CONTENTS IN THIS ISSUE
WHY do doctors fi nd it diffi cult to say sorry? It’s a key question in a post-Francis NHS with calls for a statutory duty of candour on top of professional obligations to be open and honest in admitting errors. Psychiatrist Aaron Lazare – author of the book On Apology
– wrote: “We tend to view apologies as a sign of a weak character. But in fact they require great strength. Despite its importance apologising is antithetical to the ever-persuasive values of winning, success and perfection. The successful apology requires empathy and the security and strength to admit fault, failure and weakness. But we are so busy winning that we can’t concede our own mistakes.” On page 12 of this issue Dr John Dudgeon – a medical adviser at
the Scottish Public Services Ombudsman – explores the need for a culture change in attitudes to acknowledging mistakes. The GDC has being facing increasing levels of fl ack over proposals to raise the annual retention fee by 64 per cent – and
this on top of a recent Professional Standards Authority review in which the GDC failed to meet seven out of 10 good regulation standards in fi tness to practise. On page 10, chief executive and registrar Evlynne Gilvarry addresses some of the criticisms. MDDUS case fi les contain numerous examples of negligence
claims resulting from failed joint and soft tissue injections – not just in technique but in poor consenting and explanation of risk. On page 16, Dr Lucy Douglas highlights new guidelines on best practice from the Primary Care Rheumatology Society. We also have Steve Ashton from Law at Work (p. 18) discussing dental practice health and safety. Do you have risks hiding in plain site? And on page 14 Allan Gaw recounts a medico-legal case dating back to the founding of MDDUS and involving the domiciliary use of chloroform. Would the outcome have been diff erent if ruled on by a judge today? Quite possibly not.
Jim Killgore, editor 12 SAYING SORRY 14 INDEED
John Dudgeon – GP and medical adviser with the SPSO – calls for a culture change in attitude among doctors towards saying sorry
14 A MOST SERIOUS CASE
What began with a simple work- related injury in 1902 would end a year later with a death, a court case and a piece of medico-legal history. Allan Gaw investigates
16 CLINICAL RISK REDUCTION 18 HIDING IN PLAIN SIGHT 16 Cover image:
Highland Landscape by Denis Peploe
Son of Samuel John Peploe, the noted Scottish Colourist, Denis Peploe inherited a particular feeling for the landscapes of the Highlands. This
painting depicts a landscape in the Scottish Highlands: the sombre colour palette adds a melancholy mood to the vast space depicted and is reminiscent of the style demonstrated in the artist’s other Highland pieces. Art in Healthcare (formerly Paintings in Hospitals Scotland) works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit
www.artinhealthcare.
org.uk Scottish Charity No SC 036222.
AUTUMN 2014 Editor:
Jim Killgore Associate editor: Joanne Curran
Editorial departments: MEDICAL Dr Jim Rodger DENTAL Mr Aubrey Craig LEGAL Simon Dinnick RISK Peter Johnson
Ashton considers some risk areas in dental practice so obvious they become invisible
Please address correspondence to:
Summons Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA
jkillgore@mddus.com
Design and production: CMYK Design 0131 556 2220
www.cmyk-design.co.uk
Lucy Douglas highlights new
guidelines on best practice in joint and soft tissue injections
Health and safety expert Steve
REGULARS 4 Notice Board
6 News Digest 8 Risk: What are my chances, doc? 9 Ethics: An ethical ecology 10 Q&A: Evlynne Gilvarry, GDC chief executive and registrar
20 Case studies: Lunchtime fracas, Capacity to consent, Post-op complication
22 Addenda: Fatal self-confi dence, Scarifi cator, Crossword and Vignette: Charles Hawkins Craig Macmillan, medical publisher
Printing and distribution: L&S Litho
Summons is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208
Email: General:
info@mddus.com • Membership services:
membership@mddus.com • Marketing:
marketing@mddus.com • Website:
www.mddus.com The MDDUS is not an insurance company. All the benefi ts of membership of MDDUS are discretionary as set out in the Memorandum and Articles of Association.
The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily refl ect the opinions or policies of The Medical and Dental Defence Union of Scotland.
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