11.6.1 Qualifications of medical practitioners

Reports on the nature and causation of a disease should normally be by a legally qualified medical speci — alist. With very few exceptions, reports by general practitioners are not sufficient for the purpose. GP reports are generally only acceptable on health maintenance issues for those cases where liability has been accepted i.e. ongoing treatment, medicatio — n, readiness for work etc.

Legally qualified medical specialist means a licensed medical doctor with a formal higher level qualification (i.e. membership of the relevant professional association) which in effect represents a further licence to practice in a particular medical specialty. Note: This excludes members of para professional associations such as physiotherapists podiatrists and the various chiropractic associations. Also, members of 'alternative' medical associations such as practitioners of trad — itional Chinese medicine, those with 'natural therapy' training etc. are not acceptable for this purpose.

The specialist qualification must of course be relevant to the nature of the ailment under investigation. It is clearly not appropriate, for example, for a claim relating to a psychiatric illness to be decided on the medical advice of a specialist orthopaedic surgeon. This remains the case, even where the mental ailment has allegedly emerged out of the orthopaedic condition that this specialist has b — e — en treating in the long term.

Note: While in this example the orthopaedic specialist may certainly be able to identify that there is a depressive condition present, the precise diagnosis and a confirmed cause of that illness can only be accepted on the o — pinion of a psychiatrist.

In the case of psychiatric conditions, the opinion of a psychiatrist is usually required, but that of a clinical psychologist may be acceptable in some circumstances.

• Delegates should be aware that the basic description 'psyc — hologist' covers a wide field of training, not all of which are related to identification or treatment of disease. Only the opinion of a trained 'clinical psychologist' is acceptable for liability purposes, and that only in the absence of an opinion of a p — sychiatrist.
• Note: A specialist psychiatrist has a medical degree. A psychologist does not.

In general with respect to the issues of diagnosis and causation, the opinion of a psychiatrist is to be preferred to that of a psychologist.