Out-of-hours medical services are still "not good enough", the health minister has said in the wake of the unlawful killing of a patient.

Mike O’Brien made the comment in the Commons following David Gray’s death in Cambridgeshire in February 2008.

Mr Gray, 70, died after German locum Dr Daniel Ubani gave him 10 times the recommended dose of diamorphine.

However the Conservatives warned that there are "significant failings" in the provision of services across England.

Mr O’Brien said he was "deeply sorry" for Mr Gray’s family’s loss and lessons must be learned.

Service ‘better’

Dr Ubani was working for private firm Take Care Now, which provided out-of-hours services in Cambridgeshire.

During the inquest into Mr Gray’s death, it emerged Leeds PCT had rejected a work application from Dr Ubani because he failed a language test.

Coroner William Morris said the doctor had been "incompetent" and called for a shake-up of the out-of-hours care system to ensure patient safety.

Speaking in the Commons earlier, Mr O’Brien said that while out-of-hours services were still not adequate enough, overall quality for most people was "better than it was in 2004".

Last week Mr O’Brien accepted 24 recommendations made in the report by David Colin-Thome, the government’s primary care tsar, and Steve Field, the chairman of the Royal College of GPs, which was commissioned in the wake of Mr Gray’s death.

Mr O’Brien accepted the report revealed there was "unacceptable variation" in the quality of out-of-hours medical services across England.

The recommendations included that PCTs should review the performance management arrangements currently in place to ensure services were "robust and fit for purpose".

Service ‘shambolic’

Mr O’Brien also announced plans for additional improvements.

"We will review the existing national quality requirements and introduce and mandate national minimum standards that all out-of-hours providers will be required to meet," Mr O’Brien said.

Shadow health minister Mark Simmonds earlier said the government’s decision to put out-of-hours services in private hands had been a "a significant and serious mistake" and the current service was "at best patchy".

"[It] has been described by the [Commons] public accounts committee as shambolic," he told the Commons.

While welcoming Mr Colin-Thome’s report, Liberal Democrat health spokesman Norman Lamb said the government had taken too long to respond to the recommendations.

He said that as far back as 2007 there were warnings of doctors working with "inadequate" language skills.

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