Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Where do we draw the line
- Itai Chabvapasi Matumbike (16 December 2004)
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GMC's Fitness to Practise Under Fire
- Rita Pal (20 December 2004)
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Re: GMC's Fitness to Practise Under Fire
- Carl Henshall (21 December 2004)
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Re: Re: GMC's Fitness to Practise Under Fire
- Rita Pal (22 December 2004)
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What kind of process?
- John Stone (23 December 2004)
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What else can a doctor do?
- jonathan nicholas allcock (25 December 2004)
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Itai Chabvapasi Matumbike, Clinical Observer St Francis Unit, City Hospital, Nottingham, NG5 1PB
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Admittedly, the GMC has been flawed in it a number of its policies but the Shipman debate is in danger of giving birth to impractical reforms, and crippling bureaucracy. There is a very wide spectrum between clinical excellence and professional incompetence, a good doctor is not only a knowledgeable individual but a conscientious and sincere professional. The question is, what is acceptable, or in the very least safe for our patients. Certainly, everyone deserves to be treated by the very best doctors; unfortunately, there are only so many of them around. We risk raising the standards of revalidation to a level which excludes doctors who may not be excellent but safe, with the net effect of creating an artificial shortage that could cripple the health delivery system. The revalidation process has been labeled as making trade-offs, but is it a witch-hunt or a quest to develop expertise? Doctors will not all be expected to perform to the same standard, the revalidation process should also be used to identify ways of improving a doctor’s performance if they are found wanting in a particular area. In blame culture that we live in, there is always a tendency to hold professional bodies responsible for a catastrophe. However, the road to clinical excellence is a process which will take a lot of time, with lessons learnt every step of the way. Radical changes will need to be carefully thought through so as not to disadvantage the very patient we are trying to protect. It is interesting Dame Janet, refers to a root of reactionary culture, yet her very inquiry is a reaction to the Shipman Tragedy. Before the murderer killed 200 people, the GMC was considered functionally acceptable. Indeed, there is need for more independent input for a quasi-legal council such as the GMC, but we must not forget that flaws still exist in the common law justice system and it would be a bit unfair to pick on the GMC. Competing interests: None declared |
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Rita Pal, Editor NHS Exposed.com www.nhs-exposed.com
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The General Medical Council is a body that has been criticised by a number of authorities. The Policy Studies Institute deemed their procedures to be flawed. The Neale, Shipman and Bristol Inquiries had much to say about the organisation that supposedly polices the profession. In addition, the cases Toth v GMC and Richards v GMC all criticised the decisions of the GMC. Yet, the GMC remains in the glory of " we shall change". Procedural faults result in breaches of Human Rights. There lies the problem. How many innocent and good doctors have been investigated by these flawed GMC procedures? Every criminal deserves a fair hearing in a court. By the looks of things, the GMC fails to uphold the principles of natural justice and fairness. No doctor can expect to obtain a fair hearing. The list of doctors who have raised concerns of substandard care to the GMC are now growing. They include, Wilmshurst, Pal, Phipps, Ng,Vaidya. These doctors were all investigated by the GMC following their whistleblowing episodes. In the case R Pal v GMC, the judge famously stated " The GMC is not above the law". Nevertheless, hundreds of doctors cannot be forced to suffer due to revalidation simply because the GMC cannot get its house in order. Most doctors are hardworking individuals who work above and beyond the call of duty. The organisation which cannot get its procedures right will be unlikely to assess revalidation appropriately. In my view, it is unfair for these good doctors' reputations to be tarnished and undermined simply because of a council that has been unfit to practise for many years. Whistleblowing is now a danger. Revalidation within this organisation full of procedural errors is also a danger. It is time the doctors who work hard for a living are dissociated from the General Medical Council. Doctors do not deserve to be undermined in this manner and patients should not loose faith in their good doctors simply because