Doctors to face annual checks on competence

HEALTH: Consultants to be subject to same disciplinary procedures as rest of NHS, while a faster system is urged for victims of poor treatment

HOSPITAL CONSULTANTS may face the sack under a crackdown on dangerously incompetent doctors to be announced by Alan Milburn, the Secretary of State for Health.

Senior doctors are to be subjected to annual checks on the quality of their treatment and the Government will end the system under which consultants can be suspended for years on full pay.

The move follows a series of scandals in the NHS, including baby deaths at a Bristol hospital, and women injured by Dr Rodney Ledward, who called himself the "fastest gynaecologist in the West".

Mr Milburn will announce today his intention to introduce legislation to carry out the recommendations by the Chief Medical Officer, Professor Liam Donaldson. The plan will include: an annual appraisal of the quality of hospital doctors' clinical care; scrapping their right of appeal to the Secretary of State; and new assessment centres for failing doctors. Consultants being investigated on personal grounds, such as fraud or sexual assault, or failing to meet their contracts to turn up for ward rounds or attend clinics, will be subject for the first time to the same disciplinary process as everybody else in the NHS.

The new assessment centres will tell health authorities if doctors need retraining. But they will also advise health authorities that doctors should be sacked, if their standards are so low that they cannot be put right by training.

The tougher powers will also apply to family doctors, who are currently covered by a laborious professional disciplinary system. The medical profession's own system of discipline, run by the General Medical Council, will be left in place, but it will have less relevance.

The changes follow the Prime Minister's warning to the medical profession to avoid becoming "the forces of conservatism". Mr Milburn will make clear that in the past the NHS has turned a blind eye to dangerous doctors and that will have to come to an end. He will attack the current NHS disciplinary procedures as bureaucratic, legalistic and ineffective.

Consultants' and GPs' contracts have been unchanged since the NHS was formed in 1948. Mr Milburn believes the vast majority of doctors are excellent but the present system enables bad practice to go undetected until it is too late.

A Whitehall source said: "The NHS as employers must be able to take action quickly and nip problems in the bud. The package of measures will ensure that doctors' practices are monitored; that poor performance is tackled swiftly; and that tough action is taken where necessary."

A total of 29 consultants have been suspended on full pay for over six months. Several of these cases have been going on for some years. The changes also marginalise the existing independent system for disciplining doctors operated by the General Medical Council. The source said that as the employer, the NHS will adopt its own system of discipline, leaving the GMC a more limited role within the profession. "It marks a sea change in approach."