Overseas doctors with an inadequate knowledge of English must not be allowed to practice medicine in the UK, the leader of the British Medical Association said today.

Hamish Meldrum, chairman of the BMA Council, said at the association's annual representative meeting in Brighton that tougher checks and language tests are needed to prevent another tragedy such as the death of pensioner David Gray, who was given a lethal injection of a painkiller by Daniel Obani, a German locum doctor, during his first shift in the UK.

"It cannot be acceptable for poorly trained, badly regulated doctors whose knowledge of English is about as good as my knowledge of Chinese, to be able to practise, virtually unchallenged, in the UK," said Dr Meldrum.

But he rejected suggestions that the GPs' 2004 contract, which allowed them to opt out of out-of-hours care, was responsible for what happened. "That is rubbish. It has been caused by under-funding and mismanagement of out-of-hours services by too many primary care organisations and by poor enforcement of, admittedly, inadequate regulations," he said.

"My sympathy goes out to the family of David Gray, but sympathy is not enough. We must ensure that the doctors who treat our patients are competent to do so, that they have the necessary language skills, and that they are subject to the same regulation as UK doctors. The BMA will continue its work with the government, the GMC (General Medical Council) and others to make this happen."

Discussions are currently taking place between the government and the council about EU rules which prevent the GMC from testing the language abilities and skills of foreign doctors who want to work in the UK. Niall Dickson, its chief executive, has warned that the rules do not provide patients with the protection they deserve.

In his keynote speech, Dr Meldrum also hit out at NHS privatisation, saying that "we can't go on promoting a failed market philosophy, with its burgeoning bureaucracy, competitive fragmentation and increasingly perverse incentives."

He called for honesty with the public, saying it was wrong to pretend there was enough money to do everything. There were areas where money could be saved, he said, listing what he called ill-conceived plans and dogma-driven policies that the BMA would continue to oppose:

"Incoherent and divisive market-based policies that pit trusts against each other, secondary against primary care, increase costs and, in many cases, duplicate existing services.

"Lucrative contracts for ISTCs – independent sector treatment centres – that are paid for up-front yet don't deliver on activity, often because there was no need for them in the first place.

"And new, so-called GP-led health centres, which often enjoy multiple times the funding per patient of regular GP practices, despite in many cases, very few patients registering with them."

He warned the government that the BMA would defend any attempt to cut doctors' jobs or pensions. "I've said that we should be reasonable and responsible when it comes to pay, but don't underestimate us when it comes to protecting doctors' jobs and pensions. On these, I will not be reasonable, if being reasonable means accepting cuts in the number of doctors or reneging on the recently agreed, revised pension arrangements for NHS staff," he said.

"At a time of recession, of increasing unemployment, of greater hardship and greater stress, the public needs more doctors, not fewer."