Reports > The Fifth Report > CHAPTER FIVE - Developments in the Arrangements for Monitoring General Practitioners since 1998 >
Introduction
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5.1 |
In May 1997, a new Government came into office. These were difficult times for the NHS. Concerns about the high mortality rate among children undergoing complex heart surgery at the Bristol Royal Infirmary had become public knowledge by 1995. It was known too that senior staff at the hospital had been aware of problems for some time and had taken no action. Three doctors were charged by the General Medical Council (GMC) with serious professional misconduct (SPM). Hearings began in October 1997 and ended with all three being found guilty of SPM in June 1998. |
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5.2 |
In December 1996, Rodney Ledward, a consultant gynaecologist, whose lack of skill had caused injury to many of his patients over a period of 15 years or so, had been dismissed from the hospital at which he worked. His case came before the GMC in September 1998. He too was found guilty of SPM. There had been complaints and concerns about his conduct and competence over a long period, yet he had been allowed to continue in practice. Also in September 1998, Shipman was arrested and it soon became clear that he might well have killed a large number of his patients over many years. |
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5.3 |
These events, and other less high profile incidents, focussed public attention on the adequacy of the arrangements then in place for identifying and eliminating incompetent or aberrant clinical practice. Those arrangements had patently failed to protect the patients of Ledward and Shipman, and the children who had undergone surgery at Bristol. It was evident that change was urgently needed. |
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5.4 |
The subsequent years have been a period of great change for the medical profession and the NHS. In the field of general practice, there have been significant developments in the role of primary care organisations (PCOs). They have been given additional powers which should enable them to exercise a far greater degree of control than before over the general practitioners (GPs) on their lists. In addition, they have been developing ways to improve the quality of care and to deal with doctors who are not providing an acceptable standard of care. In this Chapter, I shall describe the developments that have occurred and consider how they are working in practice. |
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CHAPTER FIVE - Developments in the Arrangements for Monitoring General Practitioners since 1998
