Violent patients face ban from GPs' surgeries

PATIENTS WHO act violently towards their doctors are to be banned from GPs' surgeries. Under a change in the law being introduced by Alan Milburn, the Secretary of State for Health, patients who have threatened doctors or staff will be ordered to seek care at hospitals or in special surgeries attached to police stations.

The change will deprive violent patients of a statutory right to treatment at local surgeries. But it will come as a relief to the GPs who face violence from their patients.

The Government said it was difficult to estimate the number of cases. More than 1,000 complaints were made by GPs about violent attacks in 1997 but officials said it was believed that was an underestimate of the true extent of the problem.

Frank Dobson, the former Health Secretary, considered banning convicted violent offenders from visiting GPs' surgeries but was told by BMA leaders that it was unworkable. Under the new rules to be introduced later this month, there will be no blanket bar on such people.

Instead, patients will be barred if they threaten their GPs and if the GP makes a formal complaint to the police.

Ministers believe a pilot scheme at a police station in Southampton could be the way forward for dealing with violent patients. The pounds 45,000 project will allow doctors to see problem patients in a secure room equipped with closed-circuit television, panic buttons, observation points and police on call.

Southampton and West Hampshire Health Authority decided on the scheme after patients attacked others in waiting rooms, spat at and threatened receptionists and abused and assaulted doctors.

Susan Deacon, Scotland's health minister, is considering banning patients with convictions for violence from doctors' surgeries.

In 1994, Dr Donald McKay, 56, died after being stabbed by a 31-year-old man, now serving a term of life imprisonment. The man had accused the GP of wrongly diagnosing his sister's fatal cervical cancer.

One GP's receptionist complained a woman threw something at her because appointments were running 15 minutes late.

Many doctors have to deal with the management of care in the community patients, who are sometimes disturbed and refuse to take medication. Doctors have been allowed to strike off patients from their lists if they were threatened with violence. But the violent patients had a statutory right to demand to be reinstated on another family doctor's list, which often meant pushing the problem patient onto a neighbouring colleague.

Dr John Chisholm, chairman of the BMA general practitioners committee said: "We have been in constructive negotiations for several months with the Department of Health about the arrangements which are intended to protect GPs and their staff to ensure that patients with a history of violence receive their health care in a secure environment.

"These negotiations were initiated at the behest of Frank Dobson who had a strong personal commitment to the protection of those who work in the NHS from violence."