These are difficult days for doctors. Harold Shipman was recognised as an aberration, but almost every week since his conviction there has been a new headline about what sceptics regard as characteristic medical incompetence or malpractice. Pathologists steal body parts. General practitioners declare themselves plastic surgeons and leave women scarred for life. Paediatricians' cardiac experiments result in the death of 35 children. Radiologists fail to notice cancer symptoms in 82 women examined in the breast screening programme.
The revelations of the radiologists' failure came at a bad time for the profession. The Kennedy report into the Bristol baby deaths had revealed a "secret society culture" in which people advance "in their careers by not rocking the boat". As if to confirm that analysis, the General Medical Council behaved like the membership committee of a country club, exactly the complaint that was made against Bristol doctors who should have exposed the cardiac experiments. The errant radiologists were found guilty but not struck off.
I know that the majority of doctors are conscientious and overworked. During the six weeks before my mother's death, I witnessed the devotion with which the staff at a great northern hospital cared for a ward of geriatrics whose conditions were beyond surgery but who responded to the palliative treatment which made their last days bearable. It made me proud to support the National Health Service. But I still understand why patients, or more likely their anxious relatives, are in a mood to inquire into the record of a surgeon before the knife goes in.
Some patients always did. The articulate, self-confident middle classes always talked on equal terms with doctors. In my asthmatic childhood, we never sent for Dr Stevens to give me the early morning adrenalin injection until the grate had been cleared and a new fire laid. I do not recall the date of my emancipation. But I do remember that when it was thought, wrongly, that I must have my gall bladder removed, David Owen offered to make inquiries about the surgeon in whose hands my life would be. His words were: "If somebody is going to cut a two-foot hole in your stomach, you need to know that he's up to the job."
Alan Milburn's independent office for information on health care performance will give the reticent masses a chance to influence their own surgical destiny. It may improve the levels of performance. And it will help to provide the feeling of confidence so important during the time that the trolley is being wheeled from the ward to the theatre. Everyone who believes that we should empower "the people of England who have not spoken yet" will welcome the idea.
So will the more sensible doctors. Few patients now are prepared to carry notes of their condition from one doctor to another without tearing open the sealed envelope. The age of deference is not quite dead. But it is dying. No general practitioner or cardiac surgeon has anything to gain from it being replaced, among the timid patient population, by an age of resentment. And that is what would happen following the recent revelations if the tragedies were brushed aside as mistakes which doctors must be allowed to deal with themselves. Worse would follow. Patients who dared not argue with their doctors face to face would increasingly sue for negligence (whether their complaint was justified or not) as the only way of breaking into the magic circle.
The critics are right to say that the publication of complicated information has its dangers. Misinterpretation by the uninitiated is always too easy. So it is important that the medical performance statistics, unlike the schools' examination results figures, are not used as if they were scores in a competition which ends with a championship trophy. With the promised help of the professional associations that can be avoided. Lord Hunt, the junior health minister said so on the radio, and I always accept what he says. Anyone who was able simultaneously to be the secretary of both the Association of Health Authorities and the Sparkbrook constituency Labour party must be a man of formidably eclectic talent.
When he was a councillor and I was an MP in Birmingham's inner city, I doubt we met many people who would openly challenge a doctor's opinion or performance. The dissatisfied patients accepted whatever was prescribed and complained to us afterwards. Politicians, quite rightly, are not surrounded by mystique. Doctors, quite wrongly, too often are. The acceptance that even one small part of the profession shall be monitored will help to destroy the myths. Knowledge is power. The more it is spread the better. What about lawyers next?
