SURGEONS are like airline pilots. When we are in their care we must trust them implicitly.

In most cases, patients who undergo an operation owe their future health - and often their lives - to their surgeon's skills.

Inevitably, things sometimes go wrong. Every profession has its share of inept staff, but when that incompetence invades the hospital theatre it makes the difference between a full recovery and a ceaseless pain - or even between life and death.

We can never eliminate surgical mistakes, only legislate to minimise them. That is why we insist that a surgeon completes many years of intensive training, and is then governed by the strict rules of the General Medical Council (GMC).

These mechanisms are vital to reassure patients that they are in the best possible hands. When they fail, they knock our collective confidence in the medical profession.

In the case of orthopaedic surgeon Nalini Senchaudhuri, they have failed badly. He made several serious errors which ruined patients' lives.

One woman was left unable to walk without sticks after being operated on by Mr Senchaudhuri; a man will never be able to raise his arm after the surgeon tried to repair his damaged shoulder.

The GMC investigated, and ruled that he should not operate unsupervised. Yet he did just that, at York Hospital.

Thanks to the vigilance of another surgeon, Mr Senchaudhuri was not allowed to carry out anything other than "relatively minor" procedures unsupervised.

But this "extremely dangerous" consultant was able to flout the GMC restrictions for weeks. He has now been struck off.

This very troubling case has exposed a serious weakness in the safeguards protecting patients. Hospitals are too reliant on doctors being honest about their past career history.

After Richard Neale and now Nalini Senchaudhuri, the North Yorkshire public's trust in their surgeons has taken a knock. That faith can only be restored by tightening the vetting procedures to ensure those wielding the scalpel are as highly skilled as patients have the right to expect.

Updated: 10:33 Tuesday, February 18, 2003