They say the motion challenges the very heart of the Hypocratic Oath.The debate is prompted by the recent case of Dr Keith Pilsworth, a GP in Lincolnshire, who was suspended from the register after an affair with a patient. “What the movers of the motion seem to be saying is, is it right, that as a matter of principle, any doctor who gets involved with a patient is doing wrong.”Those who oppose the motion say that a doctor-patient relationship can never be equal, and that severe disciplinary action is a necessary deterrent to protect the vulnerable. Suzanne Holmes, a nurse at the John Radcliffe hospital in Oxford, was one of the first. She worked alongside a heart surgeon stripping out veins for bypass operations, as is routine in America.Despite this – and the publicity the scheme attracted in 1992 – there was still an outcry when it emerged in 1994, Valerie Tomlinson, a nurse at the Treliske Hospital in Truro, had removed a patient’s appendix, albeit supervised by a surgeon.

The surgeon was cautioned and the nurse took early retirement.Gillian Erickson looks set to change all that, and with the increasing demand for health care services, and the continuing crisis in medical staffing, she will be the first of many.. A plea for greater understanding for doctors who have sex with a patient is likely to be one of the most controversial motions debated by the British Medical Association conference in Brighton this week, writes Liz Hunt. A doctor who develops a relationship with a patient in his care risks censure by the public and the profession, disciplinary action and is threatened with suspension from the medical register. But this is an outdated view, according to Dr Michael Crowe, a GP from Leicestershire, who has tabled the motion calling for an “official warning” in place of threatened suspension by the General Medical Council.
Supporters say that the careers of numerous GPs and consultants have been ruined by affairs between consenting adults which turn sour, and the patient – usually a woman – has sought revenge by making a complaint. She put forward a business proposal in which she carried out certain surgical techniques unsupervised – including biopsies, and the removal of cysts.

The proposal was accepted and consultants now refer some patients to Mrs Erickson for her own surgical list.Previous schemes, in which nurses assist surgeons, tend to have been promoted by doctors who have observed practice in American hospitals. A doctor would not delegate to anyone that he or she thought was incompetent.Dr Vivienne Nathanson, head of Professional Services at the BMA, said: “Doctors are not about individual treatment or tests, but the overall view and management of the patient and their condition.”Mrs Erickson, who has more than 20 years’ experience as a theatre nurse, is unusual in that she initiated her new role at Clatterbridge. She has the blessing of the Wirral Hospitals Trust, the surgeons at Clatterbridge hospital where she works, and the agreement of each patient. Collusion, it seems, is no longer necessary.The “nurse-surgeon” revelation has generated the predictable knee-jerk reaction from some quarters.

One senior consultant claims that people are now being treated “worse than animals which can be operated on only by a qualified vet”.That this is a minority view was reinforced by the whole-hearted backing of doctors’ leaders yesterday, who agreed with Mrs Erickson’s assertion that an experienced nurse is more competent than a junior doctor in training.Dr Mac Armstrong, Secretary of the British Medical Association, said: “This is entirely consistent with what we believe is development of the relationship between the professions.”Dr Armstrong said that the consultant had the ultimate responsibility for a patient from diagnosis to discharge. It is one of the oldest games in the book, the “doctor/nurse” game, played out in surgeries and operating theatres across the country every day, and essential to the smooth-running of the health service. The game – actually a recognised theory of nursing first described in the Sixties – revolves around a nurse making a decision about a patient, taking action and then, with the collusion of the doctor, “pretending” that the doctor did it all to appease hospital authorities, the law and the public.
Now it appears the game has moved on, with the case of a 47-year-old nurse, Gillian Erickson, who has carried out more than 200 unsupervised operations. Neither the Department for Education and Employment nor Conservative Central Office had any comment to make yesterday..