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L Mulcahy. Suffolk, UK: Open University Press. 2003. £65.00 (hardback), £19.99 (softback). 152 pp. ISBN 0 335 21245 X (hardback), 0 335 21244 1 (softback)
This book provides an important analysis of what happens when trust between doctors and patients breaks down. It is well referenced and Professor Mulcahy’s arguments are amply supported by her own detailed researches.
Before the Second World War there were few overt complaints against doctors. Poor outcome of serious illness was commonplace and people understood little of disease despite the insights offered by G B Shaw in “The Doctors’ Dilemma”. Doctors were treated with reverence—so much so that two doctors who successfully warded off what appeared to have been an indefensible claim were applauded by the vicar of East Dulwich as having had a wrong redressed: “The great sting of that wrong was that it was ungenerous and ungrateful; circumstances that ought to have elicited gratitude were turned into grounds for accusation and attack”.1
In 1947 the NHS was established with no structured procedure for complaints. Professor Mulcahy describes the subsequent developments starting with the Department of Health guidelines of 1966 that allowed complaints about doctors to be handled almost exclusively by doctors. This process was altered little by either the formal legalistic review of the Davies …