Analysis: Why are doctor complaints rising?

The number of complaints to the General Medical Council has jumped by nearly a quarter in a year. But the regulator says it is not a sign of falling standards. So what could be behind the increase?

scalpel Complaints to the General Medical Council now top 8,000 a year

On the face of it, a 23% rise in complaints in a year seems to be an indictment of the performance of the medical profession in the UK.

But as with all figures, context is everything.

Doctors are not the only profession seeing a rise in complaints made against them. Everyone from local government officers to those working in the financial sector are seeing more objections made about their conduct. Suffice to say, journalism is no different either.

So what do the figures released by the General Medical Council (GMC) tell us?

The regulator was pretty adamant it was not a sign standards in care were falling.

It said there was no evidence of this and by all other measures - satisfaction surveys and performance ratings - care seemed to be improving.

This, it suggested, pointed to a wider cultural shift in society, which had seen expectations grow and tolerance of poor performance shrink.

Full-scale investigations

It should also be remembered that while complaints have increased by 23%, not all of them are being upheld.

Of the 8,781 complaints made in 2011, nearly 5,000 were taken no further after an initial assessment. Of the rest, full-scale investigations were launched in 2,330 cases.

Action was taken in slightly more than 500 of those, with just 65 cases - less than the year before - resulting in a doctor being taken off the medical register.

Across the whole of the NHS, the number of written complaints jumped by 8% last year - and most of that rise was driven by more trusts submitting data than 12 months previously.

Dying needlessly

This raises a question about what is driving such a rapid increase.

One theory is that with revalidation - dubbed the doctor MOTs - just round the corner, problems that have been glossed over for a number of years are now being dealt with by medical directors who have become more active in reporting issues to the GMC.

Another factor that cannot be dismissed is the "Mid Staffordshire effect".

In 2009, the care regulator published a report branding standards appalling at the Mid Staffordshire NHS Trust and alleging patients had been dying needlessly.

Damning report

The report, which then led to a public inquiry due to be published later this year, sent shock waves through the system and has ushered in a new culture of accountability and whistle-blowing.

The number of complaints made to the GMC has been rising for years. In the two years up to 2009, they increased by 12%. In the two years afterwards, the rise was 52%.

What is more, a similar pattern can be seen with complaints made to the Nursing and Midwifery Council.

But whatever the reason, the challenge facing both the profession and regulator itself is how to respond to the problems being raised.

With finances tighter than they have been for a long-time and a damning report on Mid Staffordshire just months away from being published, the focus on quality of care in the health service has never been greater.

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