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A Very Simple Proposal For Medical Regulation In The United Kingdom ::: 2005 Version
- Joseph . C . Obi (14 January 2005)
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The GMC- Unfit and Shameful
- Jennie Colman (17 January 2005)
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Human Rights Act 1998 - Article 6 Violation?
- Rita Pal (18 January 2005)
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GMC - time for an MOT test?
- Oliver R Dearlove (18 January 2005)
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Re: GMC - time for an MOT test?
- Rita Pal (19 January 2005)
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There is no need for double jeopardy.
- R K Mohindra (24 January 2005)
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'GMC-Induced' Multiple Jeopardy . . .
- Joseph . C . Obi (25 January 2005)
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Joseph . C . Obi, Provost and Emeritus Chair of Nutritional Immunomodulation RCAM (Royal College of Alternative Medicine) www.RoyalCAM.org
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Those of us who have been lucky enough to survive exceedingly woeful practices at the 'Infallible' General Medical Council (GMC), would publicly agree that almost any additional form of supervison of the GMC would be an exceedingly welcome intervention indeed. However, there must be some sort of balance which is fair to all parties concerned...most especially Patients, Regulators and Doctors. It is therefore my candid view that the GMC should fully disband it's 'Fitness To Practise (FTP) Directorate' altogether ; and concentrate solely on the Registration and Revalidation of the 200,000 Medical Doctors who currently bankroll it's graceful life of luxury. All disciplinary and performance matters should henceforth be tackled jointly by the Local NHS Trusts, the National Clinical Assessment Authority (NCAA) ,Firebrand Compensation Attorneys ...and the Noble British Courts. Once Licensed, the GMC should only be able to suspend (or remove) a Doctor from it's Register , on the orders of a Serving Appeal Court Judge. In this proposal , the wronged patients would get adequately compensated, the GMC's expenditure would be dramatically reduced , while Doctors would ultimately end up paying considerably less for their Medical Practising Licenses. The Council for Healthcare Regulatory Excellence (CHRE) would then take it's rightful place as 'GMC Regulator', and all of the highly indignified legal squabbling between the CHRE and the GMC will amicably be reduced to a very bare minimum. The Director of the CHRE could then warmly spend more of his precious time 'Protecting The Public' by actually regulating the Administrators of the GMC (especially the GMC's 'Permanent CHRE Representative')...instead of daintily clobbering Poor Medical Doctors into Wasteful Professional Oblivion. A similar strategy could also equally apply to all of the many other Health Professions too. Competing interests: Professor Joseph Chikelue Obi FRCAM (Dublin) FRIPH (UK) FACAM (USA) also supervises an Interdisciplinary Revalidation Initiative (IRI) for Seasoned Practitioners in Complementary and Alternative Medicine. Please kindly visit www.RoyalCAM.org for more details |
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Jennie Colman, retired Dereham, NR19 2EA
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The fault for oppressive and regressive developments in medical regulation must be laid squarely and the door of the GMC. Dame Janet Smith was only stating what a number of us, doctor and patients, had stated for some years, that the GMC did not implement it's Fitness to Practise procedures properly or correctly. What we should be asking is - if there is persistent underperformance from the GMC in respect of implementing their procedures properly is it always a mistake or is there some underlying wilfulness concerned? The answer to this may well lay in the finding by Dame Janet that the GMC has put expediency above principle. Dame Janet has also recommended that the hearings be taken away from the GMC. That is not enough and the whole of Fitness to Practise should be removed for it is in the early handling of the cases, which is not transparent, that expediency can, and may well continue, to go undetected. The GMC is clearly not fit for purpose as a regulatory body and never has been. The GMC has also heaped opprobrium upon some of us who have dared say so, even quietly, in an attempt to divert the issue of their own shortcomings. How many more bites at the cherry are we, as doctors, going to allow this dysfunctional and shameful organisation? It would be better for everyone if all Fitness to Practise was removed from them as soon as possible. Competing interests: Former elected medical member of the GMC 2000-2003 |
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Rita Pal, Freelance Writer and Doctor UK
