Can he persuade the Spanish to stay?

JOSE Garcia-Miralles recalls vividly his first experience in the North-East. "I remember getting off a coach from Birmingham and getting into a taxi in Sunderland. I had been coming to England for years and the last worry I had was the language," he says. "As we pulled away, the bloke started speaking to me and I couldn't understand a word he was saying. It was his accent."

Now, after 13 years of working for the NHS in the North-East, the Pelton GP's accent sounds more English than Spanish.

Strong regional accents are likely to cause problems for the Spanish GPs being recruited by County Durham health officials, but Dr Miralles - he dropped the first part of his surname to make it easier for his County Durham patients to pronounce his name - is hoping to persuade his prospective new colleagues to take it in their stride.

"With accents, it is a bit like music; you just have to listen to it and you will get used to it. I can reassure the doctors who are coming over from Spain that, without noticing it, their ears will adjust," says the doctor, who cemented his relationship with England by marrying an English nurse, Diane. She who works at Sunderland Royal Hospital and the couple have twin ten-year-old boys, Christian and Matthew.

With some of the highest GP vacancy levels in the country, the authorities in the region are desperate to persuade Spanish doctors to exchange sunshine and tapas bars for drizzle and working men's clubs. Just along the Tees Valley, their counterparts on Teesside are looking to Germany to recruit more GPs. And North-East hospitals are also in the market for Spanish nurses and German hospital doctors.

The first group of Spanish nurses recruited by South Tees Hospitals NHS Trust, partly to allow the expansion of James Cook University Hospital's busy heart unit, arrived last week.

And this week a delegation representing hospitals in the region was due to attend a careers fair in Berlin, hoping to persuade German hospital doctors to cross the North Sea to start a new life in the North-East and Yorkshire.

As someone who decided to make his home in England many years ago, Dr Miralles is perfectly placed to help the NHS in their recruitment drive.

He has accompanied health officials on two trips to his home area Aragon, a region close to the Pyrenees and the French border, and the Spanish capital Madrid, and this weekend he will be escorting a group of 14 candidates around the region.

So what persuaded the young Spaniard to turn his back on his native country? Dr Miralles, now 39, was encouraged to speak English when he was a child. "I remember being told it was important to speak good English. My mum and dad wanted me to speak English," he recalls.

Dr Miralles was 12 or 13 when he first came to Britain on holiday, a country he was to visit virtually every summer until he decided to go one better and live here.

"Spain was a very Catholic and conservative country at that time and not as industrially developed as today. Some of the things I saw, which people took for granted, were unbelievable for a Spanish boy," he recalls.

To young Jose, the UK seemed an exciting, free and youth-oriented society. After completing medical school in Spain, the young postgraduate student arranged to complete his training in the UK.

"Spain has now caught up with the UK in many ways. Whether that is a good thing or a bad thing is another matter," he says. "When I was a child, nursing homes were unheard of in Spain because families stuck together. I have been back for holidays and, from what I hear, the same changes that happened here are happening now in Spain and happening very rapidly."

To some extent, the fuss being made about hiring Spanish nurses and doctors - and the trip to Berlin in search of German consultants - surprises the Pelton GP because the British Health Service is already a very cosmopolitan place.

"British hospitals have people working in them from all over the world and there are already GPs from Holland, Germany and Spain working in the North-East."

And while on the face of it, the cultural difference between Spain and England seems quite profound, Dr Miralles is not so sure.

"There are historical links between our two countries and we share many things in common. We have Christmas, we have Easter, things are very much the same," he says. "It is the little things which are important, such as the sense of humour. It is very different in Spain. We tend to be very direct and British humour is sometimes not so straightforward."

Then there's the food... "I must have been here a long time because I actually really like English food now."

Happily, the English sun was shining brightly when the ten nurses from Spain arrived on Teesside. Officials at James Cook hospital were sending silent thanks heavenward and muttering that it couldn't last. It didn't.

"The weather is certainly a difficult obstacle," says Dr Miralles. "It gets dark so quickly here, it is cold and it's rainy and you tend to live inside for half the year - but it is not insurmountable.

"During the first few months when everything is different, when you can't understand the accent, when the food is different and the weather is dodgy, you might wonder why you came. But it is just a matter of getting used to different things. For me, it has been one of the most incredible experiences. I consider myself to be very privileged to be able to feel very settled in both places."

Dr Miralles has no regrets about coming to the UK, or County Durham, where he loves to get out into the dales on his mountain bike.

"I have a lovely family who give me a lot of pleasure, I am very happy about the professional side of what I do and I still love being a GP," he says.

He is hoping some of his enthusiasm for the area will get across to any waverers.

"I am very impressed by the professional quality of the people we have seen and they have a pretty good level of English. This weekend we want to show them what County Durham is like, show them some of our surgeries and a bit of the North-East," he says.

But attracting Spanish doctors is only half of battle. Keeping them here is just as important.

"I will be meeting up with them every week. I can act as a bridge and it is important that we have a good system of social support," he says. He desperately wants to avoid the Spanish doctors forming "a bit of a ghetto". "There is no way we can make it look, taste or sound like Spain. They have got to get used to becoming English," he says.