Doctor to face GMC over death of boy, 10

An overseas-trained doctor who had 42 jobs in the NHS in 23 years is to appear before the General Medical Council today charged with serious professional misconduct following the death of a 10-year-old boy to whom he had given a dental anaesthetic.

An overseas-trained doctor who had 42 jobs in the NHS in 23 years is to appear before the General Medical Council today charged with serious professional misconduct following the death of a 10-year-old boy to whom he had given a dental anaesthetic.

The case of Dr John Evans-Appiah, which is scheduled to run for a month, will highlight Britain's reliance on overseas doctors, mainly from the developing world, who are concentrated in the lowest paid, least glamorous jobs in the least popular parts of the country. A fatal accident inquiry into the death, held in Edinburgh last year, spoke of a "tribe of wandering locums" plugging holes in the NHS.

The timing of the case is embarrassing for ministers who announced a global recruitment drive in July to hire more doctors and nurses to meet the target of an extra 9,500 doctors and 20,000 nurses over the next five years under the NHS plan.

There are 27,000 overseas qualified doctors in the UK, one in four of the workforce. They are the workhorses of the NHS, without whom it would collapse, but they are often left unsupported and unsupervised with their career prospects ignored.

Dr Evans-Appiah, 57, who was born in Ghana, arrived in Britain in 1973 after having trained in Ukraine. He spent more than two decades working round the country as a locum until he obtained full registration as an anaesthetist in 1997. Less than a year later Darren Denholm, aged 10, died at a dental surgery in Edinburgh after Dr Evans-Appiah had administered a dental anaesthetic.

The fatal accident inquiry in Edinburgh heard that his work was "dangerous, bizarre and inept", and although he was practising lawfully, he had failed parts of the exams he took to qualify as an anaesthetist.In April he was banned from practising, pending today's hearing.

Dr Evans-Appiah was granted temporary registration by the General Medical Council in 1973 which allowed him to work in the NHS for an unlimited period. The regulations were changed in 1979 but doctors already in the country were exempt.

A key issue is whether doctors working in the least attractive jobs in the NHS are being provided with adequate support. Many overseas doctors are forced to flit from post to post. A spokeswoman for the GMC said: "The case does raise questions of how a doctor could move round the country as much as that without obvious supervision."

A second issue is how Dr Evans-Appiah obtained full registration. A spokesman for the Department of Health said talks were under way with doctors' leaders about a new system for ensuring that doctors from overseas had the same academic standards and practised in a similar way to those in the UK. A system of annual appraisals for all doctors proposed by the chief medical officer was also under discussion.