PROPOSITIONS : Call the doctor to account

Nicholas Timmins previews new rules to tackle incompetent medics

Share
Related Topics
On the morning of 9 January 1982, Dr Oliver Archer, a GP in the East End of London, was called to visit eight-year-old Alfie Winn. It was to be a day that has haunted the General Medical Council, the doctors' educational and disciplinary body, ever since.

Alfie had spent the night vomiting, was delirious and had a temperature of 106F. Dr Archer agreed to turn out reluctantly. When he arrived, he kicked a bowl of Alfie's vomit under the table. When the boy failed to respond to his instructions, Dr Archer declared that if Alfie "couldn't be bothered to open his mouth, he couldn't be bloody bothered to examine him". He prescribed an antibiotic and left.

Two hours later, Alfie's mother called an ambulance. Four days later, Alfie died in hospital from meningitis. His mother complained to the GMC. Dr Archer was charged with "serious professional misconduct" - the only charge the GMC can bring - for failing to examine and treat the boy adequately and for failing to refer him to hospital. At the hearing, the facts against him were found proved. But it went on to decide his actions did not amount to "serious" professional misconduct. It acquitted him.

Two years later, Dr Archer was again before the GMC. He had told a woman undergoing a miscarriage that when the foetus emerged she should wrap it in newspaper, flush it down the toilet and see him three days later. This time he was found guilty, suspended and referred to the GMC's health committee. He eventually took himself off the medical register.

Fifteen years on, Parliament will tomorrow debate the second reading of a bill aimed at giving the GMC improved powers to deal with the Dr Archers of this world. The new performance procedures are aimed both at doctors who behave intolerably to patients and at dealing with the sort of incompetence Dr Archer also displayed.

The bill is a landmark, but doubts remain about whether it will really do the job. What it does is bolt a new procedure on to the already complex system for disciplining doctors. At present there are two procedures: one for professional misconduct, based on court-style public hearings, and another for sick doctors, which is private and emphasises treatment and advice for them. The new procedure will be private; remedial rather than punitive; with powers to suspend, require retraining and, in the last analysis, prevent a doctor from practising.

The complexity of this new system, with its three interlinked procedures, has come under fire from two distinguished former lay members of the council. Jean Robinson, a vice-president of the Patients' Association, argues cases can easily involve both conduct and competence, yet will be set off down one track or the other. Margaret Stacey, professor of sociology at Warwick University, argues the GMC should recognise "that seriously incompetent practice is in fact serious professional misconduct".

No one is quite sure how many cases there will be a year. The GMC's best guess is 100 to 150, of whom perhaps 50 might face sanctions. But retraining to make doctors competent, or to change their attitude to patients, will be expensive - perhaps £6,000 to £22,000 a case. In the newly competitive NHS, hospitals may prefer to dispose of incompetent doctors rather than invest in their retraining.

The real difficulty lies in the word "serious": since 1858 the GMC has been able to act only over "serious" professional misconduct or, as now, when a doctor's health is "seriously" impaired or performance "seriously" deficient. When the government in the Eighties first considered legislation to allow the GMC to deal with performance, it thought about tackling the word serious. But at the recent press conference to announce the bill, Gerald Malone, the Minister of Health, was anxious to assure doctors the new procedure would not be draconian. The bill has been introduced only on condition that the Opposition will facilitate its passage and not try to alter it.

The procedure should be given its chance, and the GMC has promised a review after two years. But if it is not seen to be working well, the time will have come to tear up the Medical Acts and start again.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

C# Algo-Developer (BDD/TDD, ASP.NET, JavaScript, RX)

£45000 - £69999 per annum + Benefits + Bonus: Harrington Starr: C# Algo-Develo...

Senior Data Scientist (Data Mining, Apache Mahout, Python,R,AI)

£60000 - £70000 per annum + Benefits + Bonus: Harrington Starr: Senior Data Sc...

Data Scientist (SQL,Data mining, data modelling, PHD, AI)

£50000 - £80000 per annum + benefits+bonus+package: Harrington Starr: Data Sci...

Java Developer - 1 year contract

£350 - £400 Per Day: Clearwater People Solutions Ltd: Our client based in Cent...

Day In a Page

Read Next
 

The power of anonymity lies in the freedom it grants

Boyd Tonkin
Rebel fighters walk in front of damaged buildings in Karam al-Jabal neighbourhood of Aleppo on August 26, 2014.  

The Isis threat must be confronted with clarity and determination

Ed Miliband
Ukraine crisis: The phoney war is over as Russian troops and armour pour across the border

The phoney war is over

Russian troops and armour pour into Ukraine
Potatoes could be off the menu as crop pests threaten UK

Potatoes could be off the menu as crop pests threaten UK

The world’s entire food system is under attack - and Britain is most at risk, according to a new study
Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

Seoul's plastic surgery industry is booming thanks to the popularity of the K-Pop look
From Mozart to Orson Welles: Creative geniuses who peaked too soon

Creative geniuses who peaked too soon

After the death of Sandy Wilson, 90, who wrote his only hit musical in his twenties, John Walsh wonders what it's like to peak too soon and go on to live a life more ordinary
Caught in the crossfire of a cyber Cold War

Caught in the crossfire of a cyber Cold War

Fears are mounting that Vladimir Putin has instructed hackers to target banks like JP Morgan
Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years

Salomé: A head for seduction

Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years. Now audiences can meet the Biblical femme fatale in two new stage and screen projects
From Bram Stoker to Stanley Kubrick, the British Library's latest exhibition celebrates all things Gothic

British Library celebrates all things Gothic

Forthcoming exhibition Terror and Wonder: The Gothic Imagination will be the UK's largest ever celebration of Gothic literature
The Hard Rock Café's owners are embroiled in a bitter legal dispute - but is the restaurant chain worth fighting for?

Is the Hard Rock Café worth fighting for?

The restaurant chain's owners are currently embroiled in a bitter legal dispute
Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival

In search of Caribbean soul food

Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival
11 best face powders

11 best face powders

Sweep away shiny skin with our pick of the best pressed and loose powder bases
England vs Norway: Roy Hodgson's hands tied by exploding top flight

Roy Hodgson's hands tied by exploding top flight

Lack of Englishmen at leading Premier League clubs leaves manager hamstrung
Angel Di Maria and Cristiano Ronaldo: A tale of two Manchester United No 7s

Di Maria and Ronaldo: A tale of two Manchester United No 7s

They both inherited the iconic shirt at Old Trafford, but the £59.7m new boy is joining a club in a very different state
Israel-Gaza conflict: No victory for Israel despite weeks of death and devastation

Robert Fisk: No victory for Israel despite weeks of devastation

Palestinians have won: they are still in Gaza, and Hamas is still there
Mary Beard writes character reference for Twitter troll who called her a 'slut'

Unlikely friends: Mary Beard and the troll who called her a ‘filthy old slut’

The Cambridge University classicist even wrote the student a character reference
America’s new apartheid: Prosperous white districts are choosing to break away from black cities and go it alone

America’s new apartheid

Prosperous white districts are choosing to break away from black cities and go it alone