Still No Integrity ?

Doctors have difficulty with reporting colleagues for incompetence or impairment as shown by a recent study in JAMA (Journal of the American Medical Association). In fact 31% of Doctors surveyed would not report a colleague. Yeah, OK, so 67% said they would but it's often quite easy to say when it's purely an academic situation. When polled most of the population always say they would do the the 'decent' thing in most situations about integrity, but to be a 'whistleblower' takes a lot of b***s. A lot of the time it is so much easier to cross on the other side, turn a blind eye and other such idioms because all too often the outcome is to 'shoot the messenger'.

Doctors (along with policeman), even when brought to ordure, have a knack of escaping the justice they deserve, but that is often a result of the naive belief in civilised society that the Law has anything to do with Justice, which it patently does not. We only have to refer to the bolam test to see that 'joe public' has the weight of the establishment pitched against them, if he or she questions the integrity of Medicinae Doctor. I think probably, since Hippocrates demise, doctors have contrived to cover their a**e in the event of an error of judgment or treatment and their colleagues have generally tended to back them up with an implacable wall of rhetoric, obfuscation and on occasion lies. The Management of Health care, primarily the NHS in the UK, has grasped this mettle also and we now have non-medics colluding with medics because they could also stand accused with their (often hated) colleagues.

There are allegedly, bodies to safeguard the public against the dangers of medicines excesses but it seems they have consummately and consistently failed to achieve any measure of success in this if one examines the results. Over some years, the number of bodies tasked with invigilating over Doctors, indeed all aspects Health care have burgeoned, some would say out of all proportion to need. Most have heard of the GMC, NMC who directly license Practitioners ( Doctors and Nurses that is). But we also have the National Patients Safety Agency, Medicines and Healthcare Regulatory Agency etc, etc. In fact there are a legion of bodies all monitoring this or that, some I'm sure quite uncertain of what they are for at all, and of course many monitoring overlapping areas. They burn money (some of it mine) and produce reports in their area, of alleged expertise, with tedious content couched in the language of the bureaucrat spattered with that hated word 'facilitate'.

It is not surprising then that Doctors grow weary of the 'target culture', the spreadsheet and the top down diktats of apparatchiks that often rule their lives, if they are not Consultants that is, who pretty much do what they like most of the time. A few of them even become Management, but generally, The Management are hated by Doctors, especially the good and caring one's because they get in the way of them and their patient cohort. However, that does not excuse the Profession from a lack of integrity or individuals from spineless indifference to patient care. It does not excuse the GMC and NMC from failing in it's duty to discipline adequately it's licence holders and instead to vent it's spleen on those that care enough to stand up and be counted. Or indeed to conduct it's show trials of those who have seriously betrayed the tenets of care and then let them off with minor punishments or codicils for future conduct that are meaningless in the face of the enormity of their sin's.

The future, under the last Government was invested in the possibility of a change, and I say that not without some trepidation. Because most change in the NHS has been for the worst, with funds being squandered on pointless and tedious bureaucratic interventions and organisations that have contributed little (nothing?) to the need for justice and candour in the event of medical errors and incompetence. But, looking at it's remit and the structure of the Office of the Health Professions Adjudicator  it did seem that we might be getting somewhere. Well, now it seems that this infant body, is probably going to die at birth and then be incinerated on the conflagration of the Quangos that the LibCon's are lighting up with glee. I am not convinced. For the paltry sums involved it is worth at least a try at changing the landscape of justice for the legions of the dead and injured, sacrificed on the alter of the hubris of Doctors.

A consultation is taking place at the moment. It is important that the voice of the people is heard above the clamour of the Profession and bean counters. The NHS Justice Group has some words about this from the inimitable George Kuchanny. Have your say!