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10.6 am

Mr. Roger Sims (Chislehurst): My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) has performed a signal service by bringing this matter to the attention of the House and ventilating it publicly. I congratulate her on her success in obtaining the debate and on the manner in which she has presented her case. The House will be aware that I am a lay member of the General Medical Council and, in accordance with our rules, I should declare an interest in that I receive from the GMC a modest fee in recognition of my work as a lay screener.

My hon. Friend has illustrated effectively the dilemma facing any hospital trust when a complaint is made about a doctor, particularly when it reflects on his professional ability. Clearly, if a complaint is made, the trust--the doctor's employer--will be open to criticism if it suspends him immediately, particularly if what follows is a saga such as that outlined by my hon. Friend. Equally, it could be open to criticism if it did not suspend a doctor about whom complaints had been made. My hon. Friend the Member for Lancaster (Dame E. Kellett-Bowman) mentioned a case, with which I am familiar, which demonstrates that point.

If a doctor were found to have performed a certain surgical procedure or taken some medical steps with serious consequences and it were found that complaints had been made about him previously and nobody had done anything about it, the trust could find itself open to criticism. There is a difficult balance to be struck.

Dame Elaine Kellett-Bowman: The doctor to whom I referred was under suspension, but was practising as a locum.

Mr. Sims: That is a further dimension. Although things have improved a bit, a doctor can be suspended from one

31 Jan 1996 : Column 924

hospital and then offer his services elsewhere. If that new hospital does not make some inquiries about the doctor, what follows may be similar to what my hon. Friend the Member for Lancaster described.

A doctor may be suspended quite unexpectedly from his point of view, as he may believe himself to be completely innocent. The complaint may be without any foundation, so the suspension would be extremely distressing for him and his family. It is literally a waste of money because he is being paid for doing nothing. In addition, the hospital and the local community are deprived of his skills while he is suspended.

The main issue is how long it takes to resolve the matter when a complaint has been made and a doctor suspended. My experience is that it is by no means uncommon for it to take 18 months or even two years. Why? We can draw some comparisons with the time that it takes the police to make inquiries in civil and criminal cases. It often takes many months before the matter can be brought before the court. Why does it take that long?

A hospital may receive a complaint from a patient or a patient's relative that may be of such a serious nature that it feels it has to suspend the doctor. The hospital will want to pursue the matter. It will ask for further details about the complaint and then put the full complaint to the doctor, who will have the opportunity to respond. The complainant is given the opportunity to comment on what the doctor has said. An inquiry panel must then be assembled at a time and place convenient to all concerned. I accept that going through those procedures could take some time, but surely not a year, 18 months or two years.

When the panel has heard the evidence, it may conclude that the doctor is innocent and he will be cleared of the charge. However, if it decides that the complaint is justified in some respect, it may decide to punish the doctor. He may then wish to appeal against that decision--a process that can take a very long time indeed.

The problem is that that is not the end of the matter; there is a further dimension. The panel will make a judgment on the extent to which the doctor has failed to comply with the terms of his contract. A similar process applies to general practitioners. The decision will affect the doctor's professional standing. If the original complaint involved negligence--if there is any question about his medical skills--there may have been some justification for suspension. However, if it was an administrative matter, such as some of those referred to by my hon. Friend the Member for Edgbaston, I would find it extraordinary if the doctor were suspended.

If the hospital trust finds the doctor at fault and raises doubts about his professional competence, there is a virtual double jeopardy because the papers will be sent to the General Medical Council, which must then decide whether that doctor should be allowed to continue to practice or whether there should be an inquiry, possibly leading to suspension or even to his name being erased from the register.

Not only is that doctor suspended, not only is he is being paid for a job that he is not allowed to do--which must be extremely frustrating and demoralising for him--but he knows that at the end of the local process he may have to appear before his national body--and that could lead to serious consequences.

For most employees, employers deal with problems through admonishment or even by giving someone the sack. At least those employees can then try to get other

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jobs. For a doctor, however, that is not the case, as he may have to appear before the GMC and he may be suspended or even have his name erased from the register. He will have lost his livelihood. We must be aware of the serious consequences that can follow a charge of negligence.

