EDITOR, - If any senior doctor's actions are giving rise to the sort of problems Liam J Donaldson describes the profession must take them seriously. The Consultants and Specialists Committee is not in the business of defending wrongdoing, but as chairman I must take issue with some of the statements and conclusions in what purports to be a scientific paper.

Forty nine senior hospital doctors were described as being involved in cases that were sufficiently grave to warrant disciplinary or other formal action being considered. It would have been helpful if the number of those found to be guilty was also given. As all who are concerned with the administration of justice are aware, there is a huge difference between allegation and being found guilty. Without this distinction the article becomes a list of Donaldson's own prejudices, and he is certainly not entitled to conclude that radical reform of the disciplinary processes is needed. This presumption - that any allegation of wrongdoing automatically implies guilt - illustrates very well why such legalistic disciplinary procedures are needed. If senior hospital doctors are to be subjected to a process that may ultimately deprive them of their livelihood then high standards of proof …