Why the NHS’s checks to root out the next Dr Shipman are useless
HOW rogue surgeon Ian Paterson was able to get away with his atrocious behaviour for so long is a question that many have asked this week.
The surgeon, who worked in the NhS and privately, has been convicted of carrying out completely unnecessary operations on men and women after convincing them that they were at risk of cancer when, in fact, they were not.
Lawyers believe he may have carried out thousands of botched or unnecessary procedures over 15 years and compensation payouts so far have already cost the NhS more than £18 million.
But why wasn’t he stopped sooner? I’m afraid the answer lies largely in a grotesquely inadequate system that is meant to keep the public safe from rogue doctors.
every one of Ian Paterson’s victims has been let down by a system of checks that’s not fit for purpose. The General Medical Council — the body that regulates doctors — and the politicians who introduced the scheme should hang their heads in shame for the shocking failure in their duty to protect patients.
The system was introduced after the 2005 inquiry into the Greater Manchester GP harold Shipman who murdered at least 215 victims over 25 years, making him the most prolific killer in British history.
It was designed to prevent another Shipman, but the scheme now in place — whereby doctors submit themselves to a yearly ‘ appraisal’ and five- yearly ‘revalidation’ — actually makes it easier for dangerous people such as Shipman and Paterson to practise.
These tests not only fail to weed out bad, dangerous or rogue doctors — psychopaths are very good at jumping through bureaucratic, box-ticking hoops — but also instil a false sense of security that patients are safe.
The yearly appraisal process involves demonstrating that we have been on a long list of courses and have attended lectures and teaching sessions to ensure our medical knowledge is up to date.
We have to complete a mammoth series of online forms, full of infantile questions about how dealing with difficult patients made us feel, which are then counter- checked in a meeting with a senior doctor.
Meanwhile, we’re trusted to report faithfully any complaints against us — without anyone having to check whether our version of events is true!
For ‘revalidation’ we all have to ‘reflect’ on how we feel and how patients feel about us. We are required to write thousands of words of utterly meaningless touchy-feely guff.
I’ve just gone through revalida- tion myself and it’s a complete farce. I have no objection to doctors having to demonstrate that they’re keeping up with current medical knowledge, or being tested and evaluated to ensure that we’re safe. BUT in my experience,experience some of the worst doctors — ones I wouldn’t want to care for my goldfish, let alone a patient — have passed their appraisals with flying colours.
Meanwhile truly wonderful doctors, who dedicate their entire lives to their patients, have been pulled up because they haven’t been on a training course on how to wash their hands, or something equally ridiculous.
The fact is that the harold Shipmans of this world — the ones the test was specifically designed to spot — excel at these exercises. Police reports show Shipman was loved by his patients. In court, Paterson was described as ‘charming’ by the victims he butchered.
But the brilliant, dedicated and caring doctors, who realise that all of this management-led procedure and gushy nonsense is pointless,less put it off until the last minute and scrape through by the skin of their teeth.
A friend of mine was working for a world-renowned specialist in gynaecological cancer, a dedicated, passionate clinician universally regarded as excellent.
Yet she failed her revalidation and had her clinic suspended because she had failed to complete part of her form about her career ‘plan’.
She had reasoned that, as a recognised world expert, she didn’t need to plan her career — she just wanted to keep doing the Picture: ALAMY same thing she had done for the past 30 years. But she couldn’t practise until the form was completed.
These tests aren’t about ensuring that patients are safe. They’re pointless forms administered by myopic apparatchiks. Doctors have a unique position in society and patients need to know that they can trust us absolutely.absolutely
But Ian Paterson’s case shows that trust has been woefully betrayed as a result of a medical establishment that puts political gestures before patient safety.
And I fear that Jeremy hunt’s announcement of an investigation into this recent scandal will only make things worse. Of course an investigation is essential, but I worry about the knee- jerk response from politicians keen to be seen ‘doing something’ to weed out bad apples. We’ve been here before and it doesn’t work.