Tony WrightTo ask the Secretary of State for Health what sanctions will be applied under the proposed arrangements for clinical governance to clinicians who refuse to take part in audit and clinical governance arrangements. [144439]
§ Mr. DenhamClinical governance requires all National Health Service organisations to put in place a range of mechanisms, including clinical audit, which enable them to monitor and assure the quality of their clinical services. It does not impose sanctions on individuals. The Commission for Health Improvement will provide an independent and external check on progress in implementing these arrangements.
However, the NHS Plan proposes that, subject to Parliament, all doctors working in primary care will be subject to clinical governance arrangements and we are working with the profession to finalise these proposals. We intend to introduce participation in clinical audit and annual appraisal as a contractual requirement, and general practitioners should, therefore, participate fully and positively in the process. Refusal to take part would be a disciplinary matter to be dealt with, where necessary, under disciplinary procedures. These procedures will be speeded up, with health authorities given a greater role in dealing with individual cases.
From 1 April 2001, appraisal will be a contractual requirement for all hospital consultants, and must be carried out annually. Consultants will be expected to participate positively in the appraisal process. Refusal by a consultant to participate will be a disciplinary matter to be dealt with, where necessary, under the employer's disciplinary procedures. Additionally, the chief executive will report the matter to the Discretionary Points and Distinction Award Committees, and the consultant will not be considered for an award until he or she has agreed to participate fully in the appraisal process.
The General Medical Council makes clear in "Good Medical Practice: Duties of a Doctor" that doctors should take part in regular and systematic medical and clinical audit. Indeed, clinical audit results will be a major factor for the GMC in considering whether individual doctors have met the requirement of their new revalidation system which will follow on the introduction of appraisal. This will be a powerful tool in ensuring participation in clinical audit.