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Procedural flaws within the General Medical Council are overlooked by those who do not understand its implication within Human Rights legislation. The GMC is a creature of statute empowered via the Medical Act 1983 (http://www.gmc-uk.org/about/legislation/medical_act.htm). As a creature of statute and as a public authority, the GMC is duty bound to abide by Human Rights legislation. Abiding by this legislation means following the procedures laid down by parliament. The Policy Institute's Study of the GMC was much less publicised than the Shipman Inquiry but provides a excellent summary of procedural faults. Isobel Allen formulated a document that every doctor in the UK should read. It is available on http://www.psi.org.uk/publications/publication.asp?publication_id=426 Collectively, the Shipman Inquiry and the Policy Institute Study have found the GMC to be flouting their procedures on a regular basis. This raises an important question about the rights of both the complainant and the doctor. By law and by the GMC's legal assessor's own admission in Toth v GMC, Article 6 of the Human Rights Act 1998 should be maintained. The problem here is this - the GMC has thousands of cases - each case may have been subjected to procedural flaws described by the Shipman Inquiry. If a court violates Aricle 6, it has to declare its judgments invalid and retry the case. The GMC however is not a court (GMC v BBC)and does not appear to be bound by this requirement even though its decisions and judgments have an impact on the fundamental human rights of complainant and respondent. At present, the GMC has ignored the procedural improprieties that may adversely affect countless cases. The GMC's judgments are often accepted without question. Even those who may seek to question the judgment often find that financial constraints prevent them from doing so. It would to my mind be prudent for all individuals to carefully consult the Medical Act 1983 and Statutory Instruments ( all available on GMC website or HMSO) that govern the GMC's behaviour. Complainants and respondents alike should verify that procedures have been followed at all stages. Despite their initially daunting appearance, the regulations are really not all that confusing and begin to make sense in a very short time. Of course, new regulations are now in effect but for older complaints, the regulations in effect at the time of the complaint will apply. It is essential that you verify which set of regulation apply to the complaint at hand. It is an established fact that the GMC is unable to follow their procedures laid down by parliament.This cannot be natural justice as stipulated by Lord Denning. The Shipman Inquiry has highlighted a fundamental problem - a public body ( the GMC) is routinely and blatantly disregarding the procedures that it must by law follow. The GMC can act ONLY in accordance with its procedures and may act in no other way. For the GMC to repeatedly violate these procedures is unacceptable in a democratic society. Moreover in cases where procedures have been ignored in this disgraceful manner, the GMC's findings may well be invalid and unenforcable because it has acted ultra vires ( beyond its powers). Clearly, this is entirely unacceptable, not only must this inevitably lead to decisions open to bias and injustice but can only decrease the public's confidence in the GMC's willingness and ability to protect them from rogue doctors. Surely, the only way to restore public confidence in the GMC's badly tarnished reputation and to ensure justice for the doctors who become subject to its machinations is to institute an immediate and wide ranging public inquiry. All complainants and respondents who have been unhappy with the GMC's decisions in recent years should be given the opportunity for these decisions to be reviewed by an independent and impartial judge. It would perhaps be unreasonable to expect such an inquiry to re-evaluate the details of each case. However, it is certainly not unreasonable to expect that such an inquiry could verify that procedures had been followed appropriately and thereby reassure those involved that the GMC's findings were not tainted. Regrettably, I suspect that in view of recent findings there will be a substantial number of cases in which such reassurance will not be possible. For those cases, the only just alternative will be to lever the cases from the dark corridors of GMC incompetence and air them in the cleansing light of public scrutiny. Dr Rita Pal www.nhs-exposed.com Competing interests: R Pal v GMC, Peter Lynn, Sarah Bedwell and Catherine Green |
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Oliver R Dearlove, Consultant Anaesthetist Royal Manchester Children's Hospital
