Doctors call for action on self-regulation

Could the case against Dr Janardhan Dhasmana have been avoided with better regulation?

By BBC News Online's Mandy Garner

Action needs to be taken to make the self-regulation of doctors more open and accountable according to the medical profession. This would help avoid cases such as the one in Bristol where two consultant heart surgeons and their boss have been charged with serious professional misconduct.

Professional bodies representing doctors agree that, unless the medical profession is more open and accountable, serious cases will only come to light through the action of whistleblowers - as it did in the Bristol case. And, it says, whistleblowers often don't get the support they need.

A recent paper by the British Medical Association, the Academy of Medical Royal Colleges and other medical bodies identifies several gaps in the self-regulation procedures.

More cash

One of the gaps is over adequate resourcing of the health service. The paper says the NHS needs enough cash to be able to afford to give doctors time off so they can learn about new techniques.

"The culture of lifelong learning in medicine must be supported by practical frameworks...There is little evidence that the NHS as an employer takes its responsibilities in this regard seriously enough," it says.

Ignorance

The organisations want clearer markers to be set down so that doctors can measure standards of care.

Mothers protest outside Bristol GMC hearing

And they say more should be done to alert doctors about self-regulation and how they should make complaints if they suspect a colleague is under-performing.

Few junior hospital doctors, for example, are aware of the local complaints procedure.

Doctors also fear victimisation if they complain about a colleague and they lack confidence that the complaint will be dealt with fairly or properly.

Accountability

"There is a need to address the issue of ensuring that professional self-regulation is open, responsive and publicly accountable," says the paper.

"This must include clear lines of accountability for monitoring professional and clinical standards and transparent and quick procedures to investigate any doctor about whom concerns are expressed."

Much advice already exists on self-regulation. For example, the General Medical Council published guidelines for doctor managers about how to deal with incompetent staff.

And the government's recent White Paper, The New NHS, urges the NHS to build on self-regulation systems.