Harold Shipman was said to be a good doctor when he wasn't killing people. The dead would presumably not have had the chance to rate him in the annual appraisals being proposed by the Government. That would have been done by the living, who were no doubt far happier with his bedside manner.

Fear of another Shipman is cited as the main reason behind Sir Liam Donaldson's call for doctors to be more tightly regulated. Shipman was a horror. But hard cases make bad law. The decision to give doctors annual appraisals and five-year MoTs makes good headlines, especially now that it is fashionable to blame doctors for almost all the ills of the National Health Service. But this is a large bureaucratic mallet that seems unlikely to crack this particular nut.

Of course doctors must be accountable. I have never forgotten the corporate “medical” I had with a lecher in a wood-panelled consulting room in Knightsbridge. He asked me to take off far too many clothes, took an unhealthy interest in the result, and made sure that the nurse was not around. Nor did I think much of the GP who recently referred me to a hand surgeon because of wrist pain, which a physiotherapist diagnosed within ten minutes as being caused by a simple bunching of vertebrae in my neck. These people are idiots and we should not be paying for them to jump to conclusions, patronise us or stroke our thighs.

But I am not sure that the best way to root out bad practice is to break out in a new rash of box-ticking. Many parts of big business have fallen for the fashion of 360-degree appraisals, getting feedback not just from above but from below. While there is a logic to this, I have friends who spend night after night in the office filling in 20 or 30 forms about people whom they do not know all that well. They doubt that the results are actually used to much effect. It looks as if medical regulators are going to fall for the corporate fallacy that sending someone on a “refresher course” actually confers knowledge. Personally, I prefer a GP who gets out her textbook, and leafs through it unashamedly, to one who bluffs and doesn't listen.

Reading some of the headlines, you would get the impression that medics are immune from this fashion. Not at all. Annual appraisals are written into GP and consultant contracts. At Addenbrooke's Hospital, in Cambridge, Christoph Lees, a consultant obstetrician, regularly nominates 20 people to fill in his 360-degree appraisal. About 30 patients are given comment sheets online, which all feed into his job plan for the coming year. He says that he does not mind this, although it is time-consuming. But he is sceptical about whether more of the same is needed. Another consultant tells me that he endured tough assessments as part of his junior doctor training and now feels frustrated by endless appraisals. He does not see why he should have to have his licence to practise “revalidated” every five years. This would make the British “the only doctors in the world to face losing their licence automatically with every change of government”.

One problem is getting patient feedback. Patients rarely dare to complain about someone whom they may have to rely on. In my former surgery you could never get to see the good doctor, only the useless one. The receptionist knew how hopeless she was, most of the waiting room knew, the pharmacist knew and often spotted mistakes in her prescriptions. But I'm not sure that any of us would have filled out a form for her to see. Many of us just voted with our feet and changed surgery - an option that would probably raise standards faster than any questionnaire.

Dr Neil Bacon's imaginative answer to the silence problem is a website, www.iwantgreatcare.org. Launched ten days ago, it lets patients rate their GPs and hospital doctors anonymously. The majority of views are positive - as I write, Drs Nicholas Silverton and Raj Nag each score 100 per cent for “listening”. But the ratings are as arbitrary as an Amazon book review.

Dr Bacon has caused a huge row by claiming that the Department of Health is keen on using the site to help to judge doctor performance. The General Medical Council has stoked the fire by refusing to rule out anonymous comments being used in disciplinary hearings. This is dangerous even though the site does its best to validate comments and prevents vexatious e-mailers from making multiple postings in a short time.

Doctors should not be po-faced about patients comparing their services - that is how services improve. But there must be a distinction between information which is understood to be subjective, and data used to make or break careers. Gauging doctor performance is good management. But we have numerous ways to do that. A system that tests 150,000 doctors to find one murderer is bound to be inefficient. And it risks becoming hysterical.

None of this does anything about my main problem with GPs - that they have too little time. In my GP surgery there is a notice. “Please make a separate appointment,” it says, “if you wish to discuss more than one ailment.” It's virtually impossible to get any appointment.

My surgery gets around the Government's appointment-time target by using a computerised answerphone that almost never lets you through, so they don't have to log your call. When you do arrive, your appointment is scheduled to last seven minutes. That's not much space for lateral thinking about the “whole person”. That's why so many antibiotics are prescribed, which makes the Government so furious - because we want them and there's no time for the doctor to dissuade us or propose an alternative route.

The more time doctors spend filling in forms, the less time they will spend with us. So let's keep things in proportion. If we can't get to see them, there won't be much point in asking us to rate their bedside manner.

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