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Why I'm backing Pulse's campaign

• Dr S E Ramsbotham,

Thornton Heath, London

I totally support your petition opposing a weaker standard of proof in fitness to practise cases. Doctors are more vulnerable than ever before in medical history. The inevitable increase in defensive medicine that would surely follow any weakening of the present standard of proof would

cause considerable damage

to patient care.

• Dr R Beatty, Spalding, Lincolnshire

This aspect of the CMO's proposals would create a new generation of defensive consulting, which will increase rate of referrals and NHS costs. This is not in the interests

of patient care. Sir Liam Donaldson seems to have lost the plot on this one.

• Dr Verity Wilkins, Dudley,

West Midlands

Medicine is often not an exact science in general practice.

Doctors have to live with uncertainty daily while they try to make sense of a patient's symptoms and results of investigations. The analogy of medical doctors with aviation pilots is false and misleading.

• Dr Edward Ford, Minehead, Somerset

A weaker standard of proof would increase the feeling of working under the constant threat of losing one's job.

All you need is a vindictive patient to be more believable than you and you're stuffed.

• Dr M Foulds, Hull

Is there some hidden agenda here? Encourage GPs to pack it in so they can be replaced with a cheaper workforce?

UK general practice is the jewel in the NHS crown – to quote an eminent politician. Leave it alone!

• Dr David John Bickle,

Isle of Barra

With the level of emotion

that medicine engenders, patients and relatives are very susceptible to telling lies, when in other situations they would be more honest.

• Dr Upender Verma,

Leytonstone, London

Weakening the standard of proof will lead to miscarriages of justice and further weaken the role of self regulation.

Making the role of the GMC more robust would be a fairer way of assessing a doctor's individual case.

• Dr Christopher Seward, Lymington, Hants

We should resist these changes at all costs. With increasing litigation, encouragement of patients to complain, and more and more guidelines and protocols to adhere to, we are being pushed into the realms of defensive medicine.

Major points not addressed by the process include:

• That whereas complaints against an organisation are dealt with by the organisation and often involve company procedures and such like, a complaint against a doctor is personal. Although complaints about major failings should be taken seriously, many are trivial with no substance and yet the anxiety and stress caused is immense and lasting.

• We are all told anyone can make mistakes but this is not to be allowed for doctors, it seems – like a long-running exam with a 100 per cent pass rate.

• Where no mistake has been made but the complaint has been frivolous or malicious, there is no redress against the complainer who can walk away unscathed leaving a trail of destruction – probably to do the same again.

• We are heading towards a US style where everything is investigated or referred.

• I am not convinced the public in general want to go along this route and may prefer to stick with uncertainties rather than having every symptom investigated with all the discomforts and side-effects that can follow. There will be a vociferous minority who cannot accept there can be such a thing as an accident or bad luck and that somebody must be to blame. But should the whole population have to suffer the consequences of their prejudices?

• In summary, any system must allow for judgement that may get it wrong without pillorying the person who at the end of it is trying to do

their best. This proposal will destroy that.

I have the advantage of approaching retirement so will not be likely to have to work under any regime that is instituted but feel concern for future generations of doctors – and for myself as a potential consumer.

• More messages of support on

page 34

• Dr James Hickman, North Curry, Somerset

The potential punishment is significantly worse for doctors than punishment under the law for most crimes. The burden of proof should therefore be the same as in criminal law.

• Dr Janet Thomas, Edmonton, London

It seems outrageous that the CMO feels it appropriate to weaken this standard of proof. Doctors already have to cope with the constant threat of litigation – often when there is no case to answer. This proposal will worsen an already very difficult and distressing situation.

One wonders how long it's been since Sir Liam Donaldson actually saw a patient!

• Dr John Eggleton, Exeter

Sir Liam Donaldson exhibits

an extremely worrying lack

of understanding of issues involved in medical regulation.

He was called upon to resign at an annual LMCs conference over his handling of problems with MMR vaccination. That issue was tiny in comparison to this debacle.

Good Doctors, Safer Patients will be highly detrimental to medical practice and morale, without helping patients.

The bit about the standard of proof beggars belief and should be referred to the European Court of Human Rights.

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