Good medical practice, perhaps, but bad English. Absolutely Stilton’s announcement of his latest hair shirt guidance for doctors, absolutely jointly produced with the Nursing and Midwifery Council so that it applies to nurses and midwives as well, is focused, if that is not too strong a word, on the duty of candour, more generally understood as the duty to be honest. It tells clinicians, with a ringing third degree participle prolapse, that ‘When something goes wrong with a patient’s care, doctors, nurses and midwives should: speak to the patient, or those close to them, as soon as possible after they realise what has happened.’ Wily clinicians, and those liable to be bent by their learned friends, are thereby provided with a useful loophole. So long as the patient hasn’t realised something went wrong, there is no need for the clinician to embarrass themselves. Piling Pelion on Ossa, the next point reverses the prolapse. Clinicians, the announcement says, should ‘apologise to the patient – explain what happened, what can be done if they have suffered harm and what will be done to prevent someone else being harmed in the future’. From where Dr No is sitting, it seems they absolutely don’t know who they are, and if they don’t know who they are, the what hope can there be for the rest of us knowing who we are, let alone what we should do?
Fretting about prolapsed participles may strike some readers as anal, if that’s the word Dr No is looking for, but the retention of a third degree participle prolapse in official announcement pages about guidance for doctors, nurses and midwives suggests a wooliness of thought that absolutely does not bode well for the future of professional regulation. One might have hoped that with absolutely two Councils involved, there was double the opportunity to get things right, but its seems Murphy’s Law has absolutely prevailed, with double the opportunity to get things wrong. That the guidance itself is not so burdened is neither here nor there: not everyone will read the guidance, and some that do will only do so after the shit has hit the fan. Nor does it help that, at the time of writing this post, the links on the GMC website to the guidance proper are squiffy. The obvious link – ‘Read the guidance’ with a dinky little absolutely GMC blue arrowhead beside it – absolutely disappears up it’s own backside: on being clicked, it returns to itself. Readers more determined to find the guidance may persevere; others may find themselves absolutely losing the will to live before achieving success.
Grammar aside, and ignoring the ‘Hot Topic’ link which suggests more Hot Gossip than a serious attempt at illuminating the conundrums, the announcement of the guidance contains another blooper. Bullet Point One – why, oh why, does everything have to be bulleted these days? – or put between dashes for that matter – exhorts clinicians to speak to patients/relatives ‘as soon as possible’ while Bullet Point Two – rat-tat-tat – frames what the clinician should say, including ‘what will be done to prevent someone else being harmed in the future’. This seems more than a little optimistic at such an early stage, when little if any objective assessment of what went wrong, and so what should be done to prevent future mistakes, will have been done. Again, the guidance proper is more thought through on this point; but again the point about what most people will see and read applies. Far more people read headlines and stand-firsts than read the small print.
No one can doubt the importance of honesty in clinical care, especially when things go wrong. The GMC, and others it has to be said, have added pomposity, and called the principle a ‘professional duty of candour’ but the principle itself is more fundamental, the general human principle of honesty between fellow beings. Having high-jacked what should first and foremost be a human rather than a professional principle, the GMC – ever the committee in search of a function – has published some junk on its website about the principle. Given the hundreds of thousands of pounds Stilton spends on his media goons – the Ferret Fancier provides some eye-watering figures here – we might expect clear thought through guidance on its web-pages. Instead, we get sloppy writing, dangling participles and ill thought through logic, where they don’t even know who ‘they’ are. Do they even know their arse from their elbow? More evidence, not that it is needed, that the GMC is well past it’s use-by date.