After working as a GP in south London for a few years, with the constant stresses and strains that come with life in a big city, I decided to move to the provinces. I chose the west country, where I'd long dreamed of living.

Finding the right practice to join is always difficult, so since I had no knowledge of GPs in the area, I decided to work as a locum at first. I thought I'd get to know the different partnerships before applying for a permanent position.

Locuming is the equivalent of working freelance. You fill in for other doctors who are away, say, or off sick or on study leave. It is usually on a very short-term basis, commonly just a morning or afternoon, and you can be booked in at the last minute.

I began by sending out my curriculum vitae with the names of two referees to all the practices in the district. Five came back with offers of work. Before taking up any of them, I asked my referees how many had been in contact. To my surprise, they reported that nobody had asked for a reference.

On the day of my first locum job - by chance, the day that Harold Shipman was found guilty - I was due to be the only working doctor in a nearby practice. I loaded my bag with medical items, but also copies of my certificates from the General Medical Council, the joint committee on postgraduate training for general practice, and for medical indemnity.

Never having worked as a locum before, I imagined that I would have to produce them before seeing patients. I also thought that the practices would contact the relevant bodies to confirm the certificates were genuine. As an extra precaution, I took along my passport, expecting to show it as positive proof of identity.

But when I got there, no checks were made. It's fair to say I was extremely concerned. I wasn't asked to show any documentation at all, even when I informed them that I had brought it all with me. In that practice I did meet the partners, who asked a little about me - who I was, where I was living and why I had left London - but then, with no further formalities, I was given a room, shown how to use the computer and presented with my first patient.

Within 10 minutes of starting my surgery, an urgent house call was requested. As with all calls for home visits, I prioritised it - was it urgent, or could it wait a little while? As the request was to visit a woman with diarrhoea and vomiting, I decided to delay the visit until after my surgery was finished. The woman's husband agreed, but few minutes later was back on the phone saying his wife was getting worse. I had no choice but to leave the patients in the waiting room and visit the woman immediately.

By the time I got there, however, the woman had died. I tried to resuscitate her, but it was too late.

The day had hardly begun, and of the two patients I'd seen, one was already dead. As the dead woman had not been seen by a doctor from the surgery for three months, her death was referred to the coroner and a post-mortem was arranged.

To my relief this meant I was not asked to issue the death certificate for a patient I had never previously met. (I assume the post-mortem has shown a natural cause of death.) I spent the rest of the day concerned that the practice would wonder whether I had done something I should not have done, and was relieved when the day ended with everything else running smoothly.

In the last two weeks, I've gone on to work in a further five practices, and only two have asked to see my certificates.

Another cause for concern is that each of the practices has given me a prescription pad in case I cannot use the computer to print one out. Last year the government introduced new prescriptions to try and counter fraudulent use. These pads are supposed to be signed out for use by the relevant doctor, to ensure each one is accounted for. But not once have I been asked to sign for the pack and only in one practice have I had to make a record of what I have used.

It would be extremely easy to pocket a few empty scripts for use at a later date, which would mean I could easily obtain controlled drugs such as diamorphine - the drug Shipman used to kill his patients.

In one of the practices I have covered, the only member of staff I met was a receptionist. I found it very worrying that the partners were willing to entrust the care of their patients to a complete stranger, without even saying hello. It seems to show a lack of respect to their patients, and to me, as well as a disregard for their livelihood. If I'd made a bad mistake, they'd be dealing with the consequences of it for years to come.

Interested in finding out how common my experience was, I spoke to doctors locuming in other parts of the country. They all reported similar circumstances. Some practices do ask for copies of all certificates before offering work, but a substantial number ignore such precautions.

There appears to be no legal duty on general practices to check certificates, although some health authorities are beginning to tighten up. Oxfordshire for example, has recently written to all GPs strongly advising them to obtain certificates from locums, and ring the General Medical Council for verification.

In the wake of the Shipman case, and numerous cases of impersonation of medical professionals, surely there is a need for a firm set of rules on how to hire a locum? I would suggest a minimum of GMC, JCPTGP, indemnity certificates and passport or birth certificate to be supplied by the locum before they turn up, so that they can be checked with the relevant authorities. The practice should also have copies of suitable references on file.

This may not prevent another Shipman, but would present better cover for the practice and its patients, and a feeling of working in an organised and safe atmosphere for the locum. I have been shocked by the lack of effort made by practices to ensure they are employing a fully qualified GP. I hope this article will stimulate some debate to help bring about change.