In my capacity as a lay screener, and because I sit on the GMC preliminary proceedings committee, I deal with a number of such cases. It is quite unfair on a doctor to bring him to account for incidents that happened three or four years ago. Part of the reason for the delay is that it takes a long time to go through the process described by my hon. Friend and then through the appeal procedure, which is far too protracted. I hope that my hon. Friend the Minister will take that on board and take action to expedite the whole process.

I fully accept that the interests of the patient are paramount; we must ensure that only competent doctors serve patients. However, we must not forget the interests of the doctor, who must have a fair crack of the whip. I hope that my hon. Friend the Minister will feel able to do something about the problem.

10.16 am

Mr. Simon Hughes (Southwark and Bermondsey): I welcome the initiative of the hon. Member for Birmingham, Edgbaston (Dame J. Knight), who was kind enough to brief me yesterday on the range of her concerns. The overall matter is very important, as are the legal issues that it raises. The hon. Lady pointed out the apparent contradiction with European law in that in theory a doctor is in practice, but cannot practise because he has been deprived of the ability to do so. That raises proper legal issues.

I want to suggest to the Government a way to deal with the problem. I shall first make a point that widens the issue--there are parallels elsewhere. I do not do so in any arrogant way; I want to help in the process of finding a way forward.

The case has been made. The hon. Lady cited the most horrendous examples. No one in the health service, the health authorities or any other walk of life undervalues the significance consequences for an individual who is suspended but then later found fit to carry on. It is difficult to unwrite that bit of employment history. That applies not only in the health service, but in other parallel public services.

One point that the Minister might consider is the apparent non-compliance with the guidelines. The hon. Lady said--I have no reason to doubt her--that no trust has complied with the rules. The Department needs to deal with that speedily.

Similar issues in the public domain have arisen in two or three other professions. First, there have been well-reported cases of police officers being suspended because of allegations made over long periods. Secondly, teachers are often suspended for lengthy periods after allegations, often serious and worrying, by pupils. It may be a long time before the individual can return to teaching. The rumour, speculation or allegation may be made public, and the teacher's career may be severely damaged as a result.

I declare an interest in relation to the teaching profession. I have discussed the matter with the Association of Teachers and Lecturers--a teaching union

31 Jan 1996 : Column 926

for which I act as a consultant and which, as with the hon. Member for Chislehurst (Mr. Sims) and the GMC, pays me a small amount for my advice. It does so also for some Conservative Members.

Mr. Deputy Speaker (Sir Geoffrey Lofthouse): Order. The House is debating hospital doctors.

Mr. Hughes: The parallel that I have drawn with teachers is relevant to the hon. Lady's case, and I will suggest a way forward that applies to them all.

Perhaps the Minister could consult on the use of employment law. The matter may ultimately be for the Department of Education and Employment. If the problem ranges more widely than trusts and the health service, there should be another way of dealing with it. It would be nonsense to have one system in the health service and a different one for other public services, such as local authorities and the police.

The hon. Member for Chislehurst spoke of reviews. If the Crown Prosecution Service or another authority takes too long to process a case, it is called before the magistrate to report progress. When a suspension occurs a court or, more appropriately, an industrial tribunal should have the power or be required periodically to consider the evidence from all the parties. If an individual were suspended today, for example, it would be his automatic right to have the state of the investigation regularly considered by an external person, beginning in one month's time. The suspended professional should be able to say, "I am being kept out of my job. Nothing is happening quickly. What is going on?", and an objective third party could say, "You're right. This is unacceptably slow." That third party could lay down a timetable and rules to govern the investigators.

Fundamental to the hon. Lady's case is a guarantee that the persons considering disciplinary action are entirely independent. In registered nursing homes, a disciplinary suspension and the adjudication on the individual's ability to continue in employment can be dealt with by the same people, which is entirely inappropriate. Of course the adjudicators can take evidence from the individuals who enforced the suspension, but the adjudicators must be independent and be seen to be independent. An external element may also be needed.

The House has just dealt with the final stages of a Bill to improve the procedure for health service complaints. It is unlikely that any of the hon. Lady's proposals can be incorporated in that measure. However, that Bill has just gone to the other place. It may be appropriate for any possible amendment that can quickly be made to be incorporated in that Bill. At most, that can accomplish only some things--the issue is much wider. I hope that the Minister will deal with action that can be immediately implemented by his Department, but it may be for the Department of Education and Employment to examine the issues as they apply to all professions across the range of public service.

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