The first GPs in Britain to experience the rigours of the health service ombudsman’s jurisdiction were called to account last week by MPs on the Commons select committee on public administration.
Dr William Cuthbert, a GP in Wolverhampton, was criticised by the ombudsman, Michael Buckley, for failing to respond to an out of hours call to arrange a syringe driver to administer morphine to a terminally ill patient when he was shopping on a Saturday morning.
He advised the relatives to call again on Monday morning, but by then the woman had died. The ombudsman upheld a daughter’s complaint and found that Dr Cuthbert’s actions fell well short of the professional service the patient and her family had a right to expect.
Dr Cuthbert told the committee that at the time he felt there was little he could do for the patient except send her to hospital, but the family were against that. With hindsight, he now felt he should have visited and had apologised to the family.
“I feel guilty. I feel I could have done better. There was a lack of communication,” Dr Cuthbert said. He was now more cautious and looked for possible pitfalls. Asked what lessons there were for other doctors, Dr Cuthbert replied: “Short of visiting every patient who calls—if in doubt, go and have a look.”
Dr Deepak Trevidi, a Wigan GP, was criticised by the ombudsman for acting with undue haste in removing three households—a mother, daughter, and son—from his list when only one removal was justified.
Dr Trevidi should have made more effort to preserve the doctor-patient relationship, the ombudsman said.
Dr Trevidi admitted to the MPs that at the time he was not aware of General Medical Service Committee’s guidance of some six months earlier that as a matter of courtesy GPs should inform patients of a removal and briefly outline the reasons.
Dr Trevidi now accepted that he should have explained his reasons to the families. In his experience, however, if there was a disagreement with one unit of a family it was better to remove all of them. Since 1996 the ombudsman has had powers to investigate the actions of GPs.