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This script answers the question is it only doctors who make mistakes? No-one besides the GMC has said how lucky doctors are to have them. If it were true that the GMC was light on doctors then we could look at the number of High Court appeals against their decisions. We could even call this, an externally verified validated measure of performance. There have been a number of recent appeals against the GMC (Hospital Doctor referred to this as the magnificent seven, because of their increasing and remarkable nature) of which Pal v GMC and Madan v GMC spring to mind. Madan took the GMC to the High Court because if the GMC interim suspended a doctor, an employer could fire him, before even the main case was heard. The High Court found this neither doctor-centred nor fair. I was particularly interested in Madan as I had previously framed the Royal College of Anaesthetists’ opinion to the GMC on interim orders and suggested that this might occur. Patient-centred-ness must not be at the expense of the law, see above. That is if Pal and Madan are taken into account then part of the accountability of the GMC has to be in law. Specifically the GMC has to obey the Human Rights Act [Madan] and the Freedom of Information Act (or the Data Protection Act) [Pal], just as other public bodies and ourselves have to comply with the law that concerns us. One might have thought all this was obvious nonetheless the cases were brought, so it cannot have been, even to the appointed lay members who were lawyers. The defence in one was that the GMC was not bound by the Act and in the other that it seemed rather complicated to obey. Both defences did not succeed. Let us not be too beastly to Dame Janet – appointed and not elected herself, so no wonder she was against elections of any kind to the GMC. The GMC was beating its breast in public. Confessing one’s sins in public before a judge will lead to a conviction and I am sure that she found it difficult not to plunge in the knife and finish the job- with surgical precision. It has also to be said, with a surgeon’s relish. Judges are Human but even Judges have been found to be substandard. Lord Hoffman in the Amnesty case springs to mind (1). After one of his speeches was forgotten, and the case reheard before different Law Lords because of the possibility of bias, there were no committees of inquiry. There were no impassioned editorials, declaring it ‘is changed all changed’. There was not one pussy-cat editor, who had left his journal to fetch a bowl of cream, raging that twenty years ago he had been a tiger on this very subject. No President of any kind went around saying that 5% (that is five or six) High Court Judges were substandard nor even that they all seemed to specialise in medical negligence. Lord Hoffman kept his job. He wasn’t even retrained. Lord Woolf LCJ, readers will recall (2) in December 04, very sensibly said that there were some inquiries that judges should not chair and he (the Lord Chief Justice) should have the final veto on the matter. He did not say if there were any particular politically charged issue which needed a judicial veneer of respectability that he had in mind or whether he was speaking generally. So it seems that the GMC is in a mess. We could say it has an obvious impaired fitness to regulate. That much is certain, but the way out is less certain. We know now that it will not be through the revalidation that the GMC has thrust on the profession and employers who foot the bill. Sir Donald was promising more from revalidation than he could deliver all those years ago and perhaps it is time to admit that something like revalidation would not root out mass murderers like Harold Shipman, because they conceal themselves and the evidence. It is time to reset our goals – to decide what revalidation is for, what it can reasonably and realistically achieve, how we will get there and at what cost borne by the tax payer. At present the medical profession and its regulation is being torn apart by faction and respective pressure groups and in the end it is the patients who will suffer. Oliver R Dearlove FRCA o.dearlove@man.ac.uk ref 1 http://news.bbc.co.uk/1/hi/uk_politics/255976.stm 2 Woolf wants final say over inquiries Times 15 Dec 2004 Conflict of Interest: as script. The Royal College of Anaesthetists and Central Manchester Children’s; Hospitals Trust have nothing to do with the sentiments expressed. Competing interests: as script |
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Rita Pal, Freelance Writer and Doctor UK
