The General Medical Council – which is now an unaccountable government appointed quango – has today told doctors that in future they must report most if not all knife injuries they treat to the police, whether the patient wishes them to or not.
No good, and much harm, will come of this.
Doctors are already obliged to tell the police if they become aware of a serious – which usually means life-threatening – risk to the public. Few would argue with that distasteful but necessary duty.
A number of victims of knife crime will wish to tell the police themselves. There will be no need for the doctor to tell the police – the patient will do it, if they haven’t already done so.
What we are left with, and where the new GMC rules will apply, is when the patient does not want the police to know. The new rules require the doctor to over-ride the patient’s wishes, and inform the police. It means a breach of confidentiality between the doctor and patient will occur. There is very little discretionary room for the doctor to decide whether to report or not. Most cases will be reported.
Confidentiality is central to the doctor-patient relationship. Patients need to know they can tell their doctors highly sensitive personal information without fear that the information will be given to third parties.
If a victim of a knife injury – who is of course already a victim – chooses of their own free will not to tell the authorities, then, at the end of the day that is their decision, and must be respected. Their wishes – whether we personally agree with them or not – must be accepted, not over-ruled.
Doctors have no place whatsoever acting as agents of the state in such circumstances. The fact a few knife crimes may go unreported is not a doctor’s business: it is the business of the police and the state. There can be no justification for co-opting doctors – who’s primary duty is to their patient, not the state at large – to this task.
Even more importantly, there can be no conceivable benefit to an individual patient who’s wishes are so over-ruled. In fact, and more to the point (at it were), they will suffer under the new rules.
Those with nothing to hide will, at a time of vulnerability, feel a sense of intrusion and exposure as their wishes are over-ruled and the state is informed of their misfortune. Many will feel a sense a betrayal at the hands of their doctor. Confidence in the medical profession will suffer – and both doctor and patient will be the worse for it.
The police will of course want to investigate, adding further to the sense of unwanted and unwelcome intrusion – all this at a time when the patient has suffered an injury that is itself a physical intrusion.
Those with something to hide – for whatever reason, criminal or otherwise – may well choose to visit some underground quack and as a result suffer poor or even incompetent treatment.
It goes without saying that the new rules are yet another example of social engineering by stealth. Today it is knife injuries. Not crime, but all injuries, for clearly the doctor cannot know for sure which injury is accidental and which is the result of crime. Who can know what next the state will want its doctors to report – or do – in the name of the state?
What we have here is the GMC taking action that will call the profession into disrepute. It is, you might say, stabbing the profession in the back. When an individual doctor commits such acts, the GMC can investigate and, if it sees fit, punish the doctor. It is high time we reversed the GMC’s little games – and put it in the dock for once.