Being at the mercy of a General Medical Council (GMC) investigation is considered by many doctors as the most stressful and unpleasant experience in a medical career. One of our members was unfortunate enough to be subjected to this process after a patient alleged the GP was ‘being a voyeur’ for the presence of a fixed but inactive camera in the consultation room. It is worth noting that it is common practice to have fixed cameras in some GP consulting rooms to be used as a teaching tool (as recording consultations is a formal part of GP training assessment and a requirement to to achieve the MRCGP qualification).
Over six months after the allegation was made, the GMC sent this response:
I am writing to update you on the outcome of our investigation. Our decision: The case examiners have considered the information received from Essex Police and decided to conclude this case with no further action. We do understand that this type of enquiry is stressful.”
Below is the reply by the GP.
No, I do not think you do….
I, of course, knew I had done absolutely nothing wrong. I had, in fact, merely been part of a practice wide attempt to improve training of registrars and allow qualified doctors to reflect on their practice. Instead of being congratulated on trying to improve General Practice, I (not the whole practice, just me) have been subjected to a Police investigation, an NHSE (NHS England) investigation and a GMC investigation. Only the Police have had the courtesy to deal with the matter face to face, promptly (within a couple of days) and efficiently.
Your email speaks of revalidation. This will not be an issue as I have decided to leave General Practice and this whole sorry story is why. I have devoted my life to the NHS; my personal life has always come second and this has had detrimental effects on my family. To say I feel undervalued by the system I have striven to maintain and improve is a massive understatement. I feel I have been ill-served by yourselves and by NHSE.
All three investigations have come to the same conclusion. There is absolutely no reason why it should have taken this long for the GMC to conclude its proceedings. Considering your recent response to me is the first time I have received a reply to an email clearly shows communication needs to be improved. It has only been my absolute confidence that any rational individual or group would find me innocent of this accusation that has kept me going. Unfortunately not all GMC investigation outcomes in recent years appear to have been entirely rational, so that introduces an element of doubt. It really is no wonder some Doctors kill themselves. At no time has the GMC checked on my state of health. It is fortunate that I am fairly resilient, but that does not stop me being very angry.
I can assure you that I felt I was treated as guilty until proven innocent so clearly these recommendations are yet to be implemented. I naturally do not expect this feedback to substantially alter GMC behaviour, as other more potent individuals and organisations have tried. I can assure you that most Doctors now see the GMC as the enemy rather than as a critical friend and suspect the organisation is a political tool. I do believe nonetheless that the organisation needs to hear how destructive its methods are.
Written by Anonymous
Edited by DrGandalf
Below is the full unedited version of the letter.
No, I do not think you do.
I, of course, knew I had done absolutely nothing wrong. I had, in fact, merely been part of a practice wide attempt to improve training of registrars and allow qualified Doctors to reflect on their practice. Instead of being congratulated on trying to improve General Practice, I (not the whole practice, just me) have been subjected to a Police investigation, an NHSE (NHS England) investigation and a GMC investigation. Only the Police have had the courtesy to deal with the matter face to face, promptly ( a couple of days) and efficiently.
Your email speaks of revalidation. This will not be an issue as I have decided to leave General Practice and this whole sorry story is why. I have devoted my life to the NHS. My personal life has always come second and this has had detrimental effects on my family. To say I feel undervalued by the system I have striven to maintain and improve is a massive understatement. I feel I have been ill-served by yourselves and by NHSE.
All three investigations have come to the same conclusion; there is absolutely no reason why it should have taken this long for the GMC to conclude its proceedings. Considering your recent response to me is the first time I have received a reply to an email clearly shows communication needs to be improved. It has only been my absolute confidence that any rational individual or group would find me innocent of this accusation that has kept me going. Unfortunately not all GMC investigation outcomes in recent years appear to have been entirely rational (see below) so that introduces an element of doubt. It really is no wonder some Doctors kill themselves. At no time has the GMC checked on my state of health. It is fortunate that I am fairly resilient, but that does not stop me being very angry.
From the Civitas (1) executive summary from their report “The General Medical Council: Fit to Practise?” of July 2014: –
• Some high-profile successful appeals have occurred against GMC sanctions despite the enormous legal and cost barriers of an individual taking on the GMC. Common themes include inconsistent decision making, excessive delays, flawed evaluation of the evidence and undue weight given to the testimony of the accusers.
• 96 doctors are reported to have died whilst undergoing fitness to practise procedures between 2004 and 2013. It is unknown how many were suicide. A GMC internal investigation that commenced in 2013 has not reported to date.
• The GMC seems to lack openness and insight concerning the failings in their processes. When there is no case to answer after protracted proceedings, it is exceptional for there to be any apology, or explanation about why cases were pursued.
• The GMC acknowledges that there is no evidence of any decline in standards of medical practice to justify its increased activity and no published or inferred evidence exists that the GMC FTP processes improve the quality of medical care overall.
• There is evidence that a culture of complaint and litigation may harm patient interests by fostering defensive medicine and encouraging experienced doctors to leave the profession (my underlining) or switch to low risk practice. A GMC referral is the extreme adverse professional experience for a doctor, so it is disturbing that the GMC appears to give no serious consideration to the impact of its own activity (and deficiencies) on either doctors or patients.
The GMC commissioned report was completed in December 2014 and investigated 28 deaths due to suicide or probable suicide. These tragic events are, of course, the tip of the destructive iceberg that is GMC induced Doctor dysfunction. The GMC cannot protect patients by disabling the workforce.
The recommendations from the report are as follows: –
Recommendations for current GMC practice (2):
1 Doctors under investigation should feel they are treated as ‘innocent until proven guilty’
2 Reduce the number of health examiners’ reports required for health assessments
3 Appoint a senior medical officer within the GMC to be responsible for overseeing health cases
4 Introduce case conferencing for all health and performance cases
5 Set out pre-qualification criteria for referrals from NHS providers and independent employers
6 Make emotional resilience training an integral part of the medical curriculum
7 Expose GMC investigation staff to frontline clinical practice
8 Develop a GMC employee training package to increase staff awareness of mental health issues.
I can assure you that I felt I was treated as guilty until proven innocent so clearly these recommendations are yet to be implemented.
I naturally do not expect this feedback to substantially alter GMC behaviour as other more potent individuals and organisations have tried. I can assure you that most Doctors now see the GMC as the enemy rather than as a critical friend and suspect the organisation is a political tool. I do believe nonetheless that the organisation needs to hear how destructive its methods are.
- http://www.civitas.org.uk/content/files/GMCFittoPractise.pdf
- http://www.gmc-uk.org/news/29348.asp