Doctors To Face MoTs In Shakeup

Doctors will face five-yearly ‘MOT’ tests to check their competence in a radical overhaul of medical regulation triggered by a string of scandals. The Government also plans to strip the General Medical Council of its powers to discipline doctors and prevent them from practising.

The reforms come after an inquiry into serial GP killer Harold Shipman which claimed the system was weighted too heavily in favour of protecting doctors – rather than patients. Other cases have also shaken public confidence, including Rodney Ledward, Clifford Ayling and Richard Neale.

The latest proposals mean the profession effectively loses the right to police itself, with a balance of doctors and lay people on the GMC for the first time.

An independent tribunal will be set up to judge when serious complaints are made against doctors, headed by a legally trained chairman, and decide on the punishment.

However, the GMC retains responsibility for investigating cases in the early stages – when many patients fear their complaints are too easily dismissed – aided by “affiliates” around the country looking into local problems.

A new drive to ensure doctors keep up-to-date and maintain their skills will centre on five-yearly checks which will take them a day to complete. Those found to be failing will get retraining and if necessary will be supervised while at work. Similar changes will be introduced for the Nursing and Midwifery Council at the same time.

There will also be a shake-up of death certificates, with doctors losing the right to sign off deaths on their own. Instead a medical examiner will have to scrutinise the certificate.

The reforms were demanded by the inquiry into Shipman, Britain’s biggest serial killer, who falsified details on death certificates that allowed him to murder up to 250 of his patients.

Changes put forward in a White Paper on Wednesday will go out for consultation but have been broadly welcomed by the GMC and the royal medical colleges.

But the British Medical Association and others fear patients could lose out if MOT checks are used to “muzzle” doctors, encouraging them to meet NHS targets rather than putting patients first.

Mr James Johnson, chairman of the BMA, said: “The vast majority of doctors perform well and safely but patients must be protected from the rare cases of unsafe or poorly-performing doctors so that the public can maintain the trust it shows in the medical profession.

“Our concern is that under these White Paper proposals, a doctor�s ability to continue working in this way, without fear of falling foul of political imperatives, will be jeopardised.

“Do patients want their doctor to be regulated by the state to do what the government tells them to do, or do patients want their doctor to continue to relate to them as individuals and do what is best for them?

“Proving to patients that doctors are up-to-date and safe to practise is a good thing. But any attempts in the future to introduce meeting government targets into requirements for re-licensing would be bitterly opposed by the BMA.”

Shadow health secretary Andrew Lansley said: “The outrage rightly felt as a consequence of the Shipman and other cases must not cause us to lose sight of the fundamental importance of trusting the healthcare professions to provide care for their patients.

“The Government is fixed on trying to deal with the one-in-a-million incompetent or malign doctor, but this just undermines the confidence that the public has in all other doctors.”

Liberal Democrat Health Spokesperson, Sandra Gidley MP said: “Regular ‘MOTs’ to ensure fitness to practise should raise standards and inspire confidence in the public. “It is right that each profession is broadly regulated by itself with a lay majority, but there must be some means of reviewing the performance of lay members of regulatory boards as they are currently less accountable than the elected professional members.

“People’s careers are at stake here and we must guard against the possibility of a miscarriage of justice against health professionals. In acting to avoid a future tragedy such as Shipman, we mustn�t over regulate to the point where health professionals can become afraid to act in the best interest of the patient.”

Hundreds of patients claimed they were damaged by disgraced gynaecologist Rodney Ledward, who was struck off in 1998.

Gynaecologist Richard Neale was struck off by the GMC in 2000 after being found guilty of botched operations on a dozen women, and disgraced GP Clifford Ayling was convicted of indecent assualt on women patients in the 1990s.

In these and other cases, the GMC was accused of failing to act sooner while colleagues were blamed for not raising the alarm.