New regulatory mechanisms devised to protect patients following high profile scandals such as the Shipman murders and the Bristol baby deaths will tie up doctors in excessive and unnecessary bureaucracy and offer no extra protection to the public, a leading medical indemnity organisation warned today.
The GMC proposes a raft of changes including setting up a network of GMC affiliates in every hospital and primary care organisation.
The affiliates, one medical and one lay member per organisation, will be responsible for dealing with cases at a local level and deciding whether more serious cases should be referred to the GMC.
They will liaise with trust complaints managers and others on complaints and also help develop and deliver packages of assessment, treatment, remediation or retraining for doctors who have performance problems.
They will also liaise with responsible officers, normally trust medical directors, who will maintain a log of "recorded concerns" – problems with an individuals performance or behaviour that are noteworthy yet do not reach the threshold for referral to the GMC.
But writing in the annual report of the Medical Defence Union (MDU) which provides medical indemnity cover to around half the doctors in the UK, Chairman Dr Christopher Evans says that these innovations are "unnecessary, unwelcome and have not been properly considered".
He says; "Back in 2006, when these changes were first mooted in the Chief Medical Officer’s consultation paper we said we did not believe it had been adequately demonstrated that it was necessary or in the public interest to subject doctors to any new burden of regulation.
"Yet we are still faced with the possible prospect of GMC affiliates, responsible officers and recorded concerns (now being piloted as 'agreed statements of concern') that have been devised to meet a supposed need that we do not think has been satisfactorily demonstrated to exist.
"They have the potential, at best, to involve countless hours extra work for very many members and, at worst, to increase members’ exposure to yet more regulatory procedures that we believe are unnecessary, for what we fear will be no appreciable improvement in standards of patient care and safety."
Dr Evans says the MDU argues that better and more constructive use should be made of existing procedures and of other mechanisms that exist for measuring and assessing doctors’ performance and conduct, with the aim of taking remedial action before serious concerns arise.
"We still believe that such a system would be more effective than adding new and different regulatory layers which have the potential to cost millions. We suggested in 2006 that the Department of Health prepared comparative costings, but have seen no evidence that this was done."
Recorded concerns are proposed as voluntarily-accepted sanctions, offered by responsible officers for concerns which are not serious enough to call into question a doctor’s fitness to practise, but which could be viewed by the general public.
Dr Peter Schutte, the MDU’s head of advisory services says: "There is no evidence that there would be a proper independent investigation before a concern is recorded or that doctors would have a right to representation and response. Yet any formal adverse comment made available to the public could have a detrimental effect on a doctor’s reputation and future career prospects."