Chris Hogg BBC Health Correspondent

This month a woman told a jury in Sheffield how her gynaecologist had told her to strip naked and get down on all fours for an examination.

She was one of 22 patients who complained about the treatment they had received from him.

"Basically it was our word against his," she says.

This is supposed to be a patient centred NHS

"But I ask you, how could anybody make that up? How could you think of anyone examining you in those positions if it hadn't happened."

Her complaint - and one other - was upheld. The doctor, Paul Vinall, was found guilty of indecently assaulting two of his patients.

But she had not complained at the time of the incident. She only came forward when she heard other women had suffered similar indignities.

She worked in the Health Service at the time so she was well aware of the options available: the NHS's own complaints procedure, the General Medical Council's or even trying to sue the doctor for personal injury.

Intimidating

So why did she or the other patients not complain earlier?

"I think you can feel, not inferior but intimidated, and the system is so slow."

That is a common complaint according to Anne Alexander, the senior partner at Alexander Harris, a Manchester firm which has taken up scores of complaints on behalf of patients against doctors.

Whatever comes out of the process, it will have to be quicker, and easier to use than the current set up

The other problem, she says, is that changes to the legal aid rules two years ago made the process of suing doctors more difficult.

"There is now no longer legal aid available and consequently the client has only two ways of dealing with it."

"Either to pay or to persuade a solicitor to take it on on a no win no fee. The difficulty with these cases is that usually it is the patient's word against the doctor."

"In those circumstances it is extremely difficult to find a solicitor to take it on on a no win no fee, or one who would was happy to let you risk your own money on such a case"

So that leaves you little option but to try to find your way round the NHS complaints procedure.

The biggest hurdle can be the fact that the first person you have to raise the complaint with may be the doctor himself.

Complaints must be raised locally first.

Arrogant

But the government's own evaluation of the procedure found that staff who dealt with complaints were sometimes unhelpful, aggressive or arrogant.

That does not surprise Dr Vivienne Nathanson from the main doctors' union, the British Medical Association.

"Everybody's tried hard to make it different and better over the past few years but we do not seem to have achieved that yet," she says.

"Doctors want patients who need to complain to complain early and quickly so that complaints can be dealt with properly.

"Also, if as a result, we need to change what's happening in the health service or deal with a problem individual, that needs to happen as soon as possible so that fewer people are damaged."

And that is one of the biggest concerns about the failings of the system.

Getting away with it

Rogue doctors often get away with it for years because no one makes the connection.

Although the Medical Register is available online, the body which regulates doctors, the General Medical Council, does not publish a list of complaints against doctors which have been received.

"If there were a complaint that we had found justified then it is likely we would be able to give you that information," Paul Philip from the GMC told me.

"However if the complaint had not been justified, or did not bring into question a doctor's registration then it would be wrong and unfair to the doctor to make that information available for public consumption."

"The interests of the doctor in that particular situation override the interests of the complainant."

The problem is that it is often only when a volume of complaints build up that people begin to notice that there's something wrong.

The government has promised to reform the system.

It has completed a consultation exercise. 600 responses were received. They are currently working out what to do next.

One suggestion from the Commission for Health Improvement was a centralised complaints system.

Its inspectors found the current system fails to detect professional misconduct or criminal activity.

Whatever comes out of the process, it will have to be quicker, and easier to use than the current set up.

After all this is supposed to be a patient centred NHS.

And what is the likelihood that patients will feel at the heart of the system, if when things go wrong their attempts to complain are met with bluster and delay?

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