http://www.independent.co.uk/story.jsp?story=52798
This would be a grim year for doctors, the chairman of the British Medical
Association, Ian Bogle, warned in his speech to the BMA's annual conference
last June. Even he cannot have suspected how grim.
Each week brings more revelations of medical malpractice, failings in the
NHS or unprofessional conduct.
This week a GP was convicted by the General Medical Council after failing to
spot a tumour the size of a football in the stomach of a nine-year-old girl. Dr
Krishna Mohan Singh had dismissed the anxious inquiries of the girl's mother,
telling her not to be paranoid. He was allowed to continue practising but
ordered to have retraining.
There was also news that a consultant breast surgeon, Briony Ackroyd, had
been suspended at Walsgrave hospital, Coventry over concerns about poor
practice. She is one of 240 consultants reportedly suspended at hospitals
around the country. Ms Ackroyd was a specialist in the "tram-flap"
operation in which the breast is reconstructed at the same time as a mastectomy
for breast cancer is performed. A dossier of 30 cases was reported to have been
sent to the General Medical Council and the hospital said it was reviewing all
her work since 1995.
Earlier this month, the scale of Harold Shipman's crimes was revealed by an
investigation that suggested he may have killed up to 287 people.
This week a GP in Leeds was arrested and released on police bail over
allegations about the disappearance of stocks of diamorphine (heroin) from the
surgery and the deaths of elderly patients.
The tide of adverse stories is putting the medical profession under
unprecedented pressure. Morale is said to be "terrifyingly low".
Although surveys consistently show patients trust and remain satisfied with
their doctors, public trust in and satisfaction with medical institutions is
plummeting. The scare over MMR vaccine and the reluctance of parents to accept
reassurance about its safety from the Medicines Control Agency, the Committee
on Safety of Medicines and a dozen medical organisations is evidence of that.
Next week, the publication of the inquiry into the organ retention scandal
at Alder Hey hospital, Liverpool will again see doctors cast as arrogant,
remote and insensitive to the needs of their patients. In part, this is unfair.
The welter of criticism raining down on the profession is partly generated by
its efforts to root out the bad apples. The General Medical Council has tripled
the number of disciplinary hearings to clear the backlog of cases - but this
means more doctors appear to be acting unprofessionally and being struck off.
It is also unfair to tar an entire profession with the brush of half a dozen
miscreants, even if that half dozen has become a dozen or even two. Nearly all
doctors are conscientious, hard working and driven by a desire to improve the
lives of their patients.
None the less, old attitudes die hard, and stories of surgeons who like to
boast to their patients "only two people can help you today and God's
busy" are still commonplace.
The problem was captured in a speech two weeks ago by Sir Donald Irvine,
president of the General Medical Council, who warned that doctors must reform
the secretive, paternalistic culture in which they worked. "The cultural
flaws in the medical profession show up as excessive paternalism, lack of
respect for patients and their right to make decisions about their care,
secrecy and complacency about poor practice. These all contribute to a picture
which leads the public to believe that a lot of doctors put their interests
before their patients'," Sir Donald said.
His audience at the Royal Society of Medicine did not welcome his analysis
and the BMA said the picture he painted was not one it recognised. But it is certainly
one the public recognises. The loss of deference to those in authority is one
of the biggest social changes of the past decade.
But some doctors have still to adjust to the new order.
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