Doctors warned on care of patients

A TOUGH new warning to doctors that they must treat their patients like human beings or risk being struck off the medical register is to be issued by the General Medical Council.

Doctors will be told that they must measure up to the standards of competence, care and conduct set out in Good Medical Practice, a new edition of which is due to be approved by the council today. In particular, that means providing care and comfort, listening to patients and explaining matters to them, as well as treating their illnesses with knowledge and skill.

The new edition says that being registered as a doctor brings rights and privileges and if problems arise "these are the standards against which you will be judged." The previous edition said merely that it was providing guidance, not a set of rules.

Sir Donald Irvine, president of the council, said there was a danger that with the onward march of science and technology the humanity of medicine was being forgotten: "For some doctors there is a pre-occupation with getting the science right. Listening to patients' concerns and feelings, offering explanations, answering questions - these are the facets we want to pay attention to."

He said developments such as the Internet would in some cases make patients more knowledgeable than their doctors. "It will put more power into the hands of patients. The question is how [the knowledge] is to be used. The fundamental point is the quality of the doctor patient relationship."

Good Medical Practice sets out doctors' duties to keep up to date, maintain patients' trust, and protect them from other doctors whose health or performance is a threat. It says when a patient suffers serious harm, the doctor should explain fully and honestly what has happened. In the case of a child, the parents should be told.

This part of the guidance follows a case in which family members were told by the courts that doctors had no legal obligation to tell them what had happened when their child died. Sir Donald said that under the new guidance those doctors would have been in breach of the professional code. "It recognises that doctors have wider professional and ethical responsibilities than the law requires them to have," he said.

First published in 1995, Sir Donald said Good Medical Practice set out what people could expect from doctors and was "the best thing the GMC has ever done". He said a "revolution" was under way with medical organisations seeking to introduce standards. "The job now is to get beyond the glossy brochure stage and make the statements stick and become embedded in practice. We are saying if there are departures from it, doctors will be held to account."

A survey of 800 doctors conducted for the GMC showed that while most agreed sanctions should be applied to doctors who abused their position or acted dishonestly, one-third disagreed that this was appropriate for doctors who failed to treat every patient politely, or to give them information in a way they understood. Sir Donald said: "The GMC seems closer to the public than the profession on that point."

The survey showed that only half the doctors had read Good Medical Practice. Professor Cyril Chantler, chairman of the council's standards committee, said ignorance would be no defence. "Whether or not one has read it, one will be judged by it."