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Take care over new wilful neglect offence, doctors warned

New criminal sanction could bump up police investigations, medical defence body says

Caroline White

Monday, 13 April 2015

New legislation which comes into force today, could bump up the number of police investigations of doctors, medical defence body the MDU has warned.

Section 20 of the Criminal Justice and Courts Act 2015, which applies to individuals such as doctors, dentists and nurses, makes it “an offence for an individual who has the care of another individual by virtue of being a care worker to ill-treat or wilfully to neglect that individual.”

The MDU believes there would need to be a significant or serious departure from acceptable standards for an offence to have been committed, and the Department of Health has explained that the legislation is not designed to penalise doctors who make genuine errors.

But this may not prevent a rise in the number of police investigations in cases where wilful neglect or ill-treatment is suspected, says the MDU.

Dr Michael Devlin, MDU head of professional standards and liaison, said: "No-one would condone any deliberate act or omission by care staff designed to harm or distress a patient. But ethical principles make clear how healthcare professionals should make the care of their patients their primary concern.

"The new legislation is likely to lead to more police investigations if there is any question that a doctor may have wilfully neglected or ill-treated a patient through something they did or didn't do. Even if a decision is later made not to prosecute the doctor, such investigations can last for months or even years and doctors may also be suspended by their employer and/or referred to the GMC.”

He said that it was vital that clinicians tell patients about any significant delays in their treatment or diagnosis.

“Clinicians should explain to patients why the delay has happened, for example because of a waiting list, what they are doing to try to speed things up as well as ensuring the patient understands the need to get urgent medical advice if their condition worsens. Doctors should also explain to patients if any treatment will be painful for them or significantly impact on their dignity,” he emphasised.

Good communication, including clear written instructions in the clinical records, were not only vital for continuity of care, but could also help defend a doctor should s/he be subject to a police investigation, he added.

The MDU has described some scenarios which might prompt an investigation, on the grounds of wilful neglect, including one involving a GP:

A GP sees a 5 year-old boy with a high temperature and diarrhoea. After careful examination the doctor can find nothing of concern and suspects a viral illness, and advises the parents accordingly. S/he tells them to keep an eye on the child and to contact the surgery again if his condition worsens. That child is admitted to hospital 10 hours later with meningitis and suffers brain damage. The understandably distressed parents complain that the GP was rushed and off-hand and was wilfully neglectful in not diagnosing meningitis.

The MDU has issued guidance for doctors on the implications of the new criminal sanction.

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