Letters: Scalpels out for 'mischievous, vicious, sensational, insulting' editor of 'Lancet'

I, TOO, was a medical student in the 1980s. Unlike Dr Richard Horton, the editor of The Lancet, ("How doctors have betrayed us all",14 June) I never "learned to keep other doctors' mistakes a secret". It is mischievous to suggest there is a covert code among doctors to distance them from accountability to patients when the reverse is the case.

Far from ignoring patients' views, bodies such as the General Medical Council include more patient representatives than ever before, as do hospital appointment committees, royal college working groups and consultant appointment committees. This is at the behest of the profession and it is misleading to imply otherwise.

Dr Horton's allegation of misconduct amounting to deliberate patient injury on the part of a surgical colleague is contemptible. It is compounded by the comment "this sort of practice - and far worse - is not uncommon". If he has such knowledge then the GMC is clear on where his loyalties lie - firmly with his patient. Lurid copy as it makes, unsubstantiated innuendo of this nature should be dismissed until evidence is brought forward using the appropriate channels.

The British Medical Association and the royal colleges have made enormous strides in recent years to make themselves more accessible to the public and act as a powerful focus for patient advocacy. They are a force for the improvement of patient services and for the implementation of the highest standards of medical training and practice. Such endeavours have frequently brought them into conflict with government ministers.

Dr Horton claims that the response of the profession to known failures is "denial". The very report he quotes to support this was conducted at the instigation of the fellows of the Royal College of Surgeons and the findings made public. Surely this represents an honest effort to address difficulties and institute change for the better?

Dr Horton uses the tragic Bristol cases as an example of the undermining of public confidence in the profession and quotes an increase in the number of GMC hearings as demonstrating how patient trust has been breached. Surely these cases show how committed the profession is to the philosophy of accountability and probity?

Dr Horton has used his position to add gravitas to his personal views. His conclusions are at variance with the facts. He has publicised unsubstantiated allegations and vicious innuendo.Who is guilty of betrayal?

R W Clarke, FRCS

Honley, West Yorkshire