Right of Reply: Dr Ian Bogle

The chairman of the Council of the British Medical Association replies to Monday's leader

RECENT CASES uncovering incompetence among doctors have quite rightly highlighted the way in which the medical profession seeks to regulate its performance. They have also raised the question of how the safety of patients can best be ensured.

The British Medical Association will play no part in supporting unacceptable levels of performance by doctors. The days when doctors thought they could turn a blind eye to the incompetence of their colleagues have gone.

Doctors should be under no illusion about their obligations. They are required by general medical council guidelines to report colleagues whose performance they believe to be below acceptable standards. The medical profession is now promoting a culture of openness and critical self- appraisal. I want to see the concept of whistle-blowing among doctors rendered obsolete. We must work towards a situation in which doctors who are putting patients at risk are quickly identified and helped.

We have proposed a system of individual appraisal for consultants under which senior clinical specialists would be asked to review their clinical and non-clinical performance. The way doctors conduct their work and perform is best assessed by people doing the same job.

There must also be a means by which doctors can compare their own performance with that of their peers: more information to enable doctors to compare their results, so that those whose performance is below the norm can take action to improve the situation. League tables of doctors are not necessarily the way forward but a system of greater openness and accountability can only be to the benefit of both patients and doctors.