Chris Lancelot on...Unfair discipline in the NHS

There are times when I am ashamed of doctors and managers. Consider the plight of consultant cardiac surgeon Mr Robin Roberts, who performed an operation on a patient, saved their life, and was then sacked by the hospital management because the operation he performed was not on the list of the PCT's approved procedures. Managers reported him to the GMC even though his competence was not in question.

Unfortunately, Mr Roberts isn't alone: many of our colleagues are currently in the same situation. Sometimes they have been 'disciplined' by over-eager managers, keen to assert their authority. What is unsettling is that many of these complaints appear to be initiated by envious fellow doctors: after all, if you can get a consultant sacked or suspended and reported to the GMC you can prevent them carrying on in private practice.

It is all too easy to ruin a consultant's reputation: a whisper of an allegation and everyone murmurs that there's no smoke without fire.

The National Clinical Assessment Authority (NCAA) was introduced in 2001 to control the whole suspension process. At first doctors investigated by it felt prejudged, but by 2004 the NCAA was saying that many suspensions were frivolous and caused through maladministration.

It became clear that a large proportion of hospital trusts did not know what constituted a suspendable offence.

A problem is that hospital chief executives have no direct experience of clinical care, yet are responsible for medical standards. They have to appoint medical directors to advise them: these doctors might have their own personal agendas, and might be allowed to act as an official assessor of complaints, judge, jury and then sit on the committee which manages the whole process.

Managers too often make their own rules: they need bringing to heel, perhaps through the introduction of a national regulatory and disciplinary framework for managers, similar to the GMC.

Robin Roberts is not the first consultant to have been sacked for antagonising management or colleagues. In the so-called 'noble' profession, such actions are utterly deplorable.

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

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