Prosecuting doctors won’t stop them making mistakes

Article in The National (Abu Dhabi)by Justin Thomas 4 January 2009.

It appears that there are draft proposals for criminal sanctions to be brought against negligent doctors in Abu Dhabi.

Justin says that whilt he agrees healthcare professionals need to be held accountable, "such accountability and possible culpability, should only be a small part of a system-wide approach to reducing errors and improving patient safety. In fact, individually punitive measures are actually more likely to lead to a deterioration in patient safety rather than improvements."

All human beings make errors. Punishing people for slips and lapses does not improve safety or performance; if anything, it breeds resentment and fear, which in turn can lead to the development of a blame-culture, scapegoating and cover-ups.

The article says that several studies in the UK have estimated that at least 10 per cent of all hospital admissions result in adverse events, with 50 per cent of these mishaps being viewed as preventable. Also, the UK government estimates that annually there are 10,000 adverse drug reactions, 400 deaths involving medical devices, 28,000 complaints about medical care, and £400 million (Dh2.1 billion) paid out in clinical negligence settlements.

"In terms of improving patient safety, the dismissal or even incarceration of errant professionals will have little impact, and in some cases may even make the situation worse, especially if practitioners become defensive, risk averse and demoralised."

"The answer to preventing error and improving patient safety lies in the development of organisational safety cultures, where staff have an active awareness of the potential for things to go wrong and know about things that have gone wrong previously, as well as the circumstances and causes leading up to such incidents. Such a culture should actively encourage people to speak up about mistakes, with a view to learning from them and minimising the likelihood of a recurrence."

Andy Brazier