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The BBC's Niall Dickson responds to your emails

 real 28k

Friday, 16 June, 2000, 11:49 GMT 12:49 UK
How can the NHS restore your trust?

An inquiry has been launched into how a UK pathologist continued working despite making hundreds of mistakes.

More than 200 cancer patients may have been wrongly diagnosed by the same doctor - one woman even had one of her breasts removed by mistake.

Dr James Ellwood stopped work last year and therefore cannot be punished by the General Medical Council, whose role in policing the profession is increasingly under question.

The case is the latest in a series of scare stories to hit the National Health Service and coincides with the unveiling of a new government proposal aimed at rooting out bad doctors via an "early warning system".

But will the government's action be enough to restore people's faith in healthcare professionals? Send us your views and experiences. HAVE YOUR SAY

Most of us still consider it a real privilege to be a doctor and obtain enormous satisfaction from it

Dr D, UK
This pathologist made seven serious mistakes over a career of 30 years or one every four years. That is remarkably good. I probably make one or two serious mistakes a year but because medicine is not an exact science, it is difficult to improve on this. The number of lives I save or help is far higher and it is this that keeps me in medicine.

Most of us still consider it a real privilege to be a doctor and obtain enormous satisfaction from it. To suggest that money is the driving force or that any mistake is somehow negligent, shows such little understanding, it makes me despair.
Dr D, UK



People in this profession who make one mistake should be sacked

Jay Linden, England
How many more people will suffer due to the incompetence of the NHS? This is totally disgusting, people in this profession who make one mistake should be sacked, as harsh as this seems they have to remember THEY ARE DEALING WITH LIVES, and not some office job. This is meant to be a profession to maintain people's health and not to CAUSE more illness whether physical or mental!!!!!
Jay Linden, England

My heart goes out to the doctors who tried their best, worked long and often unpaid overtime hours, and made genuine mistakes, at which they too were horrified. Isn't more ongoing training for doctors more useful than scape-goating individuals?
Jackie, UK

The NHS is under-funded, plain and simple. Bad workers in any field have no place in the NHS. Doctors cannot be immune from enquiry or scrutiny, but equally should not be blamed for poor services resulting from political decisions.
Fred, UK/USA



It's about time doctors and consultants received individual annual appraisals on their effectiveness to treat their patients

Martin, UK
It's about time doctors and consultants received individual annual appraisals on their effectiveness to treat their patients. Hospital Trusts have to produce "league tables" so why can't this be applied to individual medical staff? Maybe then the NHS can weed out poor performers and ensure that only those most competent are left to treat us.
Martin, UK

It's time to sack everyone who is guilty of substandard service and everyone who is in a leadership position within the NHS, including Tony Blair's shameless administration. Only after such a purge can confidence even have the chance of being restored.
Stephen Kenney, USA

Perhaps fewer mistakes would be made if the staff were getting enough sleep. I'm sure most experienced doctors have let a few avoidable deaths slip through.
Martin Thompson, UK

The more they diagnose accurately and prescribe appropriately the greater the confidence. Perhaps the Japanese are now the longest living because their diagnostic toilets are better than our professionals.
David de Vere Webb, UK



The NHS would be so much better if it was left to the medical staff to run things.

Neil, London
The NHS would be so much better if it was left to the medical staff to run things, managers don't know what individual departments do. Large payouts/salaries to managers/executives take valuable resources away from patient care, i.e. some are getting 250,000+ and why doctors/other department are being told every year to reduce expenditure.
Neil, London

Personally, I think the N.H.S is a disgrace. We have the lowest clear up rate for cancer in Europe; and indeed when both Britain and France were gripped by a flu epidemic but it was the British NHS that failed its people. We must move on from this juvenile debate about our NHS being the envy of the world and the socialist dogma of "free at the point of use" when patients are dying of diseases like cancer when they cannot get modern medication. A more sensible approach is needed where the health service is paid for by more than general taxation
Peter, UK

I wish people would stop whinging about the NHS. We have among the best healthcare in the world. I also think consultants should be respected in the way they are just now as it helps keep order in the workplace, if they were to lose their "godlike" status there would be more conflicts with less qualified staff. I wish the media would make more fuss over the commonplace violent crime in this country than the extremely isolated incidents of "killer doctors" then the government may do something about it. Now that would win my vote.
Mark Fullerton, UK



The "blame and shame" culture serves the interests of no-one except the legal profession.

