complaints procedure for the sector. Although some consultation with interested
parties had taken place before its introduction the procedure was not in a form
acceptable to a number of patients' organisations. It remains to be seen whether,
once the pilot comes to an end, the independent sector will be prepared to
introduce and enforce a patient-friendly complaints procedure
4.4 Disciplinary issues
For patients, the most disappointing aspect of the whole system for complaining
aboutadoctorhasbeentheGeneralMedicalCouncil.Mostpeoplehavelittleorno
knowledge of the system for complaining about doctors generally and only learn
aboutitwhentheycometohaveneedofit.Thereisavagueawareness,however,
thatdoctorsaresubjecttosomecontrolandthatifsomethinggoeswrongthereisa
body that will discipline the doctor.
What they discovered, when something did go wrong however, was that that
body was reluctant to address their problem, confining itself only to what
appearedtothemtobethemostarcanecomplaints;thatitwasextremelydifficult
to persuade it to investigate a complaint; that the procedures were complex,
lengthy and did not involve the patient to any meaningful degree; and that the
entire system was heavily weighed in favour of the doctor.
In recent years the GMC has taken major steps to try and address these
problems:
. Ithasextendeditsremitsothatitcandealnotonlywithcomplaintsinvolving
seriousprofessionalmisconductbutalsowithissuesofpoorperformance.That
hasmeantthatitcanatleastconsideracomplaintbyapatientthatadoctorhas
treated him or her badly. If the complaint discloses a serious defect in the
doctor's performance then the GMC will deal with it.
. Itisfarmorepreparedthaninthepasttoinvestigateanycomplaint,nothiding
behind difficult issues of definition.
. Patientsareseenmuchmoreaspartoftheprocessandaregivenmoresupport.
. ByincludingmanymorelaypeoplebothontheCouncilandinthedisciplinary
process it appears less biased in favour of the doctor.
NeverthelesstwofacetsoftheGMC'sprocedurestendtoleavepatientssuspicious
of those procedures. Firstly, the GMC remains in the position of both prosecutor
and judge. It is the GMC, through its Preliminary Proceedings Committee, that
decides whether a complaint should go forward; it is then the GMC that collects
the evidence and prosecutes the complaint against the doctor; and then it is the
GMC through its Professional Conduct Committee that decides whether the
complaint has been proved and what sanction, if any, should be imposed.
ThesecondareaofmajordissatisfactionisthestandardofproofthattheGMC
demands in order to uphold a complaint. It is not that which applies in all civil
cases,butratherthatappliedincriminalcases.Thecasemustbeproved`beyond
reasonable doubt' which makes it extraordinarily difficult to prove complaints.
Both these issues are currently under review.
The Complaints Dimension: Patient Complaints in Health Care Provision 55