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No complaints? Are you doing the job properly!

Dr Andrew Lawson of the Medical Ethics Unit, Imperial College, wrote in The Daily Telegraph recently that for many GPs 'it is not worth the hassle of refusing an unjustifiable request' for fear of a complaint which will 'form part of the doctor's personal be disclosed before accreditation'.

Since the demise of the health authorities we now have the additional hassle of dealing with them ourselves.

I sympathise. In recent years such complaints seem to be more frequent, often embellished by lies and insults. They are usually the result of a refusal to supply a mind-altering drug, a certificate on capacity for work or a referral to the specialist. Sometimes they are generated by GPs politely but firmly declining to medicalise the normal but transient pain of minor trauma or unhappiness with personal circumstances. Fortunately, I still have the resilience to deal with such complaints in a fair but robust manner.

However, I would contend that in the current climate the absence of such complaints in an experienced NHS GP's personal record might be construed by an accreditor as a sign that perhaps they were not doing the job properly. Perhaps there should be a target range; not too many, not to few.

The NHS can work well only when the vast majority of GPs recognise their role as gatekeeper, not only to the hospitals but also to themselves in so-called 'primary care'. As contractors we have a clear responsibility not only to our 400 or so 'regulars' but just as much to the other 80 per cent who are also forced to pay for us by their insurance premiums knowing there is no 'excess' penalty when a claim on our time and expertise is made. NHS GPs need to understand and accept this.

Dr John Fitton

Barton Seagrave


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