NHS managers must do more to protect the public from rogue doctors, the president of the General Medical Council said yesterday.
Sir Graeme Catto suggested that incompetent doctors might still go undetected for years and local trusts had "a real responsibility" to ensure that medical staff acted in a professional manner.
"I think the local systems within the NHS are not yet in place," Sir Graeme was quoted as telling the Northern Echo newspaper.
"We should insist that the local systems are much more robust. The trusts here have a real responsibility to ensure that the people they employ or contract with behave in a responsible way.
"Sometimes that conflicts with getting waiting lists down because they don't want to attack a particular doctor because they are difficult to replace."
The GMC is fighting to protect the profession's long history of self-regulation.
It was roundly criticised by Dame Janet Smith in her fifth report on the serial killer GP Harold Shipman, suggesting that it protected doctors at the expense of their patients.
Other high-profile inquiries that have raised similar concerns include the case of gynaecologist Rodney Ledward, who was struck off for botching operations; the "club culture" among doctors and managers at Bristol Royal Infirmary, where babies died because the surgeons were not good enough at heart procedures; and Alder Hey children's hospital, where organs were removed from hundreds of children without their families being asked.
The GMC believes it has streamlined procedures for dealing with complaints against doctors, including telling employers if it has cause for concern, which it hopes will help remedy failures in the system.
But the government has ordered a review of the profession's record in regulating itself.
Sir Graeme's predecessor, Sir Donald Irvine, last year suggested that around 5% of doctors were probably unfit to practice for various reasons, including losing skills, ill-health and incompetence.
Alastair Henderson, deputy director of NHS Employers, said he had no evidence standards were being compromised in pursuit of other priorities.
"Patient protection has to be top," he said. But he welcomed Sir Graeme's remarks on the responsibility of employers to check on the fitness of doctors.
"For far too long there has been an assumption amongst doctors that that [responsibility] should rest outside their employers, with the GMC or with other doctors. These processes are strengthening the whole time."
