Thursday, September 28, 2006

"Better Doctors Safer Patients"

Chief Medical Officer, Sir Liam Donaldson - Author of the 'Report Better Doctors, Safer Patients'
I am currently heavily involved in some work that has required me to read a 218 page report recently written by Sir Liam Donaldson, the Chief Medical Officer in the Department of Health.

The report is called ‘Better Doctors, Safer Patients’ and this is the culmination of inquiries, adverse reports and scandals about the behaviour of some UK doctors over the last few years. The best known is the infamous General Practitioner, Dr Harold Shipman who murdered over 250 of his patients. The exact number of patients he murdered will probably never be known.

A good friend and colleague of mine who is a well respected and high profile GP always says to me, “We must remember that Harold Shipman was first of all a murderer and secondly a doctor. All doctors should not be tarnished because of the actions of one murderer.”

I agree with that statement. The greatest quality I have come across among the hundreds (maybe thousands) of doctors I have worked with in 35 years in the NHS is their professionalism and their caring attitude for their patients.

Having said all those positive things I am nevertheless delighted to see Sir Liam’s report being so honest about the deficiencies in the regulation and continuing professional development of doctors. The report contains 44 recommendations and the report is currently out for consultation until early November.

To this point doctors have been the subject of mainly self-regulation and whilst there is clearly a place for that, it seems to me inevitable that the medical profession must be dragged – even if screaming - into the current world of appraisal from various interests rather than simply doctors judging doctors with all the inevitable problems that brings.

Sir Liam’s report is also interesting because the language used is generally straightforward and not full of intelligible NHS jargon. What a joy that is for a change!

I guess a few regular readers of Simplicity Blog might be interested in reading the report and if so you can see it at this by
clicking here

One staggering statement is that once doctors reach ‘independence’ status – i.e. consultant level – their knowledge, competence, clinical skills or performance are not formally assessed from that point until they retire. That could be 30 years. Contrast that with pilots who are formally assessed up to 100 times in that same time period.

My feeling is that Sir Liam’s report provides a framework to protect patients, the medical profession and the doctors. This can be a win-win-win if the report if implemented and acted on fully.


David Wike said...

I am absolutely astounded and horrified that consultants are not assessed in any way. After all, it has been common practice in business for as long as I can remember. But then again perhaps one shouldn’t be surprised as one constantly encounters in the public sector examples of practices that would not be tolerated or are even outlawed for private businesses.

I guess it just reinforces a recent comment you made about hospitals being dangerous places! Think I’ll try to stay healthy!

Trevor Gay said...

Thanks David

Historically the Medical profession has remained outside as you put it 'common practice in business.'

I endorse your 'world view' about this and the Liam Donaldson report will help if it is implemented fully. My worry is that some compromises will be made to keep doctors somehow 'outside' wider regulation.

Anonymous said...

If you committed a misdemeanor in business you would not be found guilty unless it 'was beyond all reasonable doubt'.

Dr Grumble fails to see why doctors should be any different.

Trevor Gay said...

Great name 'Dr Grumble' - I love it.

I agree with you that the burden of proof should be beyond reasonable doubt for Doctors. We need to find ways of ensuring doctors are treated fairly. On the other hand Doctors are vested with awesome responsibility and with that responsibility comes great accountability. I hope proposals will emerge from Liam Donaldson's report that are fair to doctors and most of ensure safety for patients and the public.