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Opinion

Manjula Arora case: the GMC stumbles again?

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1327 (Published 26 May 2022) Cite this as: BMJ 2022;377:o1327

Rapid Response:

Re: Manjula Arora case:

Dear Editor

Although the GMC’s Record of Determination on Dr Arora’s case runs to 32 pages, the essential facts are banally simple.

Dr Arora has been a doctor since 1988 and is of good character.

She asked her employer for a laptop. For context, most employees would reasonably expect their employer to provide work-related IT equipment.

She was told that none were available, but her interest would be noted for the next roll-out.

Many people would interpret this positive response to mean that they would get a laptop in due course. Clearly if her employer did not intend for her to have a laptop, they could simply have said so.

Dr Arora spoke to her IT department about getting a laptop and said she had been ‘promised’ one.

And that’s it. That is the entire extent of her ‘misconduct’.

One could regard her statement as a minor exaggeration, or loose terminology, or careless language or verbal shorthand over a trivial subject. I asked twelve ordinary decent people about it and this was their unanimous opinion. Nobody considered it to amount to ‘dishonesty’.

The tribunal took a different view. They concluded that ordinary, decent people would consider her use of the single word ‘promised’ as dishonest. But I had the opportunity to actually investigate what ordinary decent people think, and the tribunal didn’t.

The tribunal further decided that this so-called dishonesty amounted to misconduct.

They also considered that the misconduct was serious. Yes, you read that correctly.

They decided her fitness to practice was impaired, and that it was necessary to suspend her to send a message to the profession.

The tribunal has most certainly sent a message to the profession, but not, I think, the one they intended.

Not long ago the GMC sent doctors an email describing the ways in which they were becoming “an even more effective and compassionate regulator.” It is hard to see how this decision was efficient – it should have been resolved locally and never have come near a fitness to practice tribunal – and I don’t see much sign of compassion either.

It is an interesting thought experiment to universally apply the tribunal’s requirements for precision and rigidly scrupulous accuracy. Parliament would be an empty chamber with tumble weeds blowing through it, and almost every MP suspended. Doctors would naturally phone the Met Office before saying ‘good morning’, in case it wasn’t. The GMC itself might also have questions to answer about its use of statistics.

The regulator has a difficult task. Good regulation protects patients. Poor regulation harms patients, because doctors will run away from a toxic regulatory environment.

I fear this ludicrous decision will only aggravate the medical workforce crisis.

Competing interests: No competing interests

26 May 2022
Peter A Ewing
General Medical Practitioner
Red Practice, Crieff Medical Centre
Crieff Medical Centre, Crieff, Perthshire, PH7 3SA