Medical Qualification and Outcomes of General Medical Fitness to Practice Process; Cohort Study
It is with great concern that we send this reply to the research
paper produced by Charlotte Humphrey, Shaista Hickman and Martin Gilford
on behalf of the NHS BME Network.
More than10 years since the Stephen Lawrence enquiry highlighted
institutional racism within the public sector it is well recognised that
black and minority ethnic (BME) doctors and doctors who have qualified
overseas have a higher referral rate to the general medical council and
have higher impact judgements. Whilst the results of the Cohort Study come
as no surprise the percentage increase in the punishment that these
doctors face is unexpected and very concerning.
The NHS BME Network was launched last year to be an independent
"voice" for BME people including staff, patients, services users and
carers. As such the Network provides support to doctors, dentists, nurses,
other healthcare professionals and managers from a BME background. All
available evidence clearly shows that BME staff are subjected to racism
within the NHS and it is our aim and objective to ensure that
discrimination is eliminated. To this end we have established a MoU with
the Care Quality Commission and are now recognised as a key stakeholder by
the Equality and Human Rights Commission. In addition we are working in
partnership with a number of BME champions in PCTs Foundation Trusts and
other organisations.
It is essential that the Fitness to Practice process is open,
transparent and non-biased and as such annonymised results should be made
public on a regular basis and an assessment review should be conducted at
different stages. Furthermore, doctors who participate in the Fitness to
Practice process should be given an opportunity to give valid feedback to
the General Medical Council. We understand that this is not the current
practice.
More recently, the NHS BME Network supported a GP where the evidence
clearly showed his PCT had been targeting doctors from BME backgrounds.
The evidence showed there to be a 320% increase in referral of these
doctors to the PCT's managing concerns group. Furthermore, whilst non-BME
doctors where only referred for serious complaints such as indecent
assault, drink driving and manslaughter BME doctors by contrast were
referred for minor patient complaints including an inability to use
software. In the case of one BME doctor referred to NCAS on the basis of a
patient complaint concerning poor clinical skills it later transpired that
the BME GP had never seen the patient.There was no real support offered
from the traditional Medical Support association both local and National.
When these matters eventually came to light the head of the managing
concerns group, was simply transferred to a neighbouring organisation to
take up a different position . The GP's case was eventually settled out of
court with an apology and an agreement to change the structure of the
managing concerns process. The latter also included an agreement that
future appointments to the committee would be made in an open and
transparent manner rather than by selection from the "old boys" network as
the normal practice in the past.
Given the evidence we also believe that the various stages of the GMC
process should be examined under a wide angle microscope. As such changes
should be made to the current organisational structure of the GMC
assessment process to include a BME doctor as part of the assessment
process when a BME doctor's Fitness to Practice is under consideration. We
believe due regard should also be given to the fact that GPs and hospital
consultants from BME backgrounds are more than likely to be working in
hospitals/surgeries in deprived areas and BME GP surgeries are often under
- funded, held in poor premises with limited PCT support making them
unattractive for incoming GPs.
The GMC's Fitness to Practice programme is hopefully soon to change
and we sincerely hope the process will be open and transparent. It is
within this set up that discrimination amongst assessors should be
questioned and that assessors with inappropriately high levels of
referrals should be named and shamed and removed from the organisation.
Racial justice is long overdue -doctors need to be protected and
supported too!
Dr Vivienne Lyfar Cisse,
Transitional Lead
NHS BME Network
Dr Vijay Kumar FRCS(Edin) MRCGP
National GP Lead
NHS BME Network
Competing interests:
Both the authors are members of the NHS BME Networks National Transitional Commitee
Rapid Response:
Medical Qualification and Outcomes of General Medical Fitness to Practice Process; Cohort Study
It is with great concern that we send this reply to the research
paper produced by Charlotte Humphrey, Shaista Hickman and Martin Gilford
on behalf of the NHS BME Network.
More than10 years since the Stephen Lawrence enquiry highlighted
institutional racism within the public sector it is well recognised that
black and minority ethnic (BME) doctors and doctors who have qualified
overseas have a higher referral rate to the general medical council and
have higher impact judgements. Whilst the results of the Cohort Study come
as no surprise the percentage increase in the punishment that these
doctors face is unexpected and very concerning.
The NHS BME Network was launched last year to be an independent
"voice" for BME people including staff, patients, services users and
carers. As such the Network provides support to doctors, dentists, nurses,
other healthcare professionals and managers from a BME background. All
available evidence clearly shows that BME staff are subjected to racism
within the NHS and it is our aim and objective to ensure that
discrimination is eliminated. To this end we have established a MoU with
the Care Quality Commission and are now recognised as a key stakeholder by
the Equality and Human Rights Commission. In addition we are working in
partnership with a number of BME champions in PCTs Foundation Trusts and
other organisations.
It is essential that the Fitness to Practice process is open,
transparent and non-biased and as such annonymised results should be made
public on a regular basis and an assessment review should be conducted at
different stages. Furthermore, doctors who participate in the Fitness to
Practice process should be given an opportunity to give valid feedback to
the General Medical Council. We understand that this is not the current
practice.
More recently, the NHS BME Network supported a GP where the evidence
clearly showed his PCT had been targeting doctors from BME backgrounds.
The evidence showed there to be a 320% increase in referral of these
doctors to the PCT's managing concerns group. Furthermore, whilst non-BME
doctors where only referred for serious complaints such as indecent
assault, drink driving and manslaughter BME doctors by contrast were
referred for minor patient complaints including an inability to use
software. In the case of one BME doctor referred to NCAS on the basis of a
patient complaint concerning poor clinical skills it later transpired that
the BME GP had never seen the patient.There was no real support offered
from the traditional Medical Support association both local and National.
When these matters eventually came to light the head of the managing
concerns group, was simply transferred to a neighbouring organisation to
take up a different position . The GP's case was eventually settled out of
court with an apology and an agreement to change the structure of the
managing concerns process. The latter also included an agreement that
future appointments to the committee would be made in an open and
transparent manner rather than by selection from the "old boys" network as
the normal practice in the past.
Given the evidence we also believe that the various stages of the GMC
process should be examined under a wide angle microscope. As such changes
should be made to the current organisational structure of the GMC
assessment process to include a BME doctor as part of the assessment
process when a BME doctor's Fitness to Practice is under consideration. We
believe due regard should also be given to the fact that GPs and hospital
consultants from BME backgrounds are more than likely to be working in
hospitals/surgeries in deprived areas and BME GP surgeries are often under
- funded, held in poor premises with limited PCT support making them
unattractive for incoming GPs.
The GMC's Fitness to Practice programme is hopefully soon to change
and we sincerely hope the process will be open and transparent. It is
within this set up that discrimination amongst assessors should be
questioned and that assessors with inappropriately high levels of
referrals should be named and shamed and removed from the organisation.
Racial justice is long overdue -doctors need to be protected and
supported too!
Dr Vivienne Lyfar Cisse,
Transitional Lead
NHS BME Network
Dr Vijay Kumar FRCS(Edin) MRCGP
National GP Lead
NHS BME Network
Competing interests: Both the authors are members of the NHS BME Networks National Transitional Commitee