Powers for GMC against incompetent doctors

Powers for GMC against incompetent doctors

Powers for GMC GMC, through its new Committee on Professional Performance, must suspend . or make conditional that doctor’s regis- against incompete...

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Powers for GMC

GMC, through its new Committee on Professional Performance, must suspend . or make conditional that doctor’s regis-

against incompetent doctors

A serious defect in the

of effective action that

medical profession

ability of the UK regulate itself-the inability to deal with incompetent doctors who represent a threat to public safetyhas been remedied by the Medical (Professional Performance) Act 1995, which was passed on Nov 8. The Act is based on

where a doctor’s general performance is seriously deficient. : The Act introduces the concept of a "seriously deficient standard of professional performance". This term is not defined-indeed, a proposal to use "published performance standards and key performance criteria" was resisted in the House of Lords. A former president of the GMC, Lord Walton, argued that to do this for every one of the many specialties would be an "incredibly difficult task". : The GMC consultation paper provides some guidance on what constitutes seriously deficient professional performance-and the Council will provide more information in the publication Good Medical Practice. The aim is remedial-to : improve a doctor’s deficient standardsnot punitive. However, where the standard of professional performance of a . doctor has been seriously deficient, the

to

General Medical Council consultation paper published in May, 1992. Previously, the GMC was not concerned with professional performance except where registration was affecteda

:

for example, undergraduate education and preregistration experience. The GMC could act against a doctor convicted of a criminal offence or found guilty of serious or one whose fitness to practise was seriously impaired by ill-health. But otherwise the GMC was not able to ensure that all those who had been admitted to the Medical Register were competent to practise, and there has been widespread concern about this lack

professional misconduct,

Witwatersrand

can

be taken in

cases

:

University has troubles with deputy-VC

On the face of it, the main issue would appear to be a simple one. Did Prof Malegapuru (William) Makgoba submit an inaccurate and embellished curriculum vitae to the University of the Witwatersrand when he was appointed deputy vicechancellor ? This is perhaps the most serious issue that has been brought to a head by a 200-page document that was handed to the University’s vice-chancellor last week. It was signed by 13 senior academics, including eight faculty deans. It : also raised the additional issues of his poor administrative performance, and his public statements which, they allege, have brought the university into disrepute, and which warrant disciplinary action. : To call for disciplinary action against any senior faculty member is serious business, but to do so against the university’s deputy vice-chancellor, who is also chairman of the board of the South African Medical Research Council, and black, is : dynamite in a country that is trying to make the change from a white-dominated autocracy to a multiracial democracy.:

Dutch doctor cleared of

a Groningen court cleared 48-year-old family doctor Gerard Kadijk of the charge of actively ending the life of a 3-week-old girl with trisomy 13 and severe cranial and labial deformities, renal

abnormalities, and a past attack of cardiac arrest. The judgment was made on the same grounds as that of Dr H Prins (see Lancet, Nov 11, p 1291)-ie, that he acted according to accepted medical standards and to medical ethical norms. The baby’s parents had taken her home

day". Anthony Barton

highly inbred elite" and that "It is ery of democracy-a junta".

a

mock-

Such remarks were seized upon by black activists who cherished a similar Even to become a doctor at all in the old outlook-that Wits had not moved with South Africa was a major obstacle race for the and had shown little sign of times, any black person who had been saddled to of the new South the demands adapting with the then current educational Africa. They immediately leaped to Makwhich was heavily disadvantageous to and at a press conference defence, goba’s blacks. He qualified MB ChB at the Unilast week his detractors of waging accused versity of Natal before going to the UK, a racist vendetta against him. first to Oxford to do a doctorate, then to Makgoba has, admittedly, not made things spend 2 years at the University of Birmingham. Next he went to the US National any easier for himself by refusing to attend a meeting of his colleagues to discuss the Institutes of Health in Bethesda, Maryland, as a visiting scientist. He then charges against him and, perhaps wisely under the circumstances, the University returned to the UK, to the Royal Postexecutive committee has School of Medicine in London, Council’s graduate where he carried on his research in decided to appoint a tribunal of overseas immunology, eventually returning to academics to look into the allegations South Africa in October of last year, . rather than risk allegations of bias by trying to do it themselves. Whatever the outwhen he was appointed deputy vicechancellor at Witwatersrand. : come, it promises to be a very messy It was not very long, however, before business, and one that the South African academic world could well do without in the University realised that it had a its current, highly uneasy transitional by the tail when he started to make highly state. disparaging public statements about the situation at the University, which, he . claimed, was controlled by "a small, : Nick Lee

Makgoba is

no

ordinary academic.

system,

tiger

should not aid his

ending baby’s life

On Nov 13

tration The Act envisages procedures as proposed by the GMC in May, 1995. The document, now revised, is obtainable from the GMC’s External Relations Office (178-202 Great Portland Street, London WIN 6JE). However, detailed rules on this complex, four-stage procedure have yet to be agreed. Pilot tests will be done next summer, and the procedures are expected to start in the spring of 1997. The Act also contains a new provision for a doctor to apply to have hisor her name removed from the register. Parliament had envisaged cases where a doctor’s failings were beyond remedial action. A doctor failing to keep up with advances that had become the accepted techniques might realise that "it is time to call it a

own

conviction. But the

did so because the Minister of Justice wanted more judgments (the first was Prins) in these complicated matters. A specific point emphasised by the court, in response to a specific question by the Minister, was that in cases such as this, it was justified not to start attempting any form of treatment in hospital. Stopping it abruptly has in the past proved to be difficult even if the parents wanted to take the baby home to die. court

clear that there treated her pains symptomatically, but when she went into renal failure and the cranial deformities worsened and became infected, he ended her life after discussing the case with relevant specialists and with her parents. He also warned the prosecution officer of his intention. : The prosecutor did not want the charge to proceed, nor did the college of attorneys-general, on grounds that a person Marjanke Spanjer from

hospital when it

was no cure

for her.

was

Kadijk

1355