GP Morale

It used to be said that every doctor could expect to find himself before a disciplinary enquiry once in his career. After all, doctors are human and humans err.

This government, and particularly the late Secretary of State, Mr Alan Milburn have seemed to specialise in founding expensive new QUANGOS each of which may have the effect of calling GPs to account. Many of them duplicate their own effort.   Doctors are well under the political control of the NHS.

GPs now look over their shoulders and practice more and more defensive medicine, patient care suffers and morale falls even further. Each of these individual groups may serve a useful purpose but the question is, are so many duplicate QUANGOS really needed? 

Not only do doctors practice defensively but so does their regulatory body, the General Medical Council.   Fear of being thought to be too weak has resulted in the politically correct GMC holding an enormously increased number of "Fitness to Practice" disciplinary committees at more than one venue at a time.   There are now so many of these hearings that the GMC is having to advertise for more and more doctors and lay people to sit on them in judgement of the accused physicians.

Doctors found guilty of serious misconduct are nowadays struck off the register and unable to practise for a minimum of 3 years by which time their medical skills have deteriorated to the extent that it would be difficult to go back into medicine.   The doctor's career is effectively permanently snatched from him for one offence.

This, in turn, is causing more and more doctors to legally question the decisions of the Fitness to Practice Committees and several decisions have been overturned.

The definition of "serious professional misconduct" and the level needed to cross that threshhold is being lowered rapidly to the extent that political transgressions mooted by the NHS Authorities are often sufficient.

There is a national shortage of doctors, particularly GPs, in this country to the extent that the NHS is trawling the world seeking doctors to prop up the service.  At the same time this Labour government is conducting a witch hunt against doctors already practicing here.

This witch hunt is being transmitted downwards from government to NHS authorities, PCOs, Trusts and through them to the media which seems to have a schizoid love-hate relationship with the medical profession.   Patients, too, are incited to complain and to go for compensation by greedy lawyers at the merest suspicion of a medical mistake.

To add to this, the vindictive Shipman Report (which, incidentally grossly exceeded its brief in its zeal to have the profession controlled) has proposed a multitude of measures including putting the clock back 30 years by demanding that PCOs have the power to fine "errant" doctors.  See the link below.

Is there any wonder that general practice morale is low?    

In the end, patients, government and the rest will get what they deserve, fewer and fewer doctors practising more and more defensively and expensively with lower and lower morale.    

GPs who have left the profession will be replaced by a lower standard of half-educated practitioner or by pharmacists diagnosing and prescribing and nurses whose capability is not to intelligently think about diagnoses but merely to push protocol buttons on a PC at NHS Direct. But never mind, the destructive Blair will have got what he wants, control of yet another aspect of British life.

BODIES WITH POWERS TO INVESTIGATE GPs

1.         Chief Medical Officer
2.         Clinical Governance procedures
3.         Health Authorities 
4.         National Patient Safety Agency
5.         National Clinical Assessment Authority
6.         National Institute of Clinical Excellence
7.         NHS Ombudsman
8.         NHS Performance Framework
9.         Office of National Statistics
10.       Parliamentary Select Committees
11.       Members of Parliament
12.       Performance Review Groups
13.       PCO Boards
14.       PCO quality and outcomes investigatory teams
15.       Commission for Patient and Public invelvement in Healthcare
16.       The Commission for Health Improvement and Outcomes.
18.       The General Medical Council

to which all the above can report the GP for a "Fitness to Practice" hearing.

There are additional complainants groups against GPs......

19.       Colleagues who "whistle-blow"
20.       Coroners 
21.       Local Authorities 
23.       Police
24..      Press & media
25.       Revalidation procedures
27.       Community Health Council replacements  
28.       Insurance companies (For not notifying refusal to complete reports one GP was found guilty of serious professional misconduct in September 2004)

29.        The Commission for the Regulation of HeAlth Professionals aka "Council for Healthcare Regulatory Excellence" 

       ....which was instituted to oversee GMC decisions and has already shown its teeth by overturning a number of GMC "not guilty" verdicts whilst at the same time removing any trace of professional self-regulation

and, of course

30.     The Department of Health

                                 .

This list is not complete.

Colleagues who can add to it are earnestly requested to contact the author, David Roberts via the address on the Headline Front Page of this site or through Davidroberts@doctors.org.uk.

(9/7/04)

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(13/12/04)