They must be employed with a contract that clearly shows the parameters of the role.
Medical chaperone professional#
To begin with – and to ensure there is patient autonomy and transparency of professional practice – the role of the chaperone needs to be properly defined. The system is in a mess, and although policies are in place, they are not robust enough to ensure patients aren’t at risk.
But that may give rise to other privacy concerns. It is clear that more needs to be done to protect the vulnerable and prevent abuse – but what? It could be argued that there is no role for a chaperone and the installation of video cameras could provide a more effective way of preventing inappropriate behaviour, also serving to protect doctors from false allegations. In fact, in 2005, researchers found that only 37% of GPs had a chaperoning policy, with lack of staffing and resources given as excuses. While some – worryingly – use receptionists as chaperones. Other studies have found that nearly half of male GPs never or rarely use chaperones when intimately examining women. But significantly more female patients accepted chaperones from male doctors (85.4%) than from female doctors. Fewer male patients in the study accepted chaperones than female patients (3%). The remaining 66% declined because they trusted the doctor, thought it unnecessary, wanted privacy, were embarrassed, or were not bothered. One six-month survey of doctors found that while 92% of the 252 patients seen were offered a chaperone, only 22% accepted, while 12% expressed no preference. The rates of chaperone uptake are low – as is the amount of research being done on this issue. In fact, the chaperone was sent out of the room from time to time. The inquiry was told that the availability of a chaperone did not prevent Ayling from acting unprofessionally. However, the presence of a chaperone does not always prevent inappropriate behaviour – as illustrated by the Ayling case.
These include paedophile doctor Myles Bradbury (who ignored a hospital chaperone policy), and more recently, GP Jaswant Rathore, who “deliberately avoided offering chaperones” and was jailed after sexually abusing female patients between 20. While chaperone rules have stagnated, several cases involving the sexually motivated abuse of patients by doctors – which could have been mitigated by the presence of chaperones – have come to light. This lack of definitive safeguarding may be putting patients at risk, with potential problems ranging from improper practices (such as patients being given inadequate psychological and emotional support during traumatic examinations, by either chaperone or doctor) up to sexual assault. But 16 years on, many NHS trusts and health boards still do not have standardised procedures to follow. The inquiry did recommend that robust policies be put in place, and that only trained chaperones witness medical examinations. Unclear lawsįollowing the imprisonment of GP Clifford Ayling for sexually abusing female patients in 2004, a Department of Health inquiry found that there were actually four definitions that could be attached to the chaperone’s role, including that they are a “safeguard” for the patient, who “provides physical and emotional comfort” and will “identify unusual or unacceptable behaviour” from a healthcare professional, but also protect the professional from “potentially abusive patients”. And though the purpose of this person is to independently observe what is going on during a medical examination, doctors have been encouraged to use a chaperone to protect themselves from potential accusations of inappropriate behaviour. Though there is no legal basis for a patient requesting a chaperone, it has become a common practice within the NHS, and accepted by bodies such as the General Medical Council.īut despite overhauls in the law, there is still little concrete guidance on the exact role and responsibilities of a chaperone. Anyone can ask for a chaperone (an impartial adult) to attend a health screening with them. We are taught to trust doctors, believing they will not judge, that they are simply there to medically assess us, but still the prospect can be a daunting one. Intimate health examinations can be an uncomfortable experience for anyone, regardless of age, health or gender.
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