Examination of Witnesses (Questions 40-43)|
THURSDAY 7 FEBRUARY 2002
40. On that point about doctors making lots
of money out of people's ill health, what about cosmetic surgery
and so on? Where do people go if they have a complaint?
(Sir Michael Buckley) If it is under the NHS, then
cosmetic surgery is just as much within the jurisdiction as anything
else. If it is purely private, the private sector is establishing
some complaints procedures of its own. There may, of course, be
recourse to the courts, and finally the National Care Standards
Commission does have the remit of considering care right across
the whole of the health sector, irrespective of whether it is
public or private.
41. So there is a multiplicity of organisations,
therefore people out there must be totally bemused. Would you
agree with that?
(Sir Michael Buckley) Indeed so.
42. Can I move on to the question of clinical
negligence and what discussions you have had with the Chief Medical
Officer about this, whether it is difficult to make progress because
doctors band together, stonewall, to protect their interests?
(Sir Michael Buckley) The Chief Medical Officer has
set up an advisory committee, and I am a member of that committee,
so I am involved in the discussions. I think it is entirely a
matter for you to ask the Chief Medical Officer whether he is
satisfied with the rate of progress and what difficulties there
may be. What I have suggested within the context of both this
and changes in the complaints procedure is that it seems to me,
and it always has seemed to me, that there is, so to speak, a
spectrum of complaints from the really quite triviala classic
example is the temperature of tea on the wardsright through
to very serious clinical negligence cases, particularly obstetric
cases, when one may well be looking at damages in seven figures.
Clearly, at the lower end the normal complaints procedure is fine;
at the other end, I think it has to be a matter for the courts.
When one is looking at the middle, I think the present situation
is not satisfactory, and what I would prefer to see is a greater
ability within the NHS complaints procedure to pay financial redress.
One of the things, to be fair, since I have spent quite a bit
of time criticising the Government, where I think central government
has made considerable progress in the last ten years or so is
a greater willingness to pay redress for maladministration. This
Committee's predecessor studied that, and the attitudes which
were expressed at the time of that study in 1992 were very different
from those that there are now, and it seems to me that if central
government, and indeed local government, can set up systems which
will allow the payment of modest financial compensationwe
are not talking about huge sums of moneythat would help
to remove some of the problems. We know that some NHS chief executives
do pay maladministration compensation in what they regard as appropriate
circumstances, but I think their task is made difficult by the
fact that they are always having to look over their shoulder at
the auditors, and the fear that they may be getting out of line
with general practice in the NHS. If there were some sort of code
of practice, such as the Inland Revenue have, which would give
guidance on this sort of thing, it would be of considerable benefit.
43. There was a feature on the Today programme
on the radio this morning about GPs whose patients had refused
to have the MMR vaccination. Here were GPs who were striking patients
off their list because they had not accepted the MMR vaccination
and therefore they were in danger of losing their £2,000
bonus for meeting their target for getting vaccination rates up.
Is this not outrageous? Secondly, if someone complained to you,
could you do something about it?
(Sir Michael Buckley) Only what I would do in any
other circumstances of striking off, which is to examine whether
it is reasonable. As I understand the guidance by the profession,
it is not acceptable to terminate a patient relationship simply
for financial reasons. So it seems to me that it is in fact contrary
to the guidance that the General Medical Council has issued. I
would not condone such behaviour if it were to be established.
However, one other aspect one has to consider is whether it is
sensible to set that sort of target.
Chairman: That is a fine point to end on. We
shall see you again shortly to continue this conversation. This
is the first half. We are very pleased to have you. You have said
some most interesting and challenging things that we shall reflect
upon as to how we can carry some of them forward with the robustness
with which you invited us to implicitly. We have had a very good
session and we will have another one shortly. Thank you very much
for coming along.