The Medical Defence Union has a proud claim on history. When founded in 1885 it was the world’s first organisation dedicated to defending the reputation of doctors. It came to life after David Bradley was convicted of assaulting a female patient in his surgery. The charge was later proven to be false, and Dr Bradley’s name was cleared. But by then he had served eight months in prison. His legacy was the principle that doctors, and later dentists, would pool their money to help each other in times of need, especifically when one of them required legal advice. Their slogan — “Doctors for doctors” — spoke of a one-for-all and all-for-one ethos that, in appearance at least, has survived until today. But just as it was the integrity of practitioners that the MDU was set up to protect, it is now the integrity of the MDU itself that is being questioned.

If it is possible to measure the stature of an organisation by the calibre of outsider it attracts to serve on its board, the MDU is indeed well placed. Its four independent directors included a former government minister, a former Whitehall permanent secretary, one of the country’s leading actuarial experts and a worldwide authority on corporate governance. It is alarming, therefore, that these four have felt the need to resign because of their concerns over the transparency of the books and “other aspects of good corporate governance practice”.

Some of the 170,000 doctors and other practitioners who belong to the MDU and pay up to £7,000 a year into its funds may have heard news of this joint but quiet resignation. The vast majority, though, almost certainly have not. They may wish to acquaint themselves with the issues before next Tuesday’s annual meeting, at which they can make their voices heard.

There are three issues. First, the salaries of the three executive directors are currently impossible for members to discern. This is an odd arrangement for a mutual body with such noble aims. The origins of the confusion are understandable. It made sense for the MDU, when faced with the increasing zeal of patients to pursue malpractice claims, to join forces with an insurance company. But the result, that executive directors are paid two salaries, neither of which is possible to calculate from the accounts, is unsatisfactory and easily rectified. That the MDU board rejected the advice of its own audit committee to improve transparency made it look as if the well-rewarded men and women at the top have something to hide.

Secondly, the presence on the audit committee of the MDU’s chairman and deputy chairman was regarded as inappropriate by the resigning directors, and understandably so. Again, in the interests of good governance, this could be easily corrected. Thirdly, the motion before Tuesday’s meeting to remove the requirement for inde- pendent directors looks unwise, particularly because its aim is obscured.

The MDU may have an august history, but doctors would be right to have concerns for its future. Doctors should be for doctors, but they should also be for independent directors.

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