Doctors should to be held to account for behaviour of colleagues, say MPs

BMJ 2011; 343 doi: (Published 26 July 2011) Cite this as: BMJ 2011;343:d4794
  1. Helen Jaques
  1. 1BMJ Careers

Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues, MPs have recommended.

In its first annual review of the functions of the General Medical Council, the House of Commons Health Committee has called for the regulator to send “a clear signal” to doctors that they are at as much risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part.

Senior doctors and clinical team leaders in hospitals would be most accountable, but there would be “questions asked of everybody,” said Stephen Dorrell MP, chair of the health committee.

“Every practising doctor and nurse knows that in addition to their obligation to care for their patients, they have an obligation as professionals to report to their professional body any concerns they have about the quality of care being delivered by their colleagues as a result of what they know or should have known,” said Mr Dorrell. “We look to the GMC to ensure that failure to act is regarded as a serious breach of professional obligation.”

The committee raised the example of Mid Staffordshire NHS Foundation Trust, where, according to the GMC, between 120 and 150 doctors would have known about the problems at the hospital but few raised concerns through the proper channels. Doctors whose own practice was blameless but who failed to act are now under investigation by the GMC.

Paul Flynn, deputy chairman of the BMA’s Central Consultants and Specialists Committee, said, “It would be contrary to natural justice to be held to account for something you genuinely didn’t know about, but perhaps those who stick their heads in the sand and deliberately don’t look for problems should be held to account for it.”

However, doctors should first report concerns to their local governance systems before taking the “quite significant step” of going to the GMC, he adds. “Something that gets as far as the GMC in terms of poor professional performance is evidence of a failure of the system,” he said. “There do need to be robust local systems that have got their early warning radar switched on.”

The health committee acknowledged that in some cases doctors who have raised concerns about their colleagues have been subject to suspension, dismissal, or other sanctions at the hands of their colleagues and has committed to examining this issue in more detail in due course.

The House of Commons is due to consider an early day motion on protecting NHS whistleblowers, who can be “silenced and sacked” for speaking out. A total of 18 MPs have signed the motion calling for a central unit to which clinicians can report concerns, including details of inappropriate disciplinary action by health employers.

The committee also highlighted the role of professionalism in maintaining standards and called for a culture change within the health service to create “intolerance of the second best.”

Mr Dorrell said, “In the end, the quality assurance method in a care system is not the regulator in London, it’s your professional colleagues around you that themselves know what good, professional care looks like and know that it’s their registration at risk if they tolerate second rate care going on around them. This wider responsibility for the overall quality of care delivered to patients is a part of what it means to be a professional.”


Cite this as: BMJ 2011;343:d4794


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