The MDU's Dr Christine Tomkins
Hospital Dr invites Dr Christine Tomkins, chief executive of the MDU, to answer 12 questions and complete a half written sentence:
1. What is the biggest challenge the profession faces?
From a medico-legal perspective, the biggest challenge is the increasing level of regulation faced by doctors.
After a single incident, a doctor can be suspended and/or disciplined by their employer; questioned at a Coroner’s Inquest and in a Care Quality Commission investigation; investigated by the police and face a criminal trial; called to appear before the GMC at a Fitness to Practice hearing; subjected to a civil claim for alleged clinical negligence; and face the glare of the media. Obviously doctors who are not performing or who may be a danger to patients need to be identified and any concerns addressed; but the existing systems are more than enough to achieve this. Anything more is out of all proportion.
2. When did you last laugh?
About five minutes ago, when my medical student son phoned to ask me to send him a preposterous list of things he had forgotten to take back with him to university.
3. Which person influenced you the most as a doctor and why?
Donald Longson, a consultant physician at Manchester Royal Infirmary and the dean of clinical studies at Manchester Medical School. I did my pre-registration medical house job with him at Manchester Royal Infirmary and was lucky enough to have him as a friend and mentor until his death in 2002. He was wonderfully clever and perceptive, as well as funny and kind. His patients loved him, as did his colleagues and friends. He was a perfect example of an exceptional doctor and exceptional human being.
4. When were you most in danger?
A horse I was riding reared and fell on me a few years ago. I had a very narrow escape.
5. What do you hope to achieve in this role?
To drag professional indemnity into the 21st century! In most other EU countries, insurance for doctors is compulsory or the norm, and in the UK other healthcare practitioners, such as optometrists, all require a professional indemnity insurance policy so the medical profession is out of step.
Discretionary indemnity for clinical negligence claims may have served doctors well in the 19th and 20th centuries but times have changed and it’s not unusual to see compensation awards between £3 million to £4 million. A contract of insurance, and the security that successful negligence claims that come within the policy will be paid, is indisputably in the interests of patients and of doctors.
The MDU is the only medical defence organisation to provide members with insurance. This means there is still a substantial number of the UK’s doctors not covered by insurance if they are sued. With discretionary indemnity, there is no guarantee that patients who are harmed by doctors’ negligence will be compensated.
6. What is your favourite film?
To Kill A Mockingbird
7. Is the medical profession over regulated?
The MDU has repeatedly spoken out against new tiers of regulation which we believe are unnecessary and likely to be time-consuming for the profession. We see no need for the changes being brought in and strongly object to the suggestion there is a regulation gap. The medical profession is already held accountable in more ways than other professions. If anything, there is too much regulation.
8. What is your guiltiest pleasure?
Not telling!
9. How do we tackle our culture of litigation in the NHS?
If a patient has been negligently treated it is right that they be compensated. However, our evidence shows that claimants’ legal costs are excessive, often far higher than the compensation itself. We have campaigned for fairness and proportionality in claimants’ solicitors fees.
We don’t believe defendants should pay success fees in clinical negligence cases and after the event insurance should be abolished if conditional fee arrangements are in place. We would also like to see fixed hourly rates for claimants’ solicitors.
10. What was your most embarrassing professional moment?
There have been a few. I blush to remember when, as a junior doctor after a long spell on-call, I fell asleep while taking a history from a patient. Fortunately I don’t think he noticed or he was too polite to say so.
11. What has been your greatest success?
Being appointed chief executive of the MDU, the UK’s oldest and largest medical defence organisation and being the only qualified doctor leading a medical defence organisation.
12. Will the new NHS complaints system benefit both doctors and patients?
In general ‘yes’. The new procedure has just two stages and we are pleased to see greater emphasis on local resolution, as our experience is that the majority of complaints are resolved quickly, often by providing a clear explanation and a sincere apology, when appropriate. We also support the emphasis on using complaints to identify where systems need to be implemented to help prevent mistakes happening again.
On the negative side, the new procedures allow complaints to be made direct to a trust and only notified to the provider with the consent of the complainant. This means it is possible that doctors may not even be told and this means they cannot respond or address concerns.
Finish this sentence: Andy Burnham is…
…an Evertonian, so he will be much happier now than he was on the first day of the season!
Tags: Interview, Litigation
