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CAMHS won't see you now

Concern over ban on sex with ex-patients

Defence bodies and doctors in isolated rural areas believe

proposed guidelines outlawing doctors from ever having a sexual relationship with a former patient have gone too far.

The guidelines drafted by the Council for Healthcare Regulatory Excellence would ban doctors from dating former patients unless patient-professional contact had been minimal.

They have been drawn up in response to high-profile cases, such as Clifford Ayling, where vulnerable patients were abused. But as they stand they could make life difficult for single GPs moving to rural areas.

Dr Stephanie Bown, director of education and communications at the Medical Protection Society, said: 'There will be circumstances when a doctor and patient wish to embark on a consensual and perhaps long-term sexual relationship, but what are they to do if they decide to be responsible and register the patient elsewhere?

'A total ban as proposed is disproportionate and unrealistic and is a cause for concern.'

Dr Catriona James, medico-legal adviser to the Medical Defence Union, said that if the draft guidelines went ahead they would 'be a step beyond the current GMC guidelines'.

'This may make things difficult in rural areas,' she said.

Dr Martin Green, a GP in Llanidloes, Mid-Wales, said: 'It is a serious issue. We're a monopoly provider – you would have to travel 15 miles to meet someone who wasn't your patient.

'We would ensure that a young single doctor applying for a job knew the implications.'

The majority of GPs working in his area already had a long-term partner, he said.

Dr Brian Keighley, a GMC member and GP in Glasgow, said the key issue must be whether 'doctors can satisfy themselves and their peers that any personal relationship is not the result of an abuse of trust or of their professional position'.

He added: 'I don't think it is totally appropriate for a super-regulatory body to get into details about guidance. My prime professional body is the GMC and its guidance is not absolute.'

As well as barring relationships between doctors and former patients, Clear Sexual Boundaries Between Health Professionals and Patients outlines other forms of behaviour deemed unacceptable, including making sexual jokes and unnecessary examinations (see box).

'Not every act will mean being struck off, but regulators will treat any example of a doctor acting sexually towards patients very seriously,' said Julie Stone, executive lead for the Clear Boundaries project.

What else is deemed unacceptable

• Inappropriate sexual or demeaning comments

• Requesting details of sexual history with no clinical relevance

• Asking non-clinically relevant questions about the patient's body, underclothing or sexuality

• Unnecessary exposure of patient's body

• Internal examinations

without gloves

• Watching patients undress

• Keeping or taking photographs of the patient that are not clinically necessary

• Unplanned home visits with sexual intent

• Telling patients of own sexual problems or personal details

• Asking for a date

• Examinations with no medical justification

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