Smartcards plan to track errant freelance doctors

FREELANCE "LOCUM" doctors could in future be required to carry smart cards with details of their employment history to prevent those with poor performance moving from job to job, under proposals published by the government yesterday.

About 3,500 locums are working in the NHS at any one time, and in some cases hospitals have employed doctors attracted by pay of pounds 1,000 for a weekend who have been incompetent, negligent or violent. When background checks were made they were found to have lied about their age, qualifications and experience.

The requirement on locums to show evidence of their competence was part of a package of measures aimed at tightening controls on all doctors announced by Alan Milburn, the Secretary of State for Health. Every doctor in the country will be subject to an annual check and those who fail to make the grade will be investigated and could be subject to instant suspension leading to dismissal.

Where problems are spotted, doctors, including GPs, will be sent to an "assessment and support" centre where a committee with a lay chairman will investigate.

The tough package of measures drawn up by the Government's Chief Medical Officer, Professor Liam Donaldson, seeks to replace cumbersome NHS disciplinary procedures, which in some cases date back 50 years, with a new streamlined system designed to detect bad doctors rapidly.

The aim is to protect patients from dangerous doctors more effectively than the present General Medical Council procedures, which operate to criminal standards of proof. But the proposals represent a significant challenge to the principle of self regulation, and some medical organisations questioned yesterday whether they would work.

Ian Bogle, chairman of the British Medical Association, said: "It is essential the medical profession is satisfied that serious allegations about patient safety can be substantiated."

Dr James Johnson, chairman of the joint consultants' committee representing the royal colleges, said allegations of poor practice would have to be backed by hard evidence.

Mr Milburn said: "The overwhelming majority of doctors provide a very high standard of care for their patients. Sadly a few bad doctors have tarnished the reputations of the majority and in the process have not only damaged patients but also dented public confidence in the NHS."

An estimated 6 per cent of senior hospital doctors are thought to have problems either with their behaviour or because they are failing to maintain their skills. Since 1996, 20 GPs have been struck off by NHS tribunals. Since August 1997, 120 "alert" letters, warning of doctors with problems, have been circulated within the NHS. Health authorities have been reluctant to act because the process of sacking a consultant is expensive.

Hundreds of hospital doctors have been suspended on full pay over the years, some for up to a decade, and 29 are currently suspended for longer than six months at a cost of pounds 2.6m. In some cases, trusts have unofficially helped poor-performing doctors find other jobs, passing the problem on .

Professor Donaldson said doctors suspended will lose their right of appeal to the Secretary of State for Health, which can cause long delays, and may be required to give a binding undertaking not to practise privately while under investigation.The proposals could become law in two to three years.