hospitals do not bother with references and less than one in ten checks original documents.
Some locums are made to work more than 100 hours a week, putting patients at risk from overtired doctors.
The cost of hiring locums through agencies has soared more than 50 per cent in two years. NHS trusts could save an average of pounds 30,000 each and improve quality by relying less on locums and more on organised staff rotas, the report says.Reuse content