of the current media spin machine of " doctor bashing". We cannot all be blamed and punished simply because the GMC failed to detect Dr Harold Shipman early enough. The facts are that every doctor is now treated as if they are a potential Harold Shipman. That cannot be right for patients or for doctors themselves who will practise defensive medicine. In R Pal v GMC - the GMC has treated me as a potential Harold Shipman - yet no complaint was ever made against me and neither was my fitness to practise ever called into question. Yet, the barrister argued that because of Harold Shipman, the GMC could do anything to doctors in the name of " public interest". This included " covert inquiries" without the doctor's knowledge. Dr Rita Pal Competing interests: R Pal v General Medical Council application won by junior doctor |
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Carl Henshall, parent/carer Newcastle-u-Lyme, ST5
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Rita Pal(1) makes a valid statement when asserting "the GMC fails to uphold the principles of natural justice and fairness". However, this is not limited to doctors being subjected to improper investigations. In our recent Judicial Review of a decision of the GMC’s Preliminary Proceedings Committee(2) the GMC’s barrister argued that, at the screening stage, the public have no civil rights in common law or Human Right to a fair trial. Whilst this will no doubt soon be tested in law, it is of concern that a body charged with protecting the public should even think of this as a defence for non-disclosure of relevant documentation let alone be practising it. In effect, a member of the public making a complaint to the GMC has to put their faith in an organisation that has been shown to be biased, inefficient, incompetent and ineffective. The GMC may well have changed their policies and procedures, but until there is a change in mindset within the medical hierarchy, it will simply continue to protect its own and brave doctors who speak out will be sullied whilst maverick clinicians will be protected. Carl Henshall 1. Pal R. GMC's Fitness to Practise Under Fire; www.bmj.com 2. Henshall v GMC; Application for Judicial Review Competing interests: None declared |
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Rita Pal, Editor www,nhs-exposed.com
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When asked "have we lost faith? George Bernard Shaw said, "Certainly not; but we have transferred it from God to the General Medical Council." (Shaw GB. Doctors' delusions, crude criminology and sham education. London: Constable, 1932) . George Bernard Shaw ofcourse had the right idea about the General Medical Council all those years ago. These ideas have been followed through in different leading cases Toth v GMC and Richards v GMC. In a letter to the now infamous Arpad Toth, the General Medical Council stated the following " While we certainly strive to ensure our procedures are fair to all parties, we consider that Article 6 applies ONLY TO DOCTORS RIGHTS under our procedures". The link to this letter can be found at http://www.esmartstart.com/_framed/esmartbiz/generalmedicalcouncil/gmc2.htm . On the 23rd of July 2004, the Independent newspapers featured it at the following link http://news.independent.co.uk/uk/health/story.jsp?story=84842 . In the case Toth v GMC, an transcript discussion does have a statement where the legal assessor states that the complainant has a right to civil liberties. This brief interlude is lost to other complainants who have no idea that the GMC argues anything that will in the long run be convenient. Whatever the GMC argues, it is important to realise that the GMC is a public authority and under the Human Rights Act, they are obliged to maintain the civil liberties of complainants. The GMC's lawyers infamously argue varying stances at different cases for their own convenience. It is quite laughable to watch the GMC in court arguing that they are body that does not have to respect the law. This epitomises the ethos of the GMC. They honestly believe that they can do anything they like no matter what the law is. The law is ofcourse there for a reason. That is why we live in a democratic society. Harris HHJ shocked by their assertions pointed out that the "GMC is not above the law". For many years, the GMC has trampled over their opponents. The judges have had an ingrained respect for the GMC allowing their conduct to go unpunished. The Shipman Inquiry has opened the door to the reality of the GMC. A reality not known by the public. Indeed, the GMC has an inflated opinion of itself almost bordering on a sense of arrogance with no insight. It often tells the doctors registered with them to " know their limitations" yet the regulator itself fails to understand its own limitations. The leading cases Toth v GMC, Mcnicolas v GMC, Richards v GMC, Burke v GMC and Hensall v GMC are people who have had to undergo the hardships of litigation