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GMC gets tough to improve patient safety

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    Recent changes in the law and a new GMC consultation suggest that patient safety is becoming an ever more important priority. Simon Elliman considers the implications

    By Simon Elliman

Two recent developments show that the GMC is increasing its powers to protect patients. In June 2014, a change in the law empowered the GMC to check the language skills of licenced doctors in the UK. In August 2014, the GMC announced proposals to impose tough sanctions on doctors who have committed serious clinical errors, even when they have successfully retrained and improved their practice.

It is always pleasing to see some serious attention being paid to patient safety, and these recent developments suggest that this is precisely what is happening.

The importance of good language skills

Patients may tend at times to veer towards racism when they have difficulty understanding their doctor’s accent, but there is an important issue here; a doctor whose grasp of English is insufficient can neither take an adequate history from a patient, nor provide an adequate warning as to the risks of an operative procedure, to take but two examples of key medical skills. A failure in either of these areas could easily lead to a poor outcome for a patient, and potentially a finding of medical negligence.

The GMC has made a number of changes to its own rules and guidance, so doctors are aware of their duty to have the necessary knowledge of English to treat patients safely. These changes include:

–    Increasing the minimum score accepted on a recognised academic English language test
–    Introducing English language assessments into its investigations to be made if concerns about a doctor have been expressed
–    Establishing a new ground of “impairment” where there are shown to be issues with a doctor’s ability to read, write or comprehend English

Tougher sanctions

Few would argue that insisting on a minimum level of competence in the English language for doctors is controversial, but the GMC’s more recent proposals have caused some consternation within the medical profession. The three key areas of proposed reform are:

–    Giving the GMC the power to impose sanctions for serious clinical errors even if the doctor in question has successfully retrained and improved his or her practice
–    Giving the GMC power to require doctors to apologise
–    Giving the GMC the power to impose more serious sanctions on those who fail to act as “whistleblowers” when they should

The question being raised by some is why the GMC should be concerned with imposing sanctions for past behaviours when its primary role is to improve standards going forward. However, when you look at it from the injured patient’s perspective, it is easy to see why a refusal to impose a sanction on a doctor who has harmed a patient, simply because he has improved his practice and is now less likely to harm another one, does not sit easily with the patient already harmed.

Again, in my experience as a clinical negligence lawyer, it is not uncommon to find a marked and stubborn refusal to issue an apology for poor care, even when negligence has been established in some cases. Further, there is more than anecdotal evidence that an early apology makes subsequent litigation less likely. I would therefore also firmly support the second proposed power.

As for the sanction on “whistleblowers”, I would argue that this is clearly necessary. One only has to remember the pariah status inflicted on whistleblowers during previous scandals, such as the Bristol heart babies debacle, to appreciate that a shift towards demonising the opposite conduct (“turning a blind eye”) is required.

Reaction

In my view the GMC is demonstrating that it is responding to the public mood, and placing itself in the shoes of patients rather than doctors, in these recent developments. This is to be applauded, since it will reduce the likelihood of medical negligence occurring, and improve the experience of most patients.

If you or a member of your family has been affected by medical negligence then you should contact a member of the Clinical Negligence Team who will be very happy to discuss the issue with you.

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