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MDU objects to duty of candour for GPs

Changing blame culture would do far more to foster openness and honesty

Wednesday, 19 June 2013

Imposing a duty of candour on GPs and other NHS providers will just add another layer of ‘unnecessary regulation’, the Medical Defence Union has warned. It said changing the culture of blame would do far more to encourage openness and honesty in the health service.

The MDU is responding to the amendment to the Health and Social Care Bill tabled by Lord Warner, which proposed a statutory duty on health care providers to ensure that all personnel “exercise a duty of candour in their contacts with patients, service users and their families or representatives”.

The MDU pointed out that, if something goes wrong, doctors already have an ethical duty to be open and honest with patients. Secondary care providers can now be fined up to £10,000 if they breach the new contractual duty of candour that has been introduced – but this does not currently apply to primary care. The MDU described the prospect of GPs facing criminal sanctions as “a worrying development”.

The MDU’s head of advisory services Dr Michael Devlin said: “Everyone agrees that patients must be told when something goes wrong, as soon as it has happened. We have been giving this advice to our members, who are half the UK’s GPs and hospital doctors, for over 60 years. We reject suggestions that there is a culture of covering up mistakes as, in our experience, doctors are honest and do not deliberately withhold information from patients.

“When something goes wrong, doctors are already subject to multiple jeopardy. The patient can complain under the NHS procedure and to the GMC, as well as bringing a clinical negligence claim. The doctor could also face disciplinary proceedings and the provider could be investigated by CQC.”

During the Lords debate on the amendments, Baroness Northover said Government intends to introduce a statutory duty through CQC – but cautioned that to introduce criminal sanctions at an individual level could unintentionally create a ‘culture of fear’.

Dr Devlin said: “If a statutory duty of candour is introduced, GP practices and other providers could also face a further investigation and a criminal penalty. This is entirely unnecessary.

“The MDU believes the best way to support openness and honesty in the health service is not through yet more regulation which falsely implies that cover-ups are endemic. It is by ensuring doctors and their colleagues do not feel they will be unfairly blamed if they report an adverse clinical incident.”

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