THE MEDICAL AND DENTAL DEFENCE UNION OF SCOTLAND Dr C George M Fernie gfernie@mddus.com Can ethical conduct, quality assurance and regulation be legitimate or effective when different standards are applied by different entities and in different circumstances of mortality? ROUTES OF ACCOUNTABILITY Complaints Ombudsman GMC Negligence Claims CI and FAI Criminal NPIA National Clinical Assessment Service Special health authority part of the NHS’s work on quality. Provides a support service when there are concerns over the performance of a doctor or dentist. MDDUS GP claims intimated 1996 - 2007 350 300 250 200 150 100 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 MDDUS FAI/CI FILES 1990-2007 120 100 80 60 40 20 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 0 Year of intimation MDDUS GMC FILES 1990-2007 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 200 180 160 140 120 100 80 60 40 20 0 Year of intimation SERIOUS PROFESSIONAL MISCONDUCT ‘Infamous conduct in a professional respect means no more than serious misconduct judged according to the rules, written or unwritten, governing the profession. ’ Lord Justice Scrutton Fitness to Practise Rules 2004 Standard letter Compliance with Medical Act 1983 (as amended) Impairment of fitness to practise – a. Misconduct b. Deficient performance c. A criminal conviction or caution in the British Isles (or elsewhere for an offence which would be a criminal offence if committed in England or Wales) d. Adverse physical or mental health e. A determination by a regulatory body either in the British Isles or overseas Fitness to Practise Rules 2004 Rule 5 (Conviction) – direct to FTP Hearing Rule 7 Letter – Annex A Expert opinion Health Assessment Performance Assessment Case Examiners Adjudication Warnings IOP Implementing the Civil Standard of Proof The standard of proof A new provision in our Fitness to Practise rules introducing the civil standard of proof at Fitness to Practise panel hearings, when panellists are making decisions on disputed facts, took effect on 31 May 2008 REGISTER OF FORENSIC PATHOLOGISTS DISCIPLINARY RULES ISSUE 2 – JULY 2007 © British Crown Copyright 2007 Those processes are set out in this document, which covers three main areas: a. The Disciplinary Committee Rules (DS), which set out the procedure for handling complaints up to the stage at which a case is referred to a Summary Hearing Panel (DS) or a Disciplinary Tribunal (DS); b. The Summary Hearing Rules (DS), which prescribe the procedure for hearing a case where the suspension or removal of a pathologist's registration is not contemplated; and c. The Disciplinary Tribunal Rules (DS), which prescribe the procedure for handling the most serious cases, with a range of sanctions which could include the removal of a pathologist's name from the Register (DS). The purpose of the disciplinary procedures (DS) is to ensure that the Register (DS) of forensic pathologists continues to identify only those who are fit to practise (DS). They provide a mechanism for remedial as well as punitive action, and enable the Pathology Council (DS) to demonstrate to the public that the standards published in the Code of Practice (DS) and Code of Conduct (DS) as to professional performance and behaviour are being maintained. The purpose of the disciplinary procedures (DS) is to ensure that the Register (DS) of forensic pathologists continues to identify only those who are fit to practise (DS). They provide a mechanism for remedial as well as punitive action, and enable the Pathology Council (DS) to demonstrate to the public that the standards published in the Code of Practice (DS) and Code of Conduct (DS) as to professional performance and behaviour are being maintained. Can ethical conduct, quality assurance and regulation be legitimate or effective when different standards are applied by different entities and in different circumstances of mortality?