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Tribunal suspends GP after he told patient who was threatening suicide to go ahead

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5804 (Published 23 September 2014) Cite this as: BMJ 2014;349:g5804
  1. Clare Dyer
  1. 1The BMJ

A GP who told a patient to “jolly well go and do it now” after she threatened to kill herself has been suspended for three months by a fitness to practise panel.

Arun Singhal, 65, also told the patient, “If you don’t know how to do it, it’s on the internet.” He was unaware that she was secretly recording the consultation.

A panel of the Medical Practitioners Tribunal Service concluded that Singhal had probably not taken seriously the suicide threats of the woman, referred to as Patient A. The panel’s chair, Eileen Carr, said that he “was working on a daily basis with patients from a very deprived area, with a high rate of drug and alcohol abuse, who could be difficult, abusive, aggressive, and manipulative.”

“In the panel’s view,” said Carr, “it is likely that the threat to commit suicide was of a kind that the doctor would have heard before.”

The panel “inferred from all the evidence that Patient A may have been a difficult patient,” said Carr, and “did not find her wholly credible as a witness.”

Patient A visited Singhal at Hillside Road Practice in Liverpool in December 2011 seeking a doctor’s note to excuse her from a court appearance as a witness in a rape case. She feared for her safety because she lived near the brother of the accused. Singhal refused to provide a note unless she paid a fee, a statement recorded by her on her mobile phone but also entered by him into her patient record.

It was then that the exchange about suicide took place, which she recorded but which his notes did not mention. Patient A’s recording also included an exchange in which she said he was a disgrace for a doctor, to which he replied, “You know, you are a disgrace to be a patient.”

Patient A had a history of being abusive at the practice, the panel heard. Notes made by Singhal’s staff months earlier referred to her apparently threatening suicide in his waiting room and calling him a “fucking joke.”

Singhal did not attend the hearing, though he had earlier submitted testimonials describing him as “hardworking, accessible, empathetic” and providing “excellent care to his patients.” Carr added, “Whilst Dr Singhal’s non-attendance cannot be held against him, it leaves the panel in a position where it has had no evidence of any apology, insight, or remediation. In these circumstances the panel could not be satisfied that Dr Singhal would not repeat his misconduct.”

Notes

Cite this as: BMJ 2014;349:g5804

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