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Dr Richard Smith and Sir Donald Irvine
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Saturday, 18 March, 2000, 11:12 GMT
Medical errors 'kill thousands'
Experts calls for health systems to be overhauled
As many as 30,000 people die as a result of medical errors every year, according to the UK's leading health publication.

The British Medical Journal is calling for a rethink of health care systems and training to cut the number of mistakes made by doctors to the low levels of errors among pilots or nuclear plant workers.

The editor of the BMJ, Dr Richard Smith told BBC Radio 4's Today programme: "Probably 20-30,000 people a year in Britain die of medical errors but then of course many more will be injured and suffer other consequences."

I think we have a culture in medicine which doesn't quite acknowledge that all these errors happen

Dr Richard Smith, BMJ
Dr Smith said the figure was extrapolated from an American study which suggests that about 100,000 US citizens die each year from preventable hospital mistakes.

That figure - which exceeds the combined number of deaths and injuries from car and plane crashes, suicides, falls, poisonings and drownings - has shocked the USA and sparked a public debate on how to reduce the number of incidents.

But in an issue devoted to medical errors and patient safety, the BMJ says Britain has yet to face up to the problem.

"I think we have a culture in medicine which doesn't quite acknowledge that all these errors happen," Dr Smith told the BBC.

"I don't think this is a failing just of doctors but of the people who run the healthcare system, perhaps of our whole society.

"The first step must be to recognise - as they have now in America - that we have a very substantial problem."

System faults

When mistakes happen - as with the recent case of surgeons removing the wrong kidney from a patient - there is a tendency to blame individual doctors.

But Dr Smith said research suggested this reaction failed to address the reason why the error was made in the first place.

"You have to think about the whole complicated system - in the way they have done already in aviation in order to reduce the number of accidents.

"Blaming individuals is often exactly the wrong way to go."

Recommendations in the BMJ articles include improving training in specific areas such as reading X-rays and investment in new technology to relieve doctors from some decision-making.

'Fresh thinking'

But the reports also stress a shift in attitude and culture within the medical community allowing practices such as a voluntary system for reporting errors where staff are not fearful they will be blamed.

President of the General Medical Council Sir Donald Irvine said it was "a complete fallacy" to think that doctors should be expected never to make mistakes.

"Medicine is a judgement-based discipline so it is inevitable. The question is not 'can error be abolished' - it cannot - the question is 'how can we reduce it as far as possible.'

"Fresh thinking is needed," he added.

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