Alan Milburn, the health secretary, yesterday proposed an early warning system to pick up the mistakes and bad practice of rogue doctors following the scandals of the GP Harold Shipman and gynaecologist Rodney Ledward, who were both able to carry on damaging patients for many years without being unmasked. The proposal, to be unveiled by the chief medical officer, Liam Donaldson, tomorrow, is that every hospital trust and GP practice will have to keep a register of mistakes and untoward incidents. If any patient is harmed, or might have been harmed - by a wrong drugs dose, for instance - it will have to be recorded and notified to a central database.
"Overwhelmingly, doctors do a brilliant job for the NHS, but I am determined to learn a lesson from where things go wrong," Mr Milburn told the BBC's On the Record. "The chief medical officer has made proposals to set up an early warning system so we can make the alarm bells ring.
"Where there has been an adverse incident where the patient has been damaged or died, we do not have a national system for recording that or doing something about it. Things go wrong. Cases end up in the courts. We have not fully learned from those. We need to take all that data, analyse it and learn the lessons."
Mr Milburn believes Shipman and Ledward would have been picked up by such a system. Deaths in a GP's surgery would have to be recorded on the register, since they are normally very unusual. In Shipman's practice they were almost a regular occurrence.
Ledward's hysterectomies and bladder operations went wrong far more often than those of his colleagues, but no one at the William Harvey hospital in Kent or in other hospitals where he worked spoke out. Analysis of a register of mistakes would have brought his record to light.
Where the register throws up a pattern of bad practice as it would have done in these cases, inspectors from the government's commission for health improvement would be sent in. They are already trouble-shooting in trusts where problems have been detected.
The proposals emerge as a second gynaecologist, Richard Neale, today faces a disciplinary tribunal of the General Medical Council. He worked at a hospital in North Yorkshire for 10 years after his licence to practise in Canada was revoked. Eventually, in the mid-1990s, the hospital trust paid him £100,000 to go and gave him a clean reference. He was suspended by the GMC last year and now faces complaints relating to 14 patients.
The British Medical Association said yesterday that it had no problem with the idea of registers for adverse incidents. "The system exists in a number of hospitals and practices. It is part of risk management to identify incidents where patients may have been harmed," a spokesman said. "If he is saying all hospitals should do this and the register be centralised, that is worth discussing." The only problem the BMA had was with the spin about "dodgy doctors" attached by ministers to such pronouncements, the spokesman added.
Mr Milburn's announcement came as Labour councillors promised to fight reforms which they say strip local authorities of responsibility for social services in a power grab by the NHS.
Sir Jeremy Beecham, chairman of the Local Government Association and member of Labour's national executive, said the plan to merge health and social care would put the welfare of thousands of vulnerable elderly people "at risk".
Last week Mr Milburn gave the first public indication that the government was preparing to loosen local authorities' grip on social services. His motive was to ensure that older people could be moved out of hospital as quickly as possible to free beds for other patients.
Useful links
Special report on the Shipman case at Shipman trial: special report
