Choice Gp

If in doubt, start an inquiry

BMJ 1999; 318 doi: (Published 27 February 1999) Cite this as: BMJ 1999;318:a

Inquiries are all the rage in British health care. If something horrible happens, then the response of politicians is to start an inquiry. Action is being taken. But is the aim of these inquiries clear? Are they to find out what happened, allocate blame, provide an opportunity for reconciliation, make sure that nothing similar happens again, or all of these things? And are they worth the time and money?

Clare Dyer, our legal correspondent, reports on problems that are arising with the inquiry into bovine spongiform encephalopathy (BSE) and considers the implications for the inquiry that is about to start into paediatric cardiovascular surgery in Bristol (p 558). The BSE inquiry has heard from 300witnesses over 95days, and the chairman has now announced that it will not be able to report by June 1999.The difficulties are with the process. The central problem is that these inquiries feel like prosecutions to some of those giving evidence and yet do not have the strict procedural rules that apply in real court cases. Some witnesses are upset that “draft factual accounts” are being placed on the internet. These accounts may contain errors of fact and selective and inaccurate quotes from documents. Professional reputations are being put on the line without sufficient safeguards. Dyer reports that those who must run the Bristol inquiry are aware of the problems, but they may be hard to surmount.

John Gunn, professor of forensic psychiatry in London, raised similar questions about the inquiry into problems at Ashworth, a high security hospital, in the BMJ last month (23January, p 271). He asked: “Was the time, effort, and money worth it? The answer has to be no. Perhaps the worst aspect of the report is its unfairness. Witnesses did not know what they were to be accused of. Reputations are besmirched and careers may be ruined. Justice demands that anyone who is attacked in such a way should be given the opportunity to defend himself or herself properly.” GP choice

Two authors from Birmingham have been examining the possibility that female general practitioners might have a better consultation style than male general practitioners because women's use of language tends to be more cooperative —which is agreed to be good in consultations (p 576). The authors examined 26male and 14female doctors in 373consecutive consultations and found that male doctors used as much cooperative language as the female doctors, suggesting that “the professional role of the doctor may override the gendered characteristics of speech style.” Women may be from Venus and men from Mars, but general practitioners perhaps come from some other planet altogether. Uranus?


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