Doctors `plot to beat complaints system of NHS'

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The Independent Online
A "CULTURE of blame" in the NHS caused doctors to close ranks against patients when things went wrong and withhold information that could make the service safer, a committee of MPs said yesterday.

The NHS complaints system, which dealt with 89,000 complaints last year, is so unwieldy and bureaucratic that it often fails to uncover the truth, reduce risks or support patients. Even a secretary of state for health agreed the system was a "shambles," the Commons Select Committee on Health said.

In a report published yesterday, the MPs paint a coruscating picture of an NHS in which doctors cover up for each other, refuse to divulge information to patients and carry on working even when they have been marked out as poor performers.

The report highlights the problems of haemophiliacs, some of whom are only now being told of the possible risks they ran a decade ago by being treated with infected blood products (which transmitted hepatitis C) and of gynaecology patients operated on by an unnamed surgeon who had already been the subject of warnings in other parts of the NHS.

The MPs call for "an end to the ethos of defensiveness". Acknowledging that "medicine is not a risk-free occupation," they quote the health service ombudsman, Michael Buckley, who said in evidence that some doctors felt a complaint was an attack on their professional integrity and competence rather than an attempt to uncover what had gone wrong and prevent it happening again.

The report quotes the former health secretary Frank Dobson, who told the committee: "The present [complaints] system really is a bit of a shambles... and at the end of it all none of the people concerned, neither the person complained about, not the patient, nor the patient's relatives is satisfied."

The procedure is currently under review.

In place of blaming individuals, the MPs call for a "culture of organisational responsibility" in recognition of the fact that a wider system failure frequently underlies individual lapses or errors. The report acknowledges that clinical governance, the system for holding to account doctors and hospitals for the quality of the care they deliver, will begin to address this issue and recommends the Department of Health should check how it is working.

The MPs call for a national system for alerting health authorities to poorly performing doctors and systematic follow-up and counselling for patients affected by an incident in which medical care has gone wrong. They say the complaints system should be made genuinely independent by appointing review panels with a lay majority independent of their NHS trust.

After hearing of cases in which information about the death of patients was withheld from relatives, they say a legal duty should be imposed on doctors to provide such information if they ignore their professional duty to do so.

The British Medical Association said it supported the committee's desire for "greater clarity and consistency" in the investigation of complaints but questioned whether a move to a more adversarial, quasi- judicial approach was needed.

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