GMC in the spotlight
BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2594 (Published 14 June 2018) Cite this as: BMJ 2018;361:k2594
All rapid responses
It seems that neither the Williams nor the Marx review are able to tackle the most pressing difficulty faced by doctors in the front line. The GMC demand honest self-reflection for the annual appraisal process yet cannot prevent the legal consequences. The assurances from Professor Stephenson that the GMC will not use reflections in fitness to practise investigations do not reassure us. However carefully anonymised , reflections will be used by prosecuting lawyers in cases of clinical or gross professional negligence. Hence the most productive aspect of appraisal has been made valueless and the prospects for open scrutiny of error in healthcare set back further.
Competing interests: No competing interests
Both the BMJ Editor-in-Chief and GMC Chair appear to be lamenting that “legal privilege” [1][2] has not been recommended to reflective notes by the Williams Review. It seems both writers are failing to see the wood for the trees. First, Prof Stephenson (‘PS’) in particular might need reminding that the medical profession would not have been in the current parlous state, had the GMC not pursued an utterly unjust appeal which must have emotionally tortured Dr Bawa Garba; I sincerely hope, upon reflection he is now in a position to agree.
Simply criticising the Williams Review will not lessen doctors’ worsening fears, mistrust, and confidence in the GMC but there is one thing they could urgently do without insulting the intelligence of their fee-paying registrants any further. Both PS and Charlie Massey “must resign” [3] forthwith as their persisting hollow defences and reassurances have now become untenable; they are no longer respected by the wider medical profession and it is still not too late for them leave albeit at this stage, it would not be a gracious departure. Further, at least as a rather late gesture of goodwill, I would urge the GMC to refrain from instructing counsel to appear before the forthcoming Court of Appeal hearing, or if already instructed, withdraw the same.
It would have been highly contentious even to recommend that special legal privileges are afforded solely to doctors ignoring other allied professionals such as nurses, midwives, physiotherapists etc. Even if such brave recommendation was made by the Williams Review, it is highly unlikely that lawmakers would readily amend the established remit of ‘legal professional privilege’ [4]. After all, the Williams Review was never meant to promote disproportionate and legally contentious privileges for doctors. As for written reflections, at least one barrister-columnist of BMJ has recommended some useful advice as explained in my response [5], and I urge the GMC and Royal Colleges to consider the same carefully. GMC’s self-inflated regulatory ego should not be allowed to overwhelm the personal rights of doctors. If status quo is maintained, en masse disobedience would be the likely outcome if that process has not already begun.
Reference
[1] BMJ 2018;361:k2594
[2] https://blogs.bmj.com/bmj/2018/06/12/terence-stephenson-on-the
[3] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30838-9/fulltext
[4] https://en.wikipedia.org/wiki/Legal_professional_privilege
[5] https://www.bmj.com/content/360/bmj.k546/rr-1
Competing interests: No competing interests
Re: GMC in the spotlight
Today Prof Sir Terence Stephenson, Chair of the General Medical Council, published his lamentable and obfuscationary response to the Williams Review.
Nowhere in this response does he acknowledge that doctors' actual key concern with the GMC is that they had a hard working and conscientious Dr Bawa-Garba struck off because of honest mistakes when working in intolerable conditions.
If he can't even bring himself to acknowledge the strength of feeling of the profession in this regard I have no confidence in him or the GMC with him as the Chair.
Unless he has the decency and humility to accept his failings in this case and apologise unreservedly he should accept that he has lost the confidence of the profession and do the honourable thing by resigning.
Competing interests: No competing interests