Letter:Get tough on abusive doctors

Sir: Your leader suggests that the General Medical Council should be "more flexible" when dealing with doctors accused of abusing the doctor- patient relationship ("Doctors: a prescription for retaining our trust", 24 June).

You are obviously unaware that the GMC is already very flexible indeed - some of us might think too much so. I was a lay member for 14 years and sat on disciplinary committees for 12. An allegation has to be both serious and provable to get past the screener. Since the GMC has refused to carry out the recommendations of the Morrison committee that it should have an investigation unit, the complainant who cannot provide her own supporting evidence at the beginning will get no further.

The small minority of cases which reach the next stage then have to be accepted by the Preliminary Proceedings Committee. That committee selects those cases which will get through to the Professional Conduct Committee. Then the complainant will have to convince a panel of 11, most of whom will be male doctors, that she is speaking the truth. The majority of doctors are elected by the profession itself, and are well aware of their constituents' views. If the facts are found proved, it is then decided whether they amount to serious professional misconduct. If so, the panel can decide to admonish, suspend, or remove from the register. The penalty will vary according to the evidence.

The GMC does not discipline doctors for having sex, but for abuse of the professional relationship. Many GPs are now undertaking counselling roles, and this opens greater possibilities of manipulation. The damage done to the patient can be profound, and can leave her and members of her family suicidal. Similar abuse by female doctors can happen, but is uncommon.

Doctors have been given powers to discipline themselves to protect the public. If they fail to do it effectively, Parliament may decide to disband the GMC and give those powers to a lay body. I am sure that is the last thing the British Medical Association would want.

JEAN ROBINSON

Oxford