In Professor Harmer's interesting editorial speculating on the likely fall-out from the various Shipman enquiries [1] he does not mention what seems to me to be a highly likely (and welcome) change, namely restricting the current freedom for any doctor to write a private prescription for almost any drug for any person. Murderous doctors are, one hopes, rare but they would be even rarer if they were not able to obtain lethal doses of lethal drugs. One may also mention that there is one sentence which I am sure does not accurately express his beliefs: ‘If one has a criticism, from personal involvement in several cases, it would be that the emphasis has been on the protection of patients rather than the publicly perceived role of protecting the doctor’. This does not sit easily with a very recent quote in several publications (including BMA News[2]) from the Secretary of State (John Reid) as follows: ‘We want to put an end to the idea that the GMC is a representative body for doctors. It is not. Its primary role must be to protect patients’. I presume the President's use of ‘publicly perceived’ refers to the ignorant perceptions of the average member of the public rather than those of the well informed. Even so, to describe the GMC's emphasis on protecting patients as a ‘criticism’ implies that the GMC should not be doing this. As the GMC strap-line is ‘Protecting patients, guiding doctors’ this would be an unfortunate opinion to be left on the record, even though one can infer that it was not intended. I should like to thank Professor Vickers for his comments upon my recent editorial. His first point is well taken and recommendations pertaining to the availability of dangerous drugs were mentioned within the editorial as part of the contents of the fourth Shipman Report. The extension of the principle to include restrictions on ‘the current freedom for any doctor to write a private prescription for almost any drug for any person’ may become a reality. Whilst this would be a restriction on prescribing rights, will it greatly hinder anaesthetists in performing their clinical duties? As to the second point, on reflection, I can see that the wording of the sentence is likely to be interpreted as criticism of the GMC for protecting patients. That was certainly not my intention, and the change of the word ‘criticism’ to ‘observation’ would better describe my thoughts. The reason for my ‘observation’ pertains to three cases before the GMC Professional Conduct Committee over the past few years at which I have been a witness. In all three cases, the underlying accusation pertained to a single isolated incident involving a doctor who up to then had an unblemished medical career. The incidents were different for each doctor but the worse that could be said was that each made a mistake or error of judgement. A major investigation and hearing, in one instance lasting 2 weeks, was brought on the strength of a single clinical error, at worst. None of these doctors could, in my humble opinion, be considered an on-going risk to the public. The point that I had hoped to make was that, from my experience, rather than the GMC being a ‘representative body for doctors’ with a desire to protect them, it is a body determined to protect the public, even to the extent of investigating a solitary misdemeanour or error of judgement. That doesn't sound like a body out to protect doctors as implied by Dame Judith Smith and Dr John Reid. I hope this has put the record straight and I apologise for any misunderstanding caused by my inappropriate wording in the editorial.
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