- Target:
- Doctors and Patients
- Region:
- United Kingdom
Dear Colleague,
As you will see from the letter below, we are very concerned about threats to medical professionalism in the U.K. posed by the Chief Medical Officer`s (CMO) report “Good Doctors, Safer Patients”. He is seeking people`s views about his proposals for this new professional regulation of doctors in the U.K. Furthermore, Sir Donald Irvine, ex-President of the General Medical Council (GMC), has endorsed Sir Liam`s report and thinks that the current GMC should be disbanded and a successor re-formed.
We are very concerned about the impact that this report, and Sir Donald`s ideas, if implemented, would have on the way Medicine is practised, and on the doctor-patient relationship particularly.
We believe that doctors should be accountable to patients and to the GMC, not Government. We also believe that plans to appraise doctors annually with examinations and 360 degree assessments are not only time consuming, but also lack evidence to show that they would improve either patient safety or detect bad clinical practice. They would merely be an expensive and time-consuming exercise in bureaucracy. Mistrust between doctors and patients would increase, whilst morale amongst doctors would fall.
We believe that self-regulation, independent of Government and in partnership with laypeople, is the most open, fair and accountable system for both doctors and patients. A re-vitalised and re-constituted GMC would provide this.
The time to act and make objections known is NOW. We ask you to sign this open letter which will then be forwarded to the Press, the CMO, The Royal Colleges, and the GMC. We are keen to obtain as much support as possible amongst laypeople and doctors: please therefore alert your friends and colleagues whom you think would support it. We know that there is a rising groundswell of opposition. Time is of the essence: we aim to send this letter by 13th October 2006.
(signed)
Mr. Guidubaldo Querci della Rovere, Consultant Surgeon.
Dr. Margaret McCartney, GP and medical journalist.
Mrs. Hazel Thornton, Independent Advocate for Quality in Research and Healthcare.
Medical professionalism* is threatened with extinction. Immediate action is needed to avert this danger. The undersigned doctors and patients believe that trust in the unique doctor-patient relationship is the bedrock of medical practice.
We oppose the proposals for regulation of the profession presented by the Chief Medical Officer, (CMO) Sir Liam Donaldson. [1] He proposes regulation of doctors including 360 degree assessment, and standardised audit and appraisal assessments. The latter have never been shown able to objectively improve patient care and are estimated to cost a thousand hours of staff time per large hospital. The proposed revalidation by yearly exam is impracticable, of unproven efficacy and therefore unacceptable. Certainly it would not have prevented any of the strongly publicized cases of medical misconduct of the past years. Sir Liam`s proposals have been publicly endorsed (with caveats) by the former President of the General Medical Council (GMC), Sir Donald Irvine. [2] Sir Donald is calling for the council of the regulatory body (GMC) to be disbanded. Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine (JRSM) [3] has called for all those who have views about this contentious proposal to make them known to the CMO and to the JRSM. Tardiness in taking the action to reverse the decline called for by Dr. Richard Horton, Editor-in-Chief of The Lancet, in February 2002 [4] has cost us dear: it must be rectified now without delay.
The oppressive proposals would translate into doctors practicing medicine in a climate of mistrust and fear. We believe that Medicine in the 21st century should be practiced in partnership with patients: it is to patients that good doctors wish to be primarily accountable - not to the Government of the day. The GMC must remain an independent body, transparent and accountable to Parliament; it should not become an instrument of the DoH; its members should not be appointed but elected by medical professionals.
We must not allow the CMO`s proposals for regulation that followed on from Dame Janet Smith`s Report [5] on the Shipman affair to go ahead: they would alter the dynamic of the relationship between all patients and doctors forever. Crime should not go unpunished, but neither should we turn doctors into practitioners whose purpose is mere satisfaction of Government standards. To this end, it is vital that the independent GMC is retained: it must be restored, not destroyed. It must be revitalized and reconstituted to include lay and other representation so that it can provide, through transparent processes, balanced but independent Council decisions.
We must not remain silent in the face of the constant erosion of professional status and morale that threatens the very heart of medicine: the relationship of doctor with patient.
* “Medical professionalism signifies a set of values, behaviours and relationships that underpins the trust the public has in doctors.” [6]
[1] Chief Medical Officer. Good Doctors, Safer Patients. London: Department of Health, 2006.
[2] Donald Irvine. Good doctors: safer patients – the Chief Medical Officer`s prescription for regulating doctors. Journal of the Royal Society of Medicine September 2006, Volume 99, Number 9. 430-431
[3] Kamran Abbasi. From the Editor: Good and bad lessons from the United States.. Journal of the Royal Society of Medicine, September 2006, Volume 99, Number 9. Page 429
[4] Richard Horton. Commentary: The doctor`s role in advocacy. The Lancet 2002; 359:458
[5] The Shipman Inquiry. Safeguarding Patients: Lessons From the Past, Proposals for the Future. (Chairman Dame Janet Smith). London: Stationery Office, 2004.
[6] Royal College of Physicians. Doctors in society: medical professionalism in a changing world. Report of a Working Party of the Royal College of Physicians. London: RCP, 2005
THIS LETTER HAS NOW BEEN SENT AS OUTLINED ABOVE, AND WAS PUBLISHED IN THE TIMES (LONDON.) YOU ARE WELCOME TO ADD YOUR NAME BUT PLEASE ALSO SEND YOUR CONCERNS TO THE CMO DIRECTLY AS ONLY THE NAMES APPENDED UP TO THE 16TH OCTOBER 2006 WERE SENT ONWARDS. THANK YOU.
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The Avert the Threat to Medical Professionalism petition to Doctors and Patients was written by margaret mccartney and is in the category Health at GoPetition.