and the suffering of watching an authority defy all laws of natural justice. These people should not have to waste their time, energy and hard work fighting the GMC. The GMC should be able to maintain their civil liberties to be fair to all parties. It is due to this lack of insight that the GMC continues to professionally embarass itself and while they are now likened to the Titanic, they are taking the profession of good doctors with them. It is indeed time, a number of lifeboats were provided to the hardworking doctors in the land who do not deserve the bad publicity that currently surrounds them. The Shipman Inquiry was the iceberg the GMC were warned about repeatedly. As a sinking ship, they will certainly have some insight into the number of good doctors they have written off. These doctors remain at the mercy of benefits, and survive due to the kindness of the RMBF. These really are the forgotten doctors - tried within their flawed procedures. It should be noted that a number of doctors have challenged the GMC from within. Their names include Dr Richard Coleman, Dr Jennifer Coleman, Dr Andrew Ferguson and Dr Peter Wilmshurst. They have desperately attempted to maintain the rights of complainants and doctors. They remained a small voice in a huge ship. In my humble view, the General Medical Council should cease their arrogance and show the empathy and understanding to many complainants and doctors who have been failed by their system. In my view, the principles of the General Medical Council have always been sound, but those that manage the organisation should resign forthwith to make way for people who can uphold the principles of Good Medical Practise with a sense of honesty and fairness. Until those changes are made, the GMC's spin machine cannot save the sinking ship. Kind Regards Dr Rita Pal NB For anyone who is interested, the Health Select Committee are due to investigate the GMC in the future. Anyone wishing to register their interest, do contact David Hinchcliffe MP at Parliament. Competing interests: R Pal v GMC GMC lost the application to a junior doctor |
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John Stone, none London N22
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With apologies, I have quoted this passage more than once before but it is surely relevant to the present discussion. It comes from Richard Horton's 'MMR: Science and fiction - exploring the vaccine crisis' in which Horton describes incidents following Secretary of State for Health, John Reid's request to the GMC to invstigate Andrew Wakefield "as a matter of urgency": "Indeed, the GMC seemed nonplussed by Reid's intervention. The best their spokeswoman could say was 'We are concerned by these allegations and will be looking at what action, if any, may be necessary'. In truth, they had not a clue where to begin. At a dinner I attended on 23 February, one medical regulator and I discussed the Wakefield case. He seemeed unsure of how the Council could play a useful part in resolving the confusion [sic]. As we talked over coffee he scribbled down some possible lines of investigation and passed me his card, suggesting that I contact him if anything should come to mind. He seemed keen to pursue Wakefield, especially given ministerial interest. Here was professionally led regulation of doctors in action - notes exchanged ove liqueurs in a beautifully wood-pannelled room of one of medicine's venerable [sic] institutions." [p.7-8]. We must surely wonder at the editor of the Lancet's ambivalence. Any alleged impropriety on the part of Dr Wakefield pales into insignificance compared to the flawed and compromised machinery which is currently supposed to be calling him to account, apparently speculatively and on the basis of political whim. Competing interests: Parent of an autistic child |
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jonathan nicholas allcock, gp small heath b10 0jl
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The report from Dame Janet Smith is not suprising.We appear to have had continued and poor leadership at the General Medical Council;not least in introducing revalidation when the was no feasible or valid method in place to achieve it,it would have been much more plausible to introduce systems to detect poor performance and deal with it effectively.Such an approach would have been achievable and the method of revalidation could have been developed in the background.The GMC has opened itself to ridicule and has lacked logic in process. One fears politicians and the public who are after blood.I can honestly say that for myself and my colleagues life as a doctor in the NHS is not that great and frequently one comes across colleagues answering the question what else can a doctor do?Perhaps with the inevitible strengthening of inspection more of us will know the answer to that question and leave. Competing interests: None declared |
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