Hospital bosses have spent thousands of pounds on trips to recruit foreign doctors and nurses, while laying off their own staff.
Visits to destinations including India and Dubai took place as the NHS drew up plans to cut 20,000 jobs for front line health workers.
An investigation by The Sunday Telegraph has found that at least 11 NHS trusts and one health authority sent teams abroad to recruit doctors and nurses, despite such posts being earmarked for cuts.
The trips were organised despite pledges by David Cameron to cap immigration and protect British jobs, and concerns raised last week by Lord Winston, one of Britain's most senior doctors, that some nurses from Eastern Europe put patients in danger because of poor standards of English. The head of the Royal College of Nursing also condemned the visits as "incomprehensible and unacceptable".
Dartford and Gravesham Trust in Kent sent a team to Romania in November and hired 20 nurses, even though Barts and the London NHS Trust, less than 20 miles away, was drawing up plans to cut 635 posts including more than 250 jobs for nurses.
Barking, Havering and Redbridge University Hospitals Trust sent seven managers to Dublin in October, returning with seven nurses. Less than two months later, it disclosed plans for 100 redundancies.
More than 10,000 doctors and nurses who trained overseas registered to work in Britain in the first 12 months of the Coalition. There was a 53 per cent rise in foreign nurses who registered with British regulators, from 2,804 to 4,303, while the number of foreign doctors increased by eight per cent from 5,359 to 5,811.
The number of nurses from outside the European Union, where an immigration cap applies, went from 635 to 1,307.
Dr Peter Carter, the Royal College's general secretary said it was "absolutely crazy" that hospital trusts had gone abroad to recruit.
"It is incomprehensible and unacceptable to have these sorts of recruitment trawls abroad when so many staff are being laid off, and so many newly qualified nurses can't find work," he said.
Dr Carter accused hospitals of failing to work together and said the Government had encouraged "fragmented" policies instead of joint planning to fill vacancies with those who had been laid off or newly-qualified nurses.
A central body, NHS Employers, negotiates general terms and conditions but recruitment is left to trusts. Hiring staff abroad usually means paying commission to agencies, which charge up to £11,000 to fill each post.
The RCN has identified more than 40,000 posts which have been axed or earmarked for cuts within three years, under NHS plans to save £20 billion. More than half are estimated to be clinical posts, filled by doctors, nurses and health care assistants.
Wendy Cupid, a senior nurse from Hayes, west London, was made redundant in July when her trust, NHS Hounslow, was restructured. Despite more than 16 years' experience, she could not get a job and was left feeling "like a failure". Responses to freedom of information requests show that 12 trusts sent more than 50 staff abroad to recruit in the year after the election, bringing back 182 nurses and midwives and 24 doctors.
Each said it had failed to recruit at home. Some said filling vacancies abroad was cheaper than using locums and agency staff. Rotherham NHS Foundation Trust spent more than £7,500 sending a team of eight to Madras, India, to recruit 11 doctors in June last year. Months later it announced plans to cut 62 medical and surgical staff.
Northampton General Hospital Trust went to Italy and Portugal in December to hire 28 nurses and midwives. In May it announced plans to cut 310 posts over two years. Last week Lord Winston, professor of fertility studies at Imperial College London, told the House of Lords of his concerns about eastern European nurses. He said he was particularly worried about those from Romania and Bulgaria who had limited communication skills "even in their own language" and were not used to talking to patients or doctors.
Katherine Murphy, chief executive of the Patients Association, said: "We hear from patients that there are real issues with nurses from other countries including problems communicating with patients and a lack of understanding of processes and procedures."
Not every attempt to recruit was successful. Sylvia Gomes, neonatal matron at West Hertfordshire Trust, was given £500 towards a flight to Mumbai in January to visit her family, combined with an "opportunistic" attempt to recruit nurses. None was hired, as the Home Office would not provide work permits.
Simon Burns, the health minister, said: "NHS employers are only allowed to employ foreign doctors and nurses if there are no suitable staff available in the UK or European Economic Area."