New regulation council opposes NHS proposals to create blame-free culture
Patient safety and the need for professionals to report incidents
and to learn from them have to be balanced |
Opposition to Department of Health proposals intended to create a blame-free culture in the National Health Service, in order promote error reporting and more rapid redress for patients who suffer harm, is being mounted by the Council for the Regulation of Healthcare Professionals.
In a response to proposals set out by chief medical officer Sir Liam
Donaldson earlier this year (PJ, 5 July, p8), the CRHP rejects the suggestion
that health professionals who own up to mistakes, except where a criminal
offence has been committed, should be given exemption from disciplinary
action, as it argues it would not be safe to allow the individual to
continue in professional practice.
The council says that the proposal is misconceived and contrary to the
demands of public safety. Although it recognises that the motive behind
the proposal is to remove disincentives to report adverse incidents honestly,
the council says that public protection must take priority. “We
suspect that the real barrier to candour is a management climate of fear
and the perceived risk of rushed exemplary suspension or dismissal, rather
than the possibility of regulatory action, involving a fair hearing with
a right of representation,” the CRHP says. “We do recognise
that professionals may also be afraid of being reported to their regulator,
but in our view employers and regulators must be able to take action
to protect patients when ‘the system’ knows that there has
been a serious failure.”
The council also opposes a proposal that incident reports should be legally
privileged. It says: “An adverse incident report is part of the
patient’s clinical history and it seems a retrograde step to prevent
the patient from seeing it. The idea that information for a court hearing
needs to be collected afresh adds to, rather than helps to resolve, the
current problem that different dispute resolution processes are perceived
as [being] unable to use the same evidence, with resulting delays and
duplication.”
It adds that regulatory bodies would expect to be able to use such reports
in fitness to practise procedures and that some have an explicit legal
power to obtain them for that purpose. There may also be problems of
the compatibility of this recommendation with the Data Protection Act
and Article 6 of the European Convention on Human Rights.
A spokesman for the Department of Health said in response to CRHP’s
rejection of the suggestion that health professionals who own up to mistakes
should be given exemption from disciplinary action: “This was just
one issue raised as part of the consultation document ‘Making amends’.
Health care regulatory bodies have been, and remain part of, this consultation
and the subesequent policy development process.”
Comment, p698 |
