Do you have confidence in your doctor? Good. Because there isn't much else to rely on. He or she will, presumably, have a medical degree, which is some kind of guarantee that they know what they are talking about. But if they are getting on, it may be decades since anyone last checked whether they are keeping up to date with latest advances or can still wield a scalpel with the required skill.
The Bristol heart surgery scandal of the mid-1990s, in which children died because of the incompetence of the surgeons, highlighted a remarkable fact – that from the moment doctors qualified to the moment they hung up their stethoscopes there were no checks on whether they were competent to do their jobs during careers that spanned 40 years.
Since 2000, the General Medical Council (GMC) has been striving to do something about this – by introducing regular checks on performance, which doctors would be required to undergo every five years to remain on the medical register. That would transform the register from a document of historical record to one of contemporary relevance.
But standing in the way of reform has been the British Medical Association (BMA), which has found 10 years' worth of reasons to resist it. Its bullying stance almost won the day in 2005 when the two organisations were poised to introduce a watered-down version of the original tough proposals – until they fell under the gimlet eye of Dame Janet Smith, chair of the Shipman Inquiry, who crushingly observed that they had been devised "for reasons of expediency ... not principle" because of opposition from the profession. Another five years on, we have a new set of proposals, and a BMA gearing up for its annual conference season. Once again, the comrades are unhappy – and again it looks likely patients will lose out.
Does this matter? Dame Janet made clear why it did. In evidence to the Shipman Inquiry, Professor Sir Graeme Catto, former president of the GMC, said 90 per cent of doctors gave no cause for concern. That meant, Dame Janet pointed out, that there could be a problem with as many as 10 per cent. Even if it's 5 per cent, taking GPs alone, that is equivalent to a lot of patients. "It means several million people are put at avoidable risk without even knowing it. Looked at through patients' eyes, this is simply unacceptable," said Sir Donald Irvine, another former GMC president.
It beggars belief that 10 long years after the disasters exposed by the Bristol Inquiry, the Shipman Inquiry and other scandals where the absence of checks led to the avoidable injury and deaths of hundreds of patients, the medical profession is still resisting the plans.
An airline that protested it could not run proper checks on its planes because they were too complicated, time consuming or expensive would not attract many passengers. NHS patients deserve as much. It is time to ditch your objections and do as the airlines do, docs. We have waited long enough.