Views And Reviews

Medicopolitical digest

BMJ 1994; 308 doi: (Published 19 February 1994) Cite this as: BMJ 1994;308:540
  1. L Beecham

    BMA comments on guidance on doctors' performance

    In its comments on the review of guidance on doctors' performance, which the government set up in October (23 October 1993, p 1072), the BMA emphasises the need for parliamentary time to be found to legislate on the General Medical Council's proposals for new performance review procedures. Although it agrees that the guidance should be reviewed and that where a doctor's performance has fallen below an acceptable standard the results can be devastating, the association points out that the number of cases continues to be small and that public confidence in the medical profession as a whole continues to be high.

    The review group posed the BMA a series of questions. It wanted to know whether the present procedures were clear, equitable, and consistent. In its reply the BMA said that some of the procedures needed to be streamlined, simplified, and standardised. Too many different and overlapping procedures led to uncertainty in the minds of doctors, managers, and patients. Patients did not know where to lodge a complaint, and doctors were liable to suffer multiple jeopardy. The development of differing local procedures in individual trusts was confusing.

    Asked how good performance could be promoted and assessed and what prevented good performance, the BMA said that it believes that all doctors are responsible for their own performance. Employers should accept and encourage this responsibility and not rely entirely on formal contractual and managerial mechanisms to control performance. Good performance could be promoted by properly structured audit and recognition through promotion or financial reward - for example, distinction awards. …

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