House of Commons
Wednesday 31 January 1996
The House met at half-past Nine o'clock
PRAYERS
[Madam Speaker in the Chair]
Medical Misconduct
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Burns.]
9.34 am
Dame Jill Knight (Birmingham, Edgbaston): It is now 10 years since a constituency case alerted me to the need for changes in the way in which doctors are dealt with in cases of suspension for alleged medical misconduct. Since then, I have raised the issue three or four times in the House. Action has been taken, although, as I shall seek to demonstrate, regrettably it has not solved the problem.
A lady came to my constituency surgery. She was gentle, apologetic, nervous and tearful. She was clearly stressed and told me that her husband was a consultant anaesthetist at the Queen Elizabeth hospital. He had been suspended and accused of medical negligence. She was upset because he was being paid his full salary, but was sitting at home and doing absolutely nothing; he was not allowed to do anything. She said that he was clearly upset because he had no wish to take money that he was not earning. On the other hand, bills had to be paid. It was not possible not to take the money, but it upset both of them greatly. That situation had been going on for18 months.
I wrote to the health authority about the case and received a guarded response. I wrote again, and another year went by. Eventually, at the end of all that, he was found to be innocent of all charges. Meanwhile, his wife had died.
That doctor was most unjustly and wrongly treated, and his case is not unique. Other doctors are and have been in a similar position. I am worried about the injustice that they have suffered. I am also worried about the money that has been wasted paying them--money that could certainly have been better used by the national health service. Of course it is right that if people are suspended and there is nothing proven against them they should be paid. However, that does not solve the problem. I am worried about the waste of the state's huge investment in training those doctors in the first place, let alone the extra training for consultants. The doctors about whom I am talking today are or have been consultants.
It is perfectly true that the number of such cases is not huge, but I am sure that the House will agree that even one case is too many. Of the 101 cases of which I am aware, only 16 were found to be justified. That means that 85 doctors have been unjustly put through that hell, and it certainly is a hell. The resulting stress is severe, and it has four major sources. One source is the length of time that the cases take. I have cases on record that have lasted
anything from two days to 11 years. The mean length of time to resolve them is two and a half years. In three cases, the doctors involved died while suspended, before their cases could be resolved.
In another case, the dispute dragged on for so long that the doctor reached retirement age before it was fully resolved. Although the disciplinary inquiry fully exonerated him at that time, and he was still below retirement age, the employing authority refused to give him his job back.
One doctor had to go to court a year after his suspension commenced to discover why he had been suspended. I was surprised to find that it is not uncommon for another set of allegations to be made if the first looks likely to fail. One doctor had to prepare defences for no fewer than four different successive allegations made over a long period before the authority decided to withdraw all the charges against him. One can only imagine what he went through during that time. I remind the House that justice delayed is justice denied. Something must be done to shorten the long periods during which the accused man or woman is under an extremely serious cloud.
The second reason for stress is the effect that such happenings have on a doctor's career. I have pointed out that it takes two and a half years on average to clear up such accusations, which is a huge chunk out of any medical career. I doubt whether any doctor could get back on the career ladder at the place where he or she would have been if the allegations had not been made.
Dame Elaine Kellett-Bowman (Lancaster):
Myhon. Friend is referring to extremely honourable people, most of whom were exonerated. However 16 doctors were not exonerated, and what if one of them were to work as a locum, as one did in the north-west? Nobody knew that the doctor had been suspended, he secured successive jobs and he proved to be an absolute menace.
Dame Jill Knight:
I hold no brief for anyone who practises medicine after he or she has been found guilty of professional misconduct.
Dame Elaine Kellett-Bowman:
It was before.
Dame Jill Knight:
The same applies to any doctor who practises when he or she is suspended. I hold no brief for any of those 16 doctors: I am not pleading the case of doctors who should not be practising. Like myhon. Friend, I deeply regret the actions of the doctor to whom she referred. That was clearly wrong--particularly if that doctor was receiving full pay, which is the standard practice, during his suspension.
According to my findings, only a tiny minority of doctors are found guilty. Therefore, it is not unreasonable to draw the attention of the House to the injustice suffered by the majority. I understand perfectly that some individuals are very difficult to work with--that happens everywhere. There is no committee, office or school which does not have a member or an employee who could be described as an awkward cuss who does not get on with his or her colleagues. We have all had experiences of that nature, but it is not right to pillory the person who does not fit. Doctors should not be pilloried on the grounds of medical incompetence when no such incompetence exists and they should not have to face trumped-up charges.
The third reason for stress is the cost of defence. The present disciplinary procedures are based on three national health service circulars. They define the categories for disciplinary action as: professional incompetence, professional misconduct and personal misconduct. The classification vitally affects the composition of the disciplinary tribunal panel--for example, whether there is a doctor on the panel and whether the existing professional defence organisations will assist the accused.
Although in their promotional literature such bodies promise to assist in all cases of employment dispute, it does not work out that way. One doctor was forced to pay £10,000 to defend himself successfully against allegations of professional wrongdoing. In that case, the defence body wrote that it was "not minded to help". Another doctor spent about £40,000 refuting allegations, while a third spent more than £50,000 attempting to refute trumped-up allegations. That money is not recoverable and, as far as I am aware, it is paid after tax. There is no right of independent appeal in cases of personal misconduct.
The fourth cause of great stress to doctors is the appalling stigma associated with suspension. In the constituency case that I mentioned at the beginning of my speech, the wife died--perhaps as a result of the shame, the upset and the worry of that situation. One suspended doctor made a very telling comment. He said:
It is also true that the more conscientious and self-critical a doctor is, the greater his demoralisation. Doctors' professional and social standing is undermined. Such people are usually pillars of their society; they are well known and respected. They are probably members of local clubs and they enjoy a certain position in society. When the rumour of their suspension circulates, their position in society alters immediately and the stigma is terrible. They are ostracised, even though they are almost certain to be found innocent. People say that there is no smoke without fire and that there must be something in the allegations, but, if we use a little imagination, we can appreciate how hard it must be for such doctors and their entire families.
There is no better example of that than the constituency case to which I referred. Wrongly suspended doctors frequently suffer permanent ill health, and three doctors have committed suicide. Even when completely exonerated and compensated financially, very few doctors are able to come to terms with their treatment. Even after many years, they cannot let go. A core of deep resentment is established and it contributes to a serious depressive state. The cases have been checked and documented; I assure the House that I have studied the matter very carefully.
I do not know whether hon. Members are aware that all suspended doctors are locked out of their hospitals and that they could also be denied NHS treatment at those hospitals. One suspended doctor who suffered a cardiac arrest and was admitted as a patient to the intensive care unit of his hospital--perhaps his heart attack was caused by his circumstances--was transferred to another hospital because he was told that he was an embarrassment. I think that that is appalling.
"The hammer blow of suspension is utterly demoralising. One's confidence and trust in one's professional ability and eventually one's own self-esteem is severely undermined".
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