Stephen Macdonald, Scotland
Is it a coincidence that the current media frenzy over a handful of under performing doctors comes at a time when the government is attempting to blame all the problems of the health service on those working in it. It is a fact that in any organisation the size of the NHS there will be errors and poor performing individuals. The main problem of the NHS is poor systems where errors and poor practice can have such a devastating effect on patients. If more energy was devoted to improving systems and less on blaming unfortunate individuals within the service who happen to make a mistake the better the NHS will be for those who use it and work in it alike. The "blame and shame" culture serves the interests of no-one except the legal profession.
Stephen Macdonald, Scotland

I am a GP who is very concerned about the possibility of a witch-hunt amongst doctors.
Angela, UK

The NHS has been ignored and under-funded for too long. Health has for years been at the top of parties' electoral agendas, but the Health Service itself remains at the bottom of their 'To Do' lists. Cases like this demonstrate that you can't make a silk purse out of a sow's ear, and it's time for us all to accept that there is no 'magic formula' whereby we can do so, and have top-level public services and minimal taxes. This doesn't mean simply throwing money into the existing structure, but using funds to restructure and rebuild. If we want a NHS to be proud of, we have to pay for it.
Alex Steer, UK



Personally, I think the NHS is great. When I return I would pay more and never complain about it ever again

Mark, USA
Personally, I think the NHS is great. When I return I would pay more and never complain about it ever again. We are lucky to have such a service. It's just underfunded. We have recently had a baby here and it was a dreadful experience. We waited 3 hours to initially see a doctor. Drugs weren't covered by insurance and a nurse would only come by every 3 hours.
Mark, USA

How can my trust be restored? It can't. I've got private health insurance. I'm lucky to be able to afford it. However, my family comes first and that means not letting them go anywhere near the NHS.
Alex, UK

In response to Malcolm McCandless' letter, the NHS is not crumbling now. It's been crumbling for years, maybe decades. The only difference now is that we get to hear about it more often. Just like the crime figures, it's no worse now, we just hear more about it. NB I work in the NHS (not as a doctor) and I'm much more hopeful about it now than I was 5 years ago.
Alan, UK



The idea that doctors are gods has to go. Doctors are people like every other working person - they offer a service for money

Pat, USA
The idea that doctors are gods has to go. Doctors are people like every other working person - they offer a service for money. No more, no less. If they are found to be incompetent, they should be fired, along with everyone found to be involved in covering up that incompetence.
Pat, USA

The only pertinent question in this sad episode is why these incompetent doctors were allowed to carry on for as long as they did.
Ubong Effeh, UK

When the government tries to save money when they should be spending more on health, then doctors are overworked and under too much stress. Mistakes happen. They are highly educated professionals worthy of respect but they are human.
Vivien Cooksley, UK/Austria



To restore my confidence would require major surgery

Ken Beach, Germany
Just prior to returning from holiday in England, once again we had experience of waiting hour after hour for help with a long-standing knee problem, and drove away from the hospital wondering just what the NHS problem is.
Painkillers had been prescribed for someone who hadn't managed to eat for a week by doctors who simply didn't have time to listen. To restore my confidence would require major surgery.
If there really are too many managers, remove them (unbelievably the German system is less bureaucratic), but if you want a European quality of service, you are going to have to pay more for it, and over a long period of time. I fear the 'system' will prevent the change necessary from ever happening.
Ken Beach, Germany

I am more interested in how these cases all suddenly come out of the woodwork at once just in time to divert attention away from New Labour's latest PR gaffe. What else is in the closet for later?
Paul, UK



It is not simply a question of throwing more money at the NHS, but ensuring that staff are aware of their moral responsibilities

Deborah, England
Only by the setting up of a truly independent body, monitoring and preventing further medical mistakes and incompetence, can trust ever hope to be restored.
It is futile to slap a consultant on the wrist at a GMC hearing then retire him/her on an NHS pension. If more punitive action was taken perhaps it would stop the rotten apples (which appear in all professions) wreaking devastation on so many patients.
Furthermore, it is not simply a question of throwing more money at the NHS, but ensuring that staff are aware of their moral responsibilities and do not turn a blind eye to the malpractice of their peers.
Deborah, England

