Even after Shipman, patients can trust their doctors, says the BMA

Patients can and do still trust their doctors says the British Medical Association on the day the fifth report of the Shipman Inquiry is published ( 09/12/04 ). Cumulative changes to the way doctors work, introduced since
the conviction of Harold Shipman, justify the retention of professionally-led regulation, says the BMA.

Mr James Johnson, chairman of the BMA, said: "Even in the immediate aftermath of Shipman's trial, when everyone in the country was aware of the horrors he inflicted, a MORI poll showed people trusted their doctors more than any other profession. No one is complacent, we recognise that the medical profession has to demonstrate that it deserves that trust.

"The climate in the profession has changed since Shipman. The General Medical Council (GMC) has re-formed and tightened up the way it handles complaints against doctors. GPs are even more careful with recording their use of controlled drugs and when signing death and cremation certificates, and health professionals are aware they must question what colleagues do
and the way they do it."

On the Shipman Inquiry proposals to make further changes to the GMC, James Johnson said: "The newest changes to the procedures are only a month old. They should be given time to demonstrate they work effectively and fairly to protect patients before further fundamental changes are considered. The BMA will wish to consider Dame Janet's proposals very carefully."

Dr Hamish Meldrum, who represents the UK 's family doctors as chairman of the BMA's General Practitioners Committee, said: "This is a huge report with a great many recommendations with implications for GPs and primary care trusts. We will work with the government to discuss these proposals but in doing so must be conscious of the need for a proportionate response. We must not impose further excessive layers of bureaucracy on theprofession at the expense of the face to face time in consultations that
our patients value."


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countrydoctor comments:

Dame Janet Smith seems adept at calling a spade a spade.  So is countrydoctor.

The first comment must be that, in a quest for self-justification, the enquiry team has grossly exceeded its brief.  Odd, when one considers how the political WMD and Iraq war enquiry appointees grossly restricted their briefs to permit the most restrictive and centralist Prime Minister this country has ever had to escape due process.

Dame Janet Smith was asked to enquire into the misdeeds of a unique, multiple murderer who happened to be a GP.  What she has proceeded to do is to tar all GPs with the same brush and recommend that all GPs should be treated as potential murderers and have their entire professional lives restricted and governed to an absurd degree.

This Report bears all the hallmarks of a government which has long wished to break and control the medical profession.   Dame Janet has served the doctors up on a plate and the BMA is powerless to do anything about it.

Her Report is woolly minded and lacks any insight into the effect it will have on GP morale and the recruitment of GPs in the present and future.  And, of course, on the patients of this land who cannot manage without GPs.

It is ignorant in that, in calling for even more (and more) controls and complaints against GPs, it seemingly has no knowledge of the more than 30 groups who now may ensure that doctors will be enquired upon and disciplined.

It is incompetent in that it does not take into account recent changes to the structure and perormance of the GMC.

Let us now see what Dame Janet has, in her enthusiasm, proposed for general practice.  For the details we are grateful for the report in PULSE, December 13, 2004.  They proposals are listed in no particular order.

Tougher inspection powers for PCOs
Tough GP-management powers for PCOs
PCOs to have powers to fine GPs for "poorly performing" (by whose standards, politicians?)
PCOs to have powers to fine GPs for "misconduct" even where not serious enough to refer for discipline
A "whistle blower's hotline" for patients and staff of GPs to enable them to complain easily
A national GP database of complaints about GPs to be accessed by patients
Written practice policies on staff suspicions
Appraisal not to be used for revalidation
Revalidation to be tougher - to include clinical governance, PDPs, video consultations etc etc.
Stripping GMC of its disciplinary role
A data baseof GPs health to be set up
GMC to publish a website of all GP disciplinary cases and revalidation
Patients to be sent a PCO-approved letter giving the option of not being treated by disciplined GPs
GP mortality rates to be nationally monitored
It will be made easier for patients and others to complain against GPs
A complaints line to be set up by all practices
GPs must inform PCOs of all complaints against them within a "short time"

These are but a sample of the 100 or so recommendations made by Dame Janet.   It is here that readers should make a note to visit the page on over-controlled GPs (CLICK).   

countrydoctor must repeat that the Enquiry was set up to look into the misdeeds of one murderer who happened to be a doctor.   What she has done, for whatever personal or other reason, is to attempt to castrate the entire profession.

We leave it to the imagination of the reader whether he believes that the list of controls above will improve the morale and job-satisfaction of the British GP or whether it will do more to improve the rate of retirements than of recruitment.

If Dame Janet has any evidence of the overall and majority incompetence of British general practitioners then she should produce that evidence.  Curiously she fails to do so in any of the thousands of pages of the Reports.

In the absence such evidence, her Report is incompetent and damaging and serves no purpose other than to potentially make the serious situation of medical manpower even more serious.

General practice is over-controlled as it is.   countrydoctor believes that this report is detached from the reality of the real world and should be largely ignored.  However, in today's PC world that is not likely to happen.   

GPs would be well advised to batten down the hatches and prepare for either emigration, retirement or a change of profession.   A country which produces such a vindictive Report does not deserve you.

David Roberts - Editor countrydoctor

Also turn to NHS kills GP

(13/12/04)