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Dear Dr Dearlove, May I offer my congratulations on an excellent post. However I would just stress one point, R Pal v GMC is NOT an appeal against a GMC decision. The case was brought following my discovery of certain internal memoranda written by GMC staff members ( Peter Lynn et al). My discovery of these memoranda was as a result of a subject access request to the GMC under Section 7 of the Data Protection Act and was not linked to any judgment against me by the GMC, nor has there ever been such a judgment. No complaint was raised against me and I was not (officially) subject to Fitness to Practise procedures. Had I not made the subject access request, I would never have known that the GMC had been dogging my footsteps for almost two years. It is as a result of this gross invasion of my privacy that I have SUED the GMC in civil law. There appears to be a persistent misconception that the case is some form of appeal or challenge to a GMC judgment. While this is understandable because almost all such cases against the GMC are indeed appeals or challenges, that is not so in R Pal v GMC. Rather this case ( which appears to be unique in this respect) is a direct challenge to the the way the GMC have behaved rather than to any particular finding. Indeed, my case turns upon breaches of the Data Protection Act, Human Rights Act and Defamation Act none of which with the exception of the HRA would be applicable to an appeal against a GMC decision. Intriguingly the GMC appeared to be so horrified by the possibility that a junior doctor could sue them directly that they attempted to have the case struck out. During the course of the hearing, however Harris HHJ stated that the GMC were not above the law and declined to strike the case out to the apparent disbelief of the GMC barrister Jane Collier. The next stage in proceedings is likely to begin in the very near future. The judgment is one of its kind involving the rights of a whistleblower, defamation law and DPA and HRA rights. The issue of procedural impropriety pervades the entire case and is the keystone upon which many of the arguments turn. Please note the MDDUS Defence Union refused to fund this case and I have been obliged to find the finances to bring the case independently. While I was able to do so and am certainly in a position to fund the case all the way to trial should that become necessary, many other doctors would not be able to do so and their rights would be correspondingly diminished. The judgment can be downloaded from www.generalmedicalcouncil.org.uk Kind Regards Dr Rita Pal Competing interests: R Pal v GMC, Sarah Bedwell, Peter Lynn, Catherine Green |
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R K Mohindra, SpR Cardiology James Cook University Hospital, TS4 3BW
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Section 1(1A) of the Medical Act 1983 states that "The main objective of the General Council in exercising their functions is to protect, promote and maintain the health and safety of the public." Section 29(4) of the National Health Service Reform and Health Care Professions Act 2002 grants the Council for Healthcare Regulatory Excellence (CHRE) the power to refer "unduly lenient" decisions made by the General Medical Council to the High Court. But the CHRE can only do this if its action is desirable to protect members of the public. Thus it might appear that there are two bodies who are statutorily empowered to protect the public from poorly performing doctors. However this is not the case because the power of the CHRE is parasitic upon the decisions of the GMC. After the report by Dame Janet Smith (1) the need for scrutiny of the decisions of the GMC is no longer seriously in debate. What is harsh for doctors is the inelegant and inefficient structure that wrangling between the politicians and the GMC has brought into reality. There is no need for double jeopardy. A simple GMC tribunal hearing with clearly defined appeal procedures to the High Court for both parties attending the hearing would obviate the role of the CHRE. (1) Dyer C. Shipman inquiry finds GMC has "fundamental flaws" BMJ 2005;330:10 Competing interests: None declared |
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Joseph . C . Obi, Provost and Emeritus Chair of Nutritional Immunomodulation RCAM (Royal College of Alternative Medicine) www.RoyalCAM.org
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The General Medical Council (GMC) is most certainly NOT above the Law ; and must therefore never ever be indefinitely allowed to Totalitarianly Act as Exclusive PLAB Examiner, Statutory Medical Registrar , Internal Registration Appellate Body, Eternal Performance Appraiser, In-House Performance Appellate Body ,One and Only Chief Revalidator, Ultimate Discrete Inquiries Commissioner, Evangelically Eager Witch-Hunter , Part- Time Criminal Investigator, On-Demand Professional Policeman , Wannabe Qasi-Crown Prosecutor , Unlicensed Supreme Court Judge , Infallible Clinical Misconduct Jury and (Blood-Thirstily) Inept Political Executioner ; all in the very same 'Obtuse Regulatory Litter'. Thank God for the Council for Healthcare Regulatory Excellence (CHRE) !!! Competing interests: Professor Joseph Chikelue Obi FRCAM (Dublin) FRIPH (UK) FACAM (USA) also supervises an Interdisciplinary Revalidation Initiative (IRI) for Seasoned Practitioners in Complementary and Alternative Medicine. Please kindly visit www.RoyalCAM.org for more details |
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