Failure to protect doctors reflections a missed opportunity

The Williams Review’s failure to recommend giving doctors’ reflections legal protection in the criminal courts is a missed opportunity to promote a genuine learning culture, the GMC has said.

The Health Secretary announced in February that he had asked Prof Sir Norman Williams, former President of the Royal College of Surgeons, to carry out a rapid review of gross negligence manslaughter in healthcare following concerns raised around proceedings following the death of Jack Adcock at Leicester Royal Infirmary in 2011.

"We wholeheartedly support the Secretary of State’s desire to create a learning culture. The best way to achieve that is to legally protect doctors’ reflective notes. We are concerned that, in accepting these recommendations, the Government is missing an opportunity to protect all doctors by not going ahead with a recommendation to enact this legal protection."

Prof Sir Terence Stephenson

Chair of the General Medical Council

In its submission, the GMC made clear that it does not ask for doctors’ reflective notes in its investigations. However, the GMC does not control the actions of courts, and recorded reflections are not currently subject to legal protection in court proceedings. The GMC told Sir Norman’s panel that it had concluded that doctors’ reflections are so fundamental to their professionalism that UK and devolved governments should consider providing legal protection. 

Prof Sir Terence Stephenson, Chair of the General Medical Council, said:

‘We are disappointed by the Review’s recommendations.

‘We wholeheartedly support the Secretary of State’s desire to create a learning culture. The best way to achieve that is to legally protect doctors’ reflective notes. We are concerned that, in accepting these recommendations, the Government is missing an opportunity to protect all doctors by not going ahead with a recommendation to enact this legal protection.

‘We are also surprised that the Review has focussed on the GMC’s right of appeal given the case remains before the courts. If the recommendation to remove this is pursued, it will significantly reduce our ability to protect patients. 

‘Our appeals have been upheld in 16 out of 18 cases heard by the courts. We believe our actions have provided greater public safety and maintained public confidence in the profession through these rulings, all but one of which involved sexual misconduct or dishonesty.

‘We believe that a culture of learning applies to the GMC as much as to doctors, and we will reflect on the Review’s observations.’

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