How patients' lives have been put at risk

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Yesterday's Bill started life on 9 January 1982, when Dr Oliver Archer was called to Alfie Winn, an eight-year-old boy in Canning Town, east London,who had spent the night vomiting with a temperature of 106F.

The doctor kicked the bowl of vomit under the table and when the boy failed to respond to instructions, he declared that if Alfie "couldn't be bothered to open his mouth he couldn't be bloody bothered to look".

He left an antibiotic. Two hours later Alfie's mother called an ambulance. Four days later he died in hospital of meningitis. When the case came before the General Medical Council, the facts were found proved. But Dr Archer was acquitted. The GMC decided that his actions did not amount to "serious professional misconduct" - the only charge the GMC can bring.

When it later transpired that he had told a woman undergoing a miscarriage to wrap the foetus in newspaper, flush it down the lavatory and come to see him three days later, Dr Archer was found guilty. But the search for some method of dealing with incompetent or totally inconsiderate doctors began - with the GMC arguing it lacked the powers to tackle them.

Other cases since included that of Dr Carol Starkie, a pathologist from Selly Oak in Birmingham, who misdiagnosed cancer cases, resulting in patients receiving chemotherapy and operations they did not need. Although doctors had complained of difficulty getting correct and early diagnoses from her since 1985, she was only suspended by her health authority in 1993. In other cases, 700 women had to be recalled after a Gateshead GP was found to have taken cervical smears incorrectly for five years, while wrong analysis of results led to 2,000 women being recalled in Inverclyde, Scotland.

The new procedure is intended to deal not with one serious misdemeanour, which may bring a charge of serious professional misconduct, but with doctors who put patients at risk by persistent seriously inadequate practice.