Britain is not a poor country. We can afford the NHS we all want. Consultants who work one day a week in the private sector should not also be paid by the NHS for that day.
Nick, UK



It is high time that we all appreciated the fact that doctors are not rogues, that the huge majority work very hard and that they are mortified whenever they do make a mistake

M Hay, UK
The unfortunate pathologist who is now being vilified by the media missed 230 diagnoses out of 10,000 cases, giving an error rate of 2.3%, or two patients out of every hundred. How much more accurate should he have been? Had he been right 99% of the time he would still have had 100 misses and we would have been hearing sob-stories about individual patients who had been incorrectly treated.
I have great sympathy with patients who are wrongly diagnosed (I might even be one myself one day), but we are dealing with an inexact science and with ordinary, mortal human beings (not Gods, as we have been accused of being) and it is high time that we all appreciated the fact that doctors are not rogues, that the huge majority work very hard and that they are mortified whenever they do make a mistake.
M Hay, UK

While no-one can condone unsafe medical services, it is hard to see how a computer system can prevent further cases. A computer can, at best, permit earlier identification of errors, as there must be a time-lag between the time of diagnosis and the eventual discovery of incorrect diagnosis of a patient's condition.
A computer can also record the details of all the patients who consulted a doctor for a particular condition, to assist in quickly contacting other patients who may have been misdiagnosed, but the computer cannot provide a "second opinion".
Doug, Netherlands



It is time for much more openness and transparency

John, UK
The General Medical Council is toothless. This latest scandal comes on top of the controversial "do not resuscitate" cases where consultants and management have been regularly permitted to ignore guidelines.
The GMC should bring its re-training programmes into line with other professions in order that medical practitioners can be kept up to date and re-assessed regularly. We also need a newly appointed body to undertake independent inspections, perhaps similar to offsted which inspects the teaching profession.
It seems incredible that the medical profession is allowed to police itself and the NHS Trusts created by the Tories are nothing but new business bureaucracies going out of their way to avoid litigation and liability at all costs. With the NHS consuming vast amounts of public funds each year, it is time for much more openness and transparency.
John, UK



Speaking as an NHS consultant, I feel very strongly that something needs to be done to catch poorly performing doctors

Brian, Scotland
Speaking as an NHS consultant, I feel very strongly that something needs to be done to catch poorly performing doctors. I seriously doubt whether a centralised database is the best way. We haven't (yet) been told how the cases entered into this database will be selected. It's fairly plain from recent high profile media cases that critical self-analysis and humility can't be relied on. It must therefore come down to doctors watching other doctors or some other mechanism for catching adverse events.
Brian, Scotland

One of the biggest obstacles to overcome in this area, as in others such as the GM food debate and the global warming debate, is the arrogance of the professional, and the unwillingness to admit that they might be wrong. Professionalism is one thing, narrow-minded bigotry and pride is another.
Richard F, UK

An apt expression comes to mind when considering the NHS' woes - "You get what you pay for".
R. Armstrong, UK



It's about time we stopped the 'Gentleman's Club' approach to our medicine and conducted affairs in the open

Mark Dickinson, England
Why does this surprise anyone? Since the foundation of organised medicine in this country, the elite have banded together and looked after each other. They cover the tracks of those who commit these crimes and allow rogues to escape with impunity.
It's about time we stopped the 'Gentleman's Club' approach to our medicine and conducted affairs in the open. If not we leave ourselves open to more of this abuse in the future.
Mark Dickinson, England

A computer based tracking system which monitors doctors diagnoses should hopefully identify incompetent doctors before they build up an alarming number of cases. This will also make it easier for independent third party review of performance rather than relying on a hospital's own checking system, which could give a colleague and friend the benefit of the doubt. I feel however that it is impossible to eradicate incompetence totally.
Duncan, UK

Too little, too late. The NHS is crumbling before our very eyes.
Malcolm McCandless, Scotland



Strategic investment, with assistance from the private-sector is much needed

John Elliott, France
Turning around the NHS is by no means an easy task. The cost and planning to ensure a structured reform of the nation's health service is necessary. Strategic investment, with assistance from the private-sector is much needed. Rapid reform would not ensure long-term stability for the NHS. Pay increases, better conditions and incentives for hospital staff are all vitally important issues that need to be addressed.
John Elliott, France


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13 Jun 00 | Health
Plan to stop dangerous doctors
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