DOCTOR! DOCTOR! CAN I HAVE A SECOND OPINION?

PI_Ruwena_Khan By Ruwena Khan

At a time when the law of medical negligence is under particular scrutiny with the second reading of the Medical Innovation Bill (the ‘Saatchi Bill’) having taken place on 27th June 2014 and the government requiring significant amendments to be made to ensure that doctors are not at risk of additional liabilities and patients are not put at risk, research findings from Plymouth University published on 21st July 2014[i] are particularly shocking in revealing the significant rise of complaints to the General Medical Council (‘GMC’). 

 

Handling fitness to practise complaints is one of the core functions of the GMC, as it works to regulate the medical profession and to protect the public by ensuring that only those doctors who meet the standards set out in Good Medical Practice are allowed to work in the UK.  However, complaints about doctors’ fitness to practice rose from 5,168 in 2007 to 10,347 in 2012, an increase of 100 percent within just 5 years. 

 

Is the medical profession really getting so clumsy?

The reality of the situation is far from being quite so simplistic.

A team from Plymouth University, entrusted with researching the reason(s) for such a sharp rise in complaints (notably funded by the GMC), published their findings just yesterday.   Their Report provides an in-depth and independent evaluation of the social, political and cultural factors which have driven the increase in complaints from the public, focused particularly on the period 2007-2012.


Tougher oop Narth?

Analysis of the data has revealed that the rise in complaints from the general public has been relatively consistent at regional and national levels in the UK.  It is not the case that particular regions are more likely to complain than others.  This has suggested that the increase in complaints has been driven by wider social trends rather than localised factors.

 

Stop! Press!

It is phenomenally difficult to shy away from the media spotlight in this day and age and certainly regulatory bodies such as the GMC have achieved higher public profiles than in the past.  There has been increased press coverage of medical malpractice, such as supposed failings of foreign doctors, and fitness to practise cases, and in the last three years, the GMC has evolved their own communicative strategy.

However, the Report makes plain that such increased media coverage has not resulted in a similarly increased level of understanding of how the GMC operates or the limitations of what can be achieved via a fitness to practise complaint.

The Report in fact concludes that “‘knowledge’ without understanding may be contributing to increased complaints, as public expectations of the GMC as the body which is responsible for disciplining doctors are not grounded in the reality of its fitness to practise procedures.”

Indeed, with the backdrop of negative media coverage it is unsurprising that many patients now attend medical consultations with a very cynical view.

 

Down to the (telephone) wire

A further issue is that of changes to the primary care sector.  There has been an increase in the number of telephone consultations and a decrease in the number of home visits.  Although this may be satisfactory to many, to some, phone consultations are problematic and unsatisfactory.

Out of hours care and the reduction in services has attracted much negative media attention and may also be perceived by patients in a corresponding negative light.

With budgeting and service controls, the days of being attended upon by the same medical practitioner and developing a certain relationship are arguably long gone.  Indeed the area of doctor-patient communication, as opposed to the quality of care, is one of the larger areas of complaints made to the GMC.

 

See you at Court

There have also been an increased number of civil actions against the NHS.  This is rather unsurprising given the media attention given to the oft quoted ‘compensation culture’ which now reigns over the country.

There are indications that an increase in litigation against medical practitioners, and increased reporting of the same, may have contributed to an environment in which people are more likely to complain.  The Report notes that there are those who use a fitness to practise complaint as a method by which they can gather information and evidence prior to litigation.  Some law firms specialising in medical negligence matters do contribute to the general ethos of publicity by publishing information on their websites.

A Love for the Familiar

The Report also finds that it there is considerable confusion as to the wider-complaints procedure in the healthcare sector.  Such confusion does drive many members of the public to reach for the familiar and that is the GMC, a longstanding regulatory body.  Moreover, as an independent body, many would find making a complaint to the GMC preferable to complaining to the service where they suffered a negative experience.

 

What Next?

The Report has identified a number of issues which could be the focus of further exploration:

o   Research with members of the public to investigate how macro-level social trends impact upon the behaviour of individual complainants.

o   Consideration of the GMC’s relationship to the general public and how it engages with them, including through the media.

o Investigating the feasibility of changes to the wider healthcare complaint-handling mechanisms or the potential for better signposting.

 

Whether and to what extent the number of complaints to the GMC will change over the next 5 years is a matter of conjecture – certainly, the GMC needs to increase public understanding of their function and role.  Moreover, as social media expands like the Big Bang, the GMC will need to reconsider how it utilises the media to improve their relationship with the general public.

 

RUWENA KHAN

22nd July 2014

 

 

[i] ‘Understanding the rise in Fitness to Practise complaints from members of the public’ https://www5.plymouth.ac.uk/uploads/production/document/path/0/75/Archer_et_al_FTP_Final_Report_30.01.2014.pdf

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