Health watchdog to look at warrant of fitness for doctors

An investigation into whether the country's "light-handed" regulation of doctors needs to be beefed up will be the first job for New Zealand's top health watchdog after he begins a new career.

After a decade in the job, Ron Paterson will step down from his post as Health and Disability Commissioner next March to become professor of law at Auckland University in May.

Before starting teaching he will undertake an international research project, financed by a $125,000 grant from the Law Foundation, a charitable trust.

He will investigate the best practice on how the public can be confident any given medical practitioner is "a good doctor".

Mr Paterson will look at the concept of a "warrant of fitness" for doctors and the extent of disclosure to the public about the results of the regular tests.

"... there's good reason to think the vast majority of doctors practise competently and keep their skills up-to-date. Although the Medical Council is required to ensure the fitness and competence to practise of individual doctors, the way in which they do that is still fairly light-handed ... At the moment there's a fair degree of self-assessment."

He said some states were moving towards subjecting doctors to occasional reviews of their practice that went deeper than the current assessments. And websites had developed in some places to rate doctors' performance, such as one ranking British heart surgeons on their surgical death rates.

Development of such websites in New Zealand was inevitable, Mr Paterson said, but pressure to create them would in part be stemmed by striking the right balance between doctors' and patients' rights.

The Medical Council lists all registered doctors on its public-access website. The listing for each doctor shows details such as his or her qualifications, possession of an annual practising certificate, and any conditions on practice.

To obtain a council practising certificate, doctors must prove annually to their professional colleges that they have undertaken sufficient "continuing professional development" - activities such as attending medical conferences, discussing patient cases in a peer review group and having their work audited. The council audits a 10th of practising certificate applications each year to ensure the system is working.

Council chairman Professor John Campbell last night rejected the tag of light-handed regulation.

The council had no plans to increase public disclosure about doctors, he said.

"It's difficult to know what that would achieve. If people are going down that line we need very clear objectives as to why. You would also need to be very confident that the complexity of medical practice is recognised."