Should failing health workers face criminal prosecution?
A proposal put forward in the aftermath of the Stafford Hospital scandal to criminally prosecute health professionals if they hide mistakes or fail to meet standards has been backed by the independent regulator for doctors.
The General Medical Council (GMC), the independent regulator for doctors, said it supports a legal duty of candour, which would see health professionals face prosecution if they fail to meet standards or be open about mistakes.
The proposal was put forward by Robert Francis QC in a damning report into the Stafford Hospital deaths scandal, which saw up to 1,200 patients die needlessly as a result of abuse and neglect.
Patients were left in soiled beds, receptionists often decided who to treat in A&E and some patients were so thirsty they drank out of vases.
In his report, Francis suggests hiding information about poor care should become a criminal offence, as should failing to adhere to basic standards which lead to death or serious harm.
He recommends placing a statutory obligation on doctors and nurses for a duty of candour so they are open with patients about mistakes.
The report is a result of a public inquiry set up to examine why grave problems at Mid Staffordshire NHS Foundation Trust, which ran Stafford Hospital, were not identified and acted upon sooner.
The report concluded board members and other leaders at the hospital Trust failed to appreciate the “enormity” of what was happening at Stafford between 2005 and 2009, and patients were let down by “catastrophic failings”.
But while the GMC backs proposals to prosecute failing or dishonest health professionals, it stresses its guidance, Good Medical Practice, already places a requirement of candour on doctors.
“It is clear that doctors should be open and honest and act on patient complaints,” a GMC spokesperson said.
“If they seriously and persistently fail to do so, then they risk action being taken on their registration.”
Section 30 of the Good Medical Practice guidance reads: “If a patient under your care has suffered harm or distress, you must act immediately to put matters right, if that is possible.
“You should offer an apology and explain fully and promptly to the patient what has happened, and the likely short-term and long-term effects.”
This was echoed by the British Medical Association (BMA), the trade union for doctors in the UK.
BMA Chair of Council Dr Mark Porter also stressed employers have a responsibility to ensure staff feel able to speak out: “Doctors are already subject to a duty to raise and act on any concerns about patient safety, a duty defined and enforced by the General Medical Council,” he said.
“This professional obligation to speak out must be balanced with an absolute responsibility on employers to listen and protect staff who raise concerns.
“Despite all the current regulations and laws, the Francis Inquiry report describes a culture of fear, bullying and harassment that can stop healthcare professionals from speaking out.
“NHS staff will remain fearful of being open unless they know they will be protected and listened to. The two go hand in hand.”
The Royal College of Nursing (RCN) would not be drawn on whether it supported the idea of criminal prosecution, but Director of Legal Services Chris Cox said: “We are examining carefully the new offences recommended in the Francis report and their practical application.
“We fully support the need for more accurate, truthful and open reporting of safety concerns.”
Meanwhile Staffordshire Police maintains a criminal investigation would not have uncovered the failings at Stafford Hospital. A spokesperson said: “The events at Stafford Hospital have been a tragedy for the many families affected and our local communities. Like them, we are currently studying the report’s full contents.
“Whilst the five major inquiries – including two independent public inquiries - into the hospital highlighted many instances of unacceptable standards of patient care, at that time there was no evidence that the circumstances of any of the tragic deaths constituted a criminal offence under the law.
“The fact that public inquiries were commissioned indicates that a criminal investigation, using the legislation as it stood at that time, would not have been effective in uncovering the failings. This is supported by significant recommendations within the report to change the criminal law.
“We work closely with HM Coroner when cases relating to death in healthcare settings are referred to us. Officers carry out detailed reviews, liaising with the coroner’s office and, where necessary, the Crown Prosecution Service.”
Do you think health professionals should be criminally prosecuted if they fail to meet basic standards or hide mistakes? Tell us by taking part in our opinion poll on the right-hand-side of the page.