Points: Monitoring the acute phase response

natural justice. The second is even more serious. Doctors dismissed for alleged personal misconduct are also to be denied the right of appeal to an independent body. At the moment a health authority can be the complainant, prosecutor, judge, and appeal court; can conduct such inquiries in secret; and can have its own lawyers present. The accused doctor is denied legal representation and the right to call witnesses or cross examine the evidence. He or she may not even see all the allegations until entering the inquiry room door. Such iniquitous star chamber processes are contrary to the European Charter ofHuman Rights (article 6), but they are practised. Given the NHS's position as a monopoly employer, a doctor caught in this system could be deprived of livelihood for life. He could never get another NHS post and there is no realistic alternative employment. No other NHS employee faces such a hazard. Not even the army has such draconian powers over its staff. Health authorities are only too ready to use such powers. Despite the rights of free speech contained in the conditions of service, doctors who have dared publicly to criticise a health authority have been suspended and charged with personal misconduct. It is therefore essential to retain a mechanism for independent appeal. If a responsible health authority seriously believes that a healthy doctor is professionally incompetent (and so a public danger) or is behaving in an unprofessional manner then it is its public duty to report that doctor to the General Medical Council. The argument that the council could not deal with the few such cases likely to arise from responsible health authorities casts a serious slur on the professional competence of the council. Surely now is the time to recognise that HM(61)112 has outlived its usefulness and should be scrapped. Serious cases should be referred to the General Medical Council and less serious ones to the new intermediate procedure, and the health service could save over £LOm a year. Attention should then be given to reforming the methods of dealing with allegations of personal misconduct. The Society of Clinical Psychiatrists has a working party that will shortly publish a code of practice for dealing with suspended doctors. In addition Dr Jacobs, Dr Darnell, and Dr Sheila Hoyes would be happy to render help to any doctor in such a position who contacts them. In the mean time we hope that our leaders will not ratify all the recommendations of the Joint Consultants Committee-NHS working party.