Health: Breath tests urged for doctors

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Random breath testing of doctors suspected of excessive drinking should be introduced to protect patients, the medical Royal colleges said yesterday. Jeremy Laurance, Health Editor, looks at a radical response to a problem that affects an estimated 9,000 doctors.

One in 15 doctors in the UK is estimated to be dependent on drink or drugs but many continue to deny it even when confronted by colleagues. Professional pride and a refusal to recognise their problem may put patients at risk.

The Academy of Medical Royal Colleges, whose membership includes the presidents of all the medical royal colleges, has recommended that NHS managers should have the right to impose random testing on those suspected of having a drink or drug problem who continue to deny it.

Announcing the decision, agreed unanimously by the 20-member academy last week, Professor Robert Kendell, president of the Royal College of Psychiatrists, said yesterday: "It is quite a common situation and very difficult to handle. Either you believe what the doctor says and keep an open mind and see what happens or you fire the medical equivalent of a 16 millimetre shell and refer them to the General Medical Council [the doctors' disciplinary body]."

If implemented, the decision would mean that a doctor who denied having a problem would be permitted to continue working only if he or she agreed to be tested at any time without warning. "That means someone coming into their office and saying `I want to breathalyse you now'," he said. It would be up to ministers and employers whether to take the recommendation forward, he said.

Professor Kendell was speaking at the launch of a report on the misuse of alcohol and drugs by doctors drawn up by six medical organisations including the academy and the British Medical Association. The report calls for a less punitive, more supportive approach to the problem, but does not go as far as recommending random breath testing. Dr Sandy Macara, chairman of the BMA, said the association had not yet considered the formal implications of the proposal. But he added: "It is a sign we are beginning to think the unthinkable."

Professor Kendell said there was a new sense of corporate responsibility in the profession. "There is no evidence the problem [of drink or drugs] is increasing but there is a recognition that we are responsible not only for our own behaviour but also for the behaviour of our colleagues. That is what has changed."

A person is considered dependent on alcohol if they drink at least five pints of beer or equivalent a day for at least four years. Official figures show 7.7 per cent of men and 2.2 per cent of women are dependent on alcohol. Although the figure for men is close to that for doctors, Professor Kendell said the implications were "potentially much more serious for doctors, especially if they are drinking during working hours."