Doctors already have a professional duty to provide patients with an explanation and apology when something goes wrong and the Medical Defence Union's experience is that doctors do raise concerns and there is no need for a legal duty of candour. Each month the Medical Defence Union (MDU), takes several calls to its 24-hour advice line on the subject and opens files to assist medical members who want to raise concerns about patient safety.

Responding to today's Health Select Committee's report on improving patient safety*, the MDU, the UK's leading medical defence organisation, also said it welcomed proposals to 'banish the blame culture' and improve the reporting of patient safety incidents by NHS staff.

Dr James Armstrong, MDU medico-legal adviser, said:

"We support the recommendation that patients who are harmed and their relatives deserve a full explanation, unequivocal apology and an undertaking that the harm done will not be repeated. In our experience, doctors are ready to apologise when something goes wrong. The MDU has advised members to do so for over 50 years. We were happy to sign our name to the recent guidance to NHS chief executives from the NHS Litigation Authority because it is so important to get this message across.**

"The Committee's report states that the failure to be open when a patient complains is partly due to a fear of litigation. That is not our experience and we advise our members there are no legal concerns about taking this course of action. Section 2 of the Compensation Act 2006 makes it clear that an apology is not an admission of negligence.

"We do not support the Committee's recommendation that the CMO's proposal for a statutory duty of candour be considered. The inference of the recommendation is that no effective duty of candour currently exists, but this is not the case for doctors who already have an ethical duty and our experience is that doctors do raise concerns. We do not know what the sanction would be if such a legal duty were introduced, but doctors can already be erased from the medical register if their fitness to practise is impaired because they have not complied with GMC guidance. Surely that is sanction enough?

"Our experience is that many adverse clinical incidents arise because of system and equipment failures, which are not the responsibility of the individual. Doctors and other healthcare staff need to feel supported and to know they will not be unfairly blamed if they report such incidents so that lessons can be learned and necessary improvements to services can be made in the interests of patient safety. "

References

* Patient Safety, Health Committee, Friday 3 July 2009 parliament/healthcom/.

** Apologies and Explanations, guidance from the National Health Service Litigation Authority, This Week, Thursday 14 May 2009 nhsla.

The MDU is a mutual, not for profit, organisation owned by our members who include over 50 per cent of the UK's hospital doctors and GPs. Established in 1885, we were the world's first medical defence organisation. We defend the professional reputations of our members when their clinical performance is called into question. Our benefits of membership include insurance for claims of clinical negligence and a wide range of medico-legal advisory services.

Source
Medical Defence Union