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Health and Social Care Bill

As a member of the medical profession, although it is a long time since I practised, I was quite pleased to see this measure in the Bill. There is a tendency for doctors to put themselves on pedestals and to feel that they are a bit different from other professionals, but when we were told by the BMA—especially in its first briefing—that it would not like to move to the civil standard of proof because, if found guilty, a doctor would lose his livelihood, that seemed to me a weak argument, because that standard applies to all other health professionals. To lose your livelihood is just as important to a nurse, a physiotherapist or a pharmacist as it would be to a doctor. I thought that the Bill would bring the medical profession into line with other professions and that we would be seen to be dealt with equally. I also thought that the civil standard of proof from the patient’s point of view—I hope that the Minister will correct me if I am wrong—allows other incidents and complaints to be considered when someone is before the panel to have their case heard. I may be wrong, but I believe that under the criminal standard evidence can be heard only on the incident that is being investigated and other complaints may not be taken into consideration. However, in cases where, for example, doctors are accused of molesting their patients and the complaint is dismissed the first time and maybe the second time and no one is quite sure about it, such complaints need to be taken into consideration. I hope that people will correct me on that or clarify the position. My third point is about defensive medicine, which I, like everyone else, worry about. Defensive medicine is here. It has arrived and I do not think that it will be only this measure that makes doctors practise medicine more defensively. They will do so because there is more litigation; more people are prepared to follow the American model of suing and trying to make a bit of money if something has gone wrong in the health service. The health service does not have the funds that are available to private insurance companies to meet the demands of patients who sue, although that is another problem for another day. Defensive medicine is coming. Protocols and a lot of procedures have been introduced to do away with the need for a doctor to practise defensive medicine, whereby he knows what he has to do and the protocols that have to be followed. I think that on the whole it is good that the Government are backing up the General Medical Council on this by bringing in this measure, but I would like to hear the Minister’s reply to the queries that have been raised.