Bob Bury

Is the General Medical Council fit for purpose?

I wrote this 24 hours ago, but then slept on it, largely because I met the Editor earlier this week and discovered that his first thought on receiving my blog each month was ‘will we need to involve the lawyers this time?’. And I could see what he meant when I read through the first version of today’s tirade, which would probably have had the GMC’s legal Rottweilers on his doorstep with restraining orders.

Perhaps the wife’s right – I do need to think about an anger management course.

To some things, though, anger is the only possible reaction. Did you read the story about Dr Edouard Yaacoub and the GMC? – hopefully you didn’t, because it was in the Daily Wail, and some of you will understandably be nervous about vising that paper’s website, lest you should inadvertently encounter some of the readers’ comments and suffer premature rupture of your hitherto occult cerebral aneurysm.

So let me précis the report for you (and it was also reported in the BMJ, which proves it really did happen, and is a safer read). Dr Yaacoub was arraigned before the GMC in 2011 following allegations from a patient that he had sexually assaulted her during a home visit. Despite the fact that the patient’s accusations changed with time, becoming increasingly lurid, the FTP panel found him guilty and struck him off.

Last year, the High Court found that the GMC had not given adequate reasons to explain why they preferred the troublingly inconsistent claims of the patient to the evidence of Dr Yaacoub. So, he was hauled back in front of the FTP to face those same accusations again, and was duly and unsurprisingly found not guilty. At least, he was found not guilty of sexually assaulting the patient, but the panel felt obliged to point out that the gift of a small religious picture to the patient at the time of his visit constituted ‘a departure from professional standards’.

You may be asking yourselves ‘So did the GMC apologise that their actions had destroyed this man’s life and deprived him of income for four years?’, but you will be asking yourselves rhetorically, because this is the GMC, and you already know the answer. Not only didn’t they apologise, but they also dragged up the unimportant side issue of the gift to the patient, which they did not feel required any action. I can’t help but be reminded of the ‘yeah but, no but’ character Vicky Pollard in Little Britain. ‘OK’ they say, sulkily, ‘you may not have assaulted the patient, but you did give her a picture’.

The GMC have also been in the news recently for allowing a number of doctors with convictions for downloading pornographic images of children to continue practising. I’m not linking to those stories, or naming names, because it would be invidious of me to suggest that the GMC’s actions were wrong without knowing all the facts of the cases concerned. But I can’t help contrasting their behaviour there with their apparent harshness in some other cases – that of Dr Derek Keilloh, for example. His case has been reported here and elsewhere, but seems to have excited little comment in the medical press, and I think that, like Dr Yaacoub’s story, it provides another illustration of the GMC’s capricious behaviour.

I’ve read the transcript of the Keilloh hearing. It tells the story of a young, inexperienced army medic dropped into Basra at the height of the second Gulf War, with inadequate preparation and very little support. Despite his assertion of innocence, he was deemed not to have fulfilled his responsibilities to Iraqi detainees by reporting evidence of mistreatment of one of his patients, and to have lied about his inaction. This was in 2003. In the years since then, Dr Keilloh had become a highly-regarded GP in Northallerton, and his patients, family and friends ran a campaign to get him reinstated.

The GMC paid lip service to the fact that he had been working under extreme pressure in Basra, with inadequate support from his seniors, and that he did everything possible to resuscitate his unfortunate patient. They also seemed to agree that he represented no risk to his patients now or in the future – quite the opposite, if you believe his patients in Northallerton. But that all went for naught, as the FTP decided that they had ‘no alternative’ to erasure. Really? In that case, it shouldn’t be beyond the whit of man to devise one.

In the meantime, his medical career is over, and his patients have lost a much-respected family doctor. When responding to criticism over Dr Yaacoub’s treatment, the GMC’s lawyer re-iterated their responsibility to ‘protect the public’. That is clearly not an issue with respect to Dr Keilloh, whose treatment seems to me more like retribution than any concern as to his competence.

The comments appended to the Pulse report on Dr Yaacoub’s acquittal are illuminating, and are echoed on a number of medical websites, and in conversations with colleagues. Many doctors have felt for some time that the organization is no longer fit for purpose, and wonder why they should pay large sums of money to a body which on occasions appears to treat the rights of doctors coming before its FTP with disdain.

We might even wonder if we’d be better off taking our chances with a separate, quasi-judicial and publicly-funded body to deal with our real or supposed shortcomings, and just pay the GMC a tenner a year to maintain the register. Such an organisation could require the same level of evidence as a criminal court, rather than the civil ‘balance of probabilities’ which is currently all that is needed to end a medical career.

But then we see a surgeon sent to prison for manslaughter and realise that the profession is now between a rock and a very hard place indeed.

So, keep your fingers crossed, make sure your defence society fees are on a standing order, practise defensive medicine, don’t ever, whatever you do, make a mistake. Me? I’ve never been so happy to be retired.

And…relax.

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4 Responses to “Is the General Medical Council fit for purpose?”

  1. GUMDoc says:

    I agree that the GMC are not fit for purpose. I’ve been a doctor since 1985. From what I’ve heard over the years, I am not confident about the competencies of the individual exercising GMC procedures, or the procedures themselves, and my impression of the GMC is as a well-meaning, but scary organisation.

  2. waffles says:

    Bob, some doctors are completely without shame and the episode re. surgeon sent to prison for manslaughter was a shocking case of neglect-he only got one year btw. I don’t think responsible doctors have much to fear from a “separate, quasi-judicial and publicly funded body” as an alternative to the GMC.

  3. The other side of the coin says:

    Agreed that the GMC do not seem to be fit for purpose.

    My experience is that of a relative making a complaint about a GP who twice dishonestly misrepresented his position on a certificate he signed – after not carrying out any test for capacity. The same same doctor failed in many of the requirements laid down by the GMC for ‘good medical practice’.

    When taking the patient on, this doctor failed to revue her records and continued the previous repeat prescription for Roypnol and other psychotropic drugs. How can taking Rohypnol daily be consistent with mental capacity in the legal sense? How can a GP be allowed to prescribe multiple mind numbing benzos causing major problems, including the patient’s zombie like confusion, with both the patient and her family? Like most GPs this doctor had no training for treating mentally ill patients.

    A major chunk of the patient’s Medical records for the patient were ‘lost’ by the doctor.

    Yet the GMC failed to find any fault with the GP. Almost all of the income that is enjoyed by the GMC comes from the fees charged in it’s ‘regulation’ and registration of doctors.

    If my experience with them is anything to go by the GMC is failing to protect patients

  4. A. Doctor says:

    I recently went through a GMC discipliniary procedure and was struck off. I made a website about it. http://www.daniel-gore.com

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