Trying to prevent yet another scandal

As seen in the Northern Echo, from the UK

Proposals for the biggest shake-up in the medical professional in a generation will see doctors undergoing regular "fit to practise" check-ups.

Campaigners last night welcomed the plans, put forward by the Government's Chief Medical Officer, Professor Sir Liam Donaldson, after a number of medical scandals, including the case of disgraced gynaecologist Richard Neale.

They said the shake-up, which devolves power from the General Medical Council (GMC), in London, to local watchdogs, could prevent a repeat of scandals that have shaken public confidence in the medical profession.
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Under the recommendations, which go out for consultation until November, doctors would have to renew their licences in order to stay on the medical register and have the right to work.

Specialist doctors or GPs would have to re-certify via their relevant royal colleges.

The aim is to proactively ensure the doctor is safe to work and not just to identify there are no current concerns.

The 44 recommendations aimed at bolstering public confidence also propose setting up an independent tribunal to judge when serious complaints are made against doctors.

The amount of proof needed in fitness to practise disciplinary cases would drop from that of beyond reasonable doubt to that of on the balance of probabilities.

It is hoped this will close loopholes where a doctors work can be viewed as so bad they may have committed a criminal offence but not bad enough for them to be struck off the medical register.

The General Medical Council, the doctors' watchdog, would be stripped of some of its powers, with a network of trained and accredited GMC affiliates appointed to act as the eyes and ears for patient safety at a local level.

The most serious cases would be passed to the GMC to investigate.

The investigation was ordered in the wake of the Harold Shipman scandal and a number of other notorious cases, including that of Richard Neale.

The consultant gynaecologist, who worked at the Friarage Hospital, in Northallerton, North Yorkshire, was struck off after botching operations, lying to patients and altering medical records.

Other scandals examined by Prof Donaldson included that of William Kerr, a former North Yorkshire psychiatrist who was convicted of indecent assault after a string of complaints from female patients.

Michael Haslam, also a former North Yorkshire psychiatrist, was jailed for four counts of indecent assault following complaints from female patients.

In all three cases, patients believe their complaints were not taken seriously by the medical and health authorities because of a culture that put doctors before patients.

Last night, Health Secretary Patricia Hewitt announced that the proposals will now be subject to widespread consultation before any further action is taken.

Prof Donaldson has spent the last couple of years working through the recommendations of the Shipman, Ayling, Neale, Kerr and Haslam inquiries to devise his own recipe for reform.

Kent GP Clifford Ayling was jailed for indecently assaulting female patients.

The main trigger for reform were the recommendations contained in the fifth report into the Shipman Inquiry, which was critical of the GMC and medical regulation arrangements.

Shipman, who hanged himself in prison, is believed to have killed more than 250 of his patients. He was convicted in 2000 of murdering 15 of them.

The Shipman inquiry made more than 100 recommendations in areas including disciplinary procedures, whistle-blowing and the monitoring of GPs.

More recommendations were made by the Neale, Kerr and Haslam inquiries, including a call for better checks before doctors were recruited and extra supervisory powers.

Prof Donaldson said while standards of care provided by doctors were "very high" there was a need to bolster patients' trust in the system.

Last night, Graham Maloney, advisor to the support group set up by some of Neale's former patients, said: "These proposals will go a long way to prevent someone like Richard Neale operating again in our hospitals."

Kathy Haq, a victim of William Kerr and a spokeswoman for former patients of Kerr and Haslam, said: "I am pleased that they are finally doing something to sort this out.

"The change to the standard of proof will make it easier to take action against doctors who abuse or harm their patients."

Yes, we definitely want to make sure that doctors, especially psychiatrists, our pet peeve, are held responsible for their criminal actions.