The jigsaw of child protection.

Heather Payne cites two cases involving Dr David Southall in her article ‘The jigsaw of child protection’ (JRSM 2008;101:93–94). She uses these to advance general propositions about the role and operation of the GMC. Dr David Southall has appealed the more recent decision to the High Court. It would be inappropriate for me to comment on either case in advance of that appeal. But there is a more general point about the way that the GMC’s critics allow a very small number of specific cases to dominate their arguments and skew their assertions about how paediatricians are treated by the GMC. The GMC’s statutory purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. We investigate complaints about individual doctors in order to establish whether their fitness to practise is impaired. Paediatricians attract complaints like other doctors, but it is untrue that large or disproportionate numbers of paediatricians are represented in our fitness-to-practise procedures or that other than a very small number are referred for a public hearing. Between April 2006 and April 2008, we received 9400 enquiries or complaints about doctors of all specialities. Of those we investigated, 14 were about paediatricians allegedly in connection with child protection work. 11 of the 14 have concluded without reference to a fitness-to-practice panel or other action by the GMC. Three investigations have not yet been concluded. It is actually extremely rare for a paediatrician to appear before a panel in connection with child protection work. Since 2004, panels have considered more than 600 cases. Only two could reasonably be said to have been about paediatricians involved in child protection. We agree it cannot be in the public interest if doctors are inhibited from acting to protect children or deterred from giving evidence honestly and truthfully and within their competence. But, equally, it cannot be in the public interest, or the interests of the medical profession, if the GMC does not act when doctors practise incompetently or inappropriately.