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GPs attack trusts over zero tolerance

Two GPs have accused their primary care trusts of making a nonsense of the Government's zero-tolerance policy after they were censured for striking abusive patients from their list.

Both GPs were dragged through the complaints pro-cess by patients who had been removed for verbally abusing reception staff.

Dr Peter Ashby, a GP in Streatham, south London, was told by South East London Shared Services Partnership, which handles complaints for Lambeth PCT, he should have given the patient a warning before striking him off.

Dr Helen Tattersfield, a GP in Bromley, Kent, appeared before an independent review panel after removing an abusive patient and their family. She said she received no support from Lewisham PCT and Lambeth, Southwark and Lewisham health authority for her actions.

The GPs' ordeal came despite Department of Health regulations and GMC guidance which says GPs may remove violent and abusive patients from their list without first warning them.

Dr Tattersfield said her experience had proven 'zero tolerance does not exist', even though her decision to remove the family was vindicated by the panel.

She added: 'The review did not like the way we had done it ­ we should have taken a bit longer. But if we can't take a patient off before they whack us, zero tolerance clearly does not exist.'

Dr Ashby, who avoided a panel hearing but was reprimanded in a letter from the complaints handling body, said the whole process was 'a complete nonsense'.

He added: 'It's not standard practice to give a warning, not with zero tolerance. They have missed the whole point. Zero tolerance removals are not complaints procedures.'

Lambeth PCT said Dr Ashby had not followed standard practice on removals laid down by the ombudsman.

The ombudsman said in its 2001/2 annual report it supported the right to remove

violent and abusive patients, but GPs considering a removal should talk to the patient and 'give them a chance to change'.

A spokesman for the Department of Health said it was committed to zero tolerance, but trusts were free to make local policies.

Both Lambeth and Lewisham PCTs said there

was a need to 'balance the tenets of zero tolerance with good practice'.

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