We are always accountable, Mr Johnson

The health secretary, Alan Johnson, has tacitly accused GPs of complicity in the rise of antibiotic-resistant bacteria by reminding us not to prescribe antibiotics in viral infections.

This health policy is one with which we all fundamentally agree. However, it is easy for ministers to say these things in principle and quite a different matter for individual doctors who have to take specific decisions for which they will be held accountable.

Undoubtedly Mr Johnson believes himself to be accountable - to the electorate. As with every MP, his constituents will include some with a personal grudge against him, together with a handful of nutters.

Fortunately for Mr Johnson, at election time this small number of individuals will be outweighed by the tens of thousands of ordinary people who will be voting more rationally. Providing he gets a majority vote he can't be ousted purely by an individual bearing a grudge. The only credible risk to his status as an MP would be if he broke the law or failed to abide by parliamentary standards' regulations.

Not so for the GP. Each of us is vulnerable to any single patient who, by complaining, can cause mayhem for months. It only needs one patient to report us to the primary care organisation or GMC and our livelihoods and reputation are instantly at risk.

Whenever we limit our antibiotic prescribing in line with government policy we will miss one or two people who are harbouring a bacterial infection and who could complain afterwards that we were negligent. It is harsh if, through trying to follow the government's recommendations, we put at risk our medical registration and our personal happiness.

What can be done? Firstly, the government needs to acknowledge the high levels of uncertainty GPs have to deal with over apparently simple medical decisions.

Secondly, it must recognise that we are held responsible for our individual actions in a way that politicians never are. But a truly practical response would be for the government to enact legislation to ensure that the defence of 'following public policy' became an instant and near-absolute rebuttal to any charge of medical negligence.

Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com.

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