Magazine article New Statesman (1996)

Reliable Evidence? Moves Are Afoot to Firm Up Checks on Doctors Who Give Expert Evidence in Court, Reports Jon McLeod

Magazine article New Statesman (1996)

Reliable Evidence? Moves Are Afoot to Firm Up Checks on Doctors Who Give Expert Evidence in Court, Reports Jon McLeod

Article excerpt

The recent decision by the Attorney General Lord Goldsmith QC to order a review of a number of child killings has thrown into sharp relief the issue of the quality and reliability of expert evidence given in courts by doctors. Lord Goldsmith (above right) was prompted by the overturning of the murder conviction of mother Angela Cannings; the episode saw the expert evidence of Professor Sir Roy Meadow on the syndrome Munchausen's by proxy called into question.

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Clearly the role of such evidence can be central to the issues at stake in many criminal trials. But medical experts also play an important role in personal injury claims in the civil courts, and their role here, too, is coming under scrutiny.

The General Medical Council (GMC), which regulates doctors, has agreed changes, due to take effect from January 2005, to the process of "revalidating" doctors, effectively the MOT that gives them the continued licence to practise. The information that doctors will have to supply to secure revalidation will mostly accrue in the course of appraisals conducted in the "managed environment" of the NHS or within private practice, for example, in Bupa hospitals. Appraisals are the product of peer review, including patient feedback, and will also reflect on professional development activities undertaken by the doctor in question.

However, these measures will also apply to medical experts who make their living largely from giving evidence in court or work in producing medico-legal reports for personal injury claims. If not done in a managed environment, it will require revalidation via a "portfolio" assessment of performance.

The difficulty here is twofold: first, medical expert work is a fiercely competitive market, making peer review commercially difficult; and second, there is little involvement of the Royal Colleges or other professional oversight as to how such evidence is prepared and presented.

"All personal injury cases need a medical report. Yet there is no professional oversight, and no accepted standards have been set as to how this should be done: it is an unregulated market," according to Dr Sohail Bhatti, president of the Registration Council of Medical Experts (RCME) and also a director of legal services company Invaro. "There is a huge conflict of interest inherent here, which the Royal Colleges have been unable to address."

The British Orthopaedic Association and the British Medical Association (BMA) have themselves sought to provide templates for medical reports, but the fact remains that this is work done in a private market. …

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