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Costs sank plan to take action on bad doctors

Judy Jones,Health Services Correspondent
Saturday 28 August 1993 18:02 EDT
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PLANS for a legal clampdown on incompetent doctors were dropped because the Government was unwilling to foot the multi-million pound bill for re- training them, it has emerged.

Health ministers shelved proposals from the General Medical Council for a bill in the forthcoming session of Parliament after advisers warned that they risked signing a 'blank cheque', the Independent on Sunday has learned.

But the Department of Health has been forced to consider reviving the plan after last week's revelations about cancer test blunders spanning eight years by a consultant pathologist in Birmingham.

Bone cancer specialists at the Royal Orthopaedic Hospital, who sent tissue samples to Dr Carol Starkie at Selly Oak hospital, failed to alert the South Birmingham health authority to her frequent misdiagnoses. They feared they would get an even worse pathology service if they reported their suspicions. Dr Starkie is known to have made 42 misdiagnoses, and a further 1,800 of her tests are to be re-checked.

Checks have also been made on a further 1,000 diagnostic tests made by Dr Starkie on samples from patients suspected of having conditions other than bone cancer.

The cancer specialists at the Royal Orthopaedic breached guidelines requiring doctors to inform health authorities of any concerns about a colleague's competence.

Under the Medical Acts, the General Medical Council can strike from the register any doctor that its disciplinary committee finds guilty of serious professional misconduct. But only the worst offenders tend to be disciplined, and there is no way to ensure reporting of poor practice.

The new bill would have enabled the council to discipline doctors whose incompetence or unreliability was less obvious. It would also have enabled the GMC to require that some doctors hauled up before its disciplinary committees are retrained before being allowed to resume practice.

But as a condition for supporting the bill, the council and the British Medical Association - which represents the profession - insisted that doctors should not have to pay for their retraining.

Well-placed sources have confirmed to the Independent on Sunday that until last week's revelations about Dr Starkie, ministers had decided not to press ahead with the legislation because of the extra cost to the health service.

One of them said: 'Why spend money on retraining doctors who are perhaps nearing the end of their career anyway, when you have young doctors coming through the system whose training has already been funded?'

In the wake of the Starkie affair, Kenneth Calman, the Government's chief medical officer, has begun a review of systems for identifying sub- standard performance by doctors. It will consider the BMA's plea to ministers this week to revive the plans for early legislation.

In a statement yesterday, the Department of Health said: 'It is important to get it right.

'The chief medical officer is in the process of setting up a working group of representatives of the GMC, the profession, and the NHS. It will look at the effectiveness of the current guidance, and at procedures for identifying poor performance.'

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