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We need to regulate real threat - managers

We've heard a lot about regulation of doctors recently but, when it comes to endangering life and limb, the really worrying deeds have been perpetrated by NHS management, and particularly that element concerned with primary care.

I believe there is a 'we can get away with anything' mentality - and, in the worst cases, downright sleaze.

The rules and regulations currently in force are widely ignored. Given the harm that can be done by the people running the health service, I think a beefed up disciplinary system is long overdue.

Serious complaints should not be dealt with behind closed doors. In my view, offenders should face disciplinary proceedings with the verdict being determined by a vetted and fully independent jury made up, at least in part, of patients. The proceedings should be reported to ensure openness and accountability.

Managers who commit serious transgressions should be 'struck off' - that is, prevented from working in healthcare. If rehabilitated and reinstated later, they should be made to work under strict supervision.

Grounds for disciplinary action of this sort would include:

  • Deliberately putting patients at risk
  • Premeditated dishonesty - particularly when this has serious consequences or when the dishonest act is repeated
  • Intentionally falsifying documents, such as the minutes of meetings or replies to requests for information
  • Actively covering up for colleagues who have committed serious offences
  • Sins of omission, such as failure to investigate serious matters - particularly where patient safety is concerned
  • Serious breaches in confidentiality or encouragement of clinicians to breach confidentiality, for example by financial inducements
  • Using taxpayers' money to cover their own misdeeds or those of their colleagues, friends or accomplices.

If readers wish to suggest further offences sufficiently serious to merit being dealt with in this way, or to comment on my suggestions, please send brief details to (ideally from your NHS email address so as to filter out bogus replies). I will, of course, anonymise replies before disseminating them.

Dr John Cormack, Essex

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