Open surgery

A recent Channel 4 TV series took a long, hard look at this important question. Sad stories were told about patients who had suffered through poor doctoring. Lawyers and journalists pointed the finger of blame, making the usual accusations of cover-ups and incompetence. It made painful viewing.

I have a confession to make. I am a doctor, and I sometimes make mistakes. My doctor friends make mistakes too. As the saying goes, "The man who never made a mistake never made anything". I wish I could be sure to never made a medical error as long as I lived, but I can only do that by giving up doctoring, just as the only way a goalkeeper can be sure never to let a goal in is to give up football. We all get it wrong sometimes, but even without mistakes, medicine is an uncertain business where a good result can't be guaranteed.

As a GP tutor, I believe that continuing, lifelong education for all doctors is our best chance to promote good practice and reduce mistakes. GPs must put in at least 30 hours a year of continuing medical education, and I know that we would all like to do more if our heavy workload allowed us. The doctors I talk to about education all say the same thing-"we don't have enough time!" and they are right. We have the cheapest health service and the biggest GP list sizes in Europe, and increasing the number of doctors to a sensible level would be the single most helpful thing that would reduce medical accidents and errors.

However, that isn't going to happen any time soon, so in the meantime we are trying even harder to improve GPs' training. New rules, including annual appraisal of all doctors to support and improve their practice are being introduced. Schemes like TARGET (Time for Audit, Reflection, Guidelines, Education and Training) will give hard-pressed doctors time away from the surgery to keep their practice up to date. That should reduce the risk of error. Significant Event Audit, which is about learning from mistakes, will also help. The problem is that some of us are afraid to own up to getting it wrong for fear of punishment, which some people think is the answer. "Strike off all the bad doctors!" they say. OK then, sack us all because we've all made mistakes.

Doctors are like parents - imperfect ones are all we have. The real question is how we can get the best possible doctors, and enough of them. Constant criticism is no encouragement to the bright young men and women who could choose to train as doctors, or make an easier, richer, living in business or law.

Yes, some doctors are so bad they should not be allowed to practise. However, most medical errors are made by decent doctors who were overworked, tired, sick, or had too little time for training. If Britain had as many doctors per head as other European countries, these risks could be reduced.

So, we doctors do get it wrong sometimes, but on the whole I think we do better than our MPs. Doctors didn't privatise the railways, starve the NHS of resources for 20 years, and if we had been given a billion pounds to spend to celebrate the millennium, we would have built new hospitals, not a silly tent in Greenwich!