Doctors: Suspension (Hansard, 19 March 2003)

§ Baroness Andrews
My Lords, the National Clinical Assessment Authority has helped the NHS manage concerns about medical performance and has supported doctors in over 500 cases. The Chief Medical Officer has recently reminded NHS employers in 235 England to consider asking the NCAA for advice when they have serious concerns about the performance of a doctor which might lead to suspension.

§ Baroness Knight of Collingtree
My Lords, is the Minister aware that there is strong and growing criticism of the NCAA that its assessments are frequently biased and wrong? Is she also aware that the authority has spent some £9.5 million in two years yet has completed only 16 assessments of the 300 cases referred to it? Does she really think that the NCAA is providing good value for money, as, additionally, all suspended doctors are on full pay and do nothing, sometimes for months and even years, because of delayed judgments?

§ Baroness Andrews
My Lords, I know how deeply the noble Baroness feels about inappropriate suspension and the distress that that causes doctors. The NCAA was set up to address those concerns. So the number of assessments does not represent in any way the sum total or value of the NCAA's work. There have been 18 assessments but 500 cases have been dealt with; in many instances, they have not gone to assessment and the doctors have not been suspended because the intensive advice presented by caseworkers, often over a period of time, has meant that issues have been resolved on the ground. When the noble Baroness asks me whether I think the NCAA is good value for money, I would say yes. Every doctor who is not suspended and has returned to work, maybe with retraining, represents a gain to the NHS. The feedback that we have had after the first 18 months shows that 80 per cent of the people dealt with have reported positively.

§ Lord Clement-Jones
My Lords, is it not far from clear whether the NCAA is really doing the job that it was set up to do in reducing the number of long-term suspensions of doctors? I have here an e-mail from a junior doctor who says: I have not been told whether I am suspended, on sick leave, study leave or special leave. This can't be right". Does the NCAA really provide value for money? Should not the National Audit Office look into this matter?

§ Baroness Andrews
My Lords, this body has been in operation for only 18 months. It has moved fast to address serious concerns and to create a culture in which doctors are more confident in what they do and health authorities are more confident that the procedures are right. We believe that it is working well. In addition, the national project on long-term suspension deals specifically with cases in which doctors have been suspended for longer than six months. Over the last quarter there were 29 such cases; 10 of those doctors have been returned to work and are no longer suspended, and 19 are being actively managed to give them support, retraining, or whatever they need.

§ Lord McColl of Dulwich
My Lords, is the Minister aware that some doctors are suspended for as long as 236 four years, which causes terrible trauma for them and their families? At the end of that time they are very often exonerated. What happens to their false accusers?

§ Baroness Andrews
My Lords, the noble Lord is absolutely right. The reason for setting up the NCAA in 2001 was because there were some outstanding cases from the late 1990s. Having a body to which health employers can refer instantly when they identify a problem and from which they can obtain appropriate advice so that the problem is nipped in the bud means that we do not have these interminable cases which cause such distress for both doctors and patients.

§ Lord Campbell-Savours
My Lords, does not the noble Lord, Lord Clement-Jones, have a point? Is there not a possibility that this matter could be referred to the National Audit Office? I am sure that it would produce a very interesting report.

§ Baroness Andrews
My Lords, it so happens that the National Audit Office is considering the whole range of clinical suspensions and is looking at all health authorities across the range of specialties. We hope that it will report some time in the summer. So, although it is not looking at exactly the same population, we will have more information on which to build good practice.

§ Lord Chan
My Lords, does the Minister agree that a disproportionately high number of suspended doctors are from ethnic minority groups? Has that been investigated by the NCAA or the Department of Health?

§ Baroness Andrews
My Lords, the noble Lord has told me something I did not know. There has been no attempt to look at the suspension of ethnic minority doctors separately from that of anyone else, but I will write to the noble Lord and give him whatever information the department holds on that.

§ Lord Campbell of Alloway
My Lords, is there no procedure for appeal against a suspension, which could take four years? If there is, could the Minister tell the House what it is?

§ Baroness Andrews
My Lords, as I understand it, there is an appeal procedure for general practitioners who have been suspended and, I believe, for hospital doctors. I will have to write to the noble Lord, as I am not familiar with the details.

§ Baroness Masham of Ilton
My Lords, how many people have been working as doctors under false pretences, without qualifications?

§ Baroness Andrews
My Lords, I think that that goes slightly wide of the Question. I take some consolation 237 from that, because I am afraid I have no idea. I imagine it is rather difficult to find out. I do not know whether I have helped the noble Baroness at all.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that some cases have lasted much longer than the four years that has been quoted today? When I was on a regional health authority, one doctor had been suspended on what I suppose could be called gardening leave for over a decade on full pay. It is wrong that there is no employment procedure. We have heard about the hardship for doctors, but there is also hardship for the National Health Service and for patients if someone cannot be reinstated in that period. There should be some way of terminating the employment.

§ Baroness Andrews
My Lords, I believe the noble Baroness was referring to a case that was notorious in the mid to late 1990s. The new procedures to manage suspension came in as a result of that. I agree that we must look carefully to ensure that nothing like that happens again.