Take As Prescribed By Your Doctor?

The combined effect of ever more complex drugs and a change in the way most doctors are taught pharmacology and prescription skills has resulted in a staggering 500% increase in adverse drug reactions since the early 1990s. The NHS drug spend is now estimated to cost £7 bn per annum but the cost of treating adverse drug reactions has reached £500 million a year. Not scaremongering by case hungry clinical negligence lawyers but the findings of a group of senior members of the medical profession.

In 1993 guidance issued to medical schools by the General Medical Council led to a reduced emphasis on the skills necessary to prescribe medication. The effect of that change has been such that Professor Sir Mike Rawlins, chairman of NICE (the National Institute for Health and Clinical Excellence) recently called for the problem to be addressed and is reported as saying that 80% of adverse drug reactions are avoidable, a great deal of mis-prescription being the result of a lack of knowledge on the part of doctors. If Professor Rawlins is correct, better education could save the NHS over £400 million a year in reduced care costs, to say nothing of the reduction in pain, suffering and even recorded deaths amongst unfortunate patients affected by this problem.

The chairman of NICE is not alone in expressing his concerns. Whilst the GMC and the Department of Health have defended current standards, Sir Liam Donaldson, the government’s chief medical officer has suggested that the GMC should no longer be responsible for setting educational standards for the medical profession and the President elect of the British Pharmalogical Society has confirmed that much of the danger could be prevented by greater knowledge of the drugs being prescribed by those prescribing them.

For the lawyer faced with a client who has suffered an adverse drug reaction the question must then arise as to whether mis-prescription is indeed negligent or whether the standards of the medical profession have fallen to the extent that a reasonable body of medical opinion would support the same unacceptable approach!

Published 26/04/2007.