MANDATORY REPORTING FOR DOCTORS

Red News Readers,

Its about time the Medical Board got their act together and doctors realised that they are just like the rest of the health service employees with duties and responsibilites for standards in patient care. Doctors have been allowed to regulate themselves for too long and the Butcher of Bega is a terrible example of how that system has failed.

I thought the AMA comments were somewhat insensitive in the context of the patients of the Butcher of Bega having such a struggle to be heard and believed. It may be the case that patients do not always give their doctors reliable information on which to base their medical judgements but that was hardly the case with the Butcher of Bega whose medical practice was most irregular, and probably criminal, whatever his patients told him

Jenny Haines

No more medical secrets

By Clair Weaver, Sunday Telegraph

April 13, 2008 12:00am

COMPLAINTS against doctors will be aired at open hearings chaired by lawyers under landmark legislation to smash the code of secrecy surrounding rogue operators such as the "Butcher of Bega".

In the fallout from the Bega case, where Dr Graeme Reeves is accused of mutilating hundreds of women, the NSW Government will today announce an unprecedented overhaul of the medical regulatory system.

It means doctors will no longer be able to escape scrutiny by appearing at closed and confidential hearings presided over by fellow medics.

The laws will include:

* a ``guillotine provision'' that automatically bans any doctor who breaches conditions on their practice;

* new powers for the NSW Medical Board to urgently suspend a doctor to protect the lives or health of patients;

* making Professional Standards Committee (PSC) hearings open to the public and publishing findings;

* employing non-medical personnel to help decide on disciplinary action against doctors, with a legal representative as chairperson;

* forcing doctors by law to report colleagues they believe have engaged in sexual abuse, drug or alcohol intoxication or other serious misconduct;

* requiring the NSW Medical Board and the Health Care Complaints Commission (HCCC) to consider all patient complaints, even after a doctor has been struck off;

* ordering professional disciplinary bodies to examine doctors' overall ``patterns of conduct'' rather than on an individual complaint basis.

In an exclusive interview with The Sunday Telegraph, NSW Health Minister Reba Meagher said doctors will face more scrutiny than ever before.

The new legislation will be presented to parliament early next month

It comes in the wake of revelations about Reeves, the disgraced ex-gynaecologist and obstetrician who allegedly mutilated and abused hundreds of women across NSW without detection by authorities for more than a decade.

"The Reeves case challenged public confidence in the way the medical profession was being regulated and disciplined,'' the minister said.

But the proposals have met a lukewarm response from the medical profession.
Dr Andrew Keegan, president of the Australian Medical Association (NSW), doubts they will make a lot of difference and is concerned about practicalities.

"Frankly, lay people and legal people are not going to understand (medical details at PSC hearings), so you need a medical person there,'' he said.

"Doctors need to have guidance on reporting colleagues - you can't work on hearsay.

"The other thing we know is what we are told by patients is not always reliable.''

But Dr Rosanna Capolingua, president of the Federal AMA, supported the laws, which she said "enshrine existing professional and ethical obligations''.

For the first time, anyone will be able to attend PSC hearings into alleged professional misconduct by doctors.

"At the moment, it's assumed the (hearings) will be heard in private _ we say it's going to be the other way around,'' Ms Meagher said. ``Any sort of public scrutiny is bound to make a system more accountable.''

Legal and non-medical representatives will be introduced in a bid to overturn the system of "doctors regulating doctors'' and improve objectivity.

Doctors who fail to raise the alarm about colleagues who have committed serious misconduct may face "failure to report'' penalties themselves.

This could range from counselling to being suspended or struck off.

Those who do make a report must have good grounds and will be granted immunity from defamation.

But they will not be given anonymity.

Under the "guillotine provision'', the Medical Board will be able to immediately suspend or deregister a doctor who breaks rules of practice.

It took the Board 20 months to deregister Reeves after discovering he was breaching an obstetrics ban - during which time he was able to treat other patients.