I am a long-time Trustee of a small mental health charity supporting those experiencing the psychological effects of trauma (PTSD). We are an excellent organisation using evidence-based therapies.
We also carefully evaluate our outcomes, which are very good, using standard psychological assessment tools. The organisation is supervised externally by one of the leading academic psychology departments in the UK.
There is no statutory requirement for registration of the organisation with the CQC or any other body, but a number of years ago we were voluntarily registered with one of the non-statutory psychological regulatory bodies. That was when the trouble started!
I was Chair of the Trustees at the time when we received notification from the regulator that an official complaint had been raised against us and the decision had been taken to proceed to a full disciplinary hearing. We were advised to take legal advice since the consequences could be serious.
The complaint had been made by a volunteer trainee counsellor who, nearly three years previously, had been dismissed from a placement post without notice having seriously breached the terms of the volunteer agreement. The decision was based on the clear written advice of our external supervisor (at that time) who himself had been a leading figure in the regulatory body.
The complaint was extensive covering a whole range of issues most of which were vexatious, un-evidenced, untrue and completely unrelated to the dismissal. But rather than go for the option of local arbitration which would have resolved most of the issues, and probably have been better for the trainee, the regulator chose to bring the full force of a disciplinary hearing against us.
We were too poor to hire a lawyer so the bulk of the work fell on me, and many hours were spent in preparing the defence.
I found the hearing itself intensely stressful. With a dry mouth and pounding heart I sat opposite a stony faced panel of three who showed no sympathy or empathy of any sort. The complainant sat at an adjacent table seemingly enjoying the day in court. Fortunately the bulk of the complaint was dismissed immediately as irrelevant and unproven, and they focussed on the real issue which was the dismissal.
The fact that we had acted on the direction of our supervisor was considered but deemed unimportant. The responsibility, it seemed, lay directly with us. I left the hearing shaking and sweaty and emotionally exhausted.
A couple of weeks later we received the verdict – we were judged to have acted unfairly towards the volunteer. The “sanction” against us was that we were to prepare and implement a detailed policy for handling situations where there was a breakdown in relationship between our organisation and a volunteer.
We responded by informing the regulator that the incident had happened by now nearly four years previously. The organisation had changed and developed significantly in this time and that we no longer accepted counselling students on placement (as a result of this incident). The “sanction” was therefore completely irrelevant and of no practical value to us or anyone else for that matter.
However this made no difference – we were to comply or face the consequences! After some thought and a further exchange of letters we decided that this was simply organisational bullying and we walked away.
In consequence they published the complaint in its entirety in their official journal and declared us guilty of everything despite the fact that most of it, as agreed by the panel, was vexatious and irrelevant. They also contacted the local press to ensure as much bad publicity for us as possible. We were struck off the list of recognised organisations, (we had already resigned anyway). It was an emotionally very stressful time for myself and others in the team.
I write this because I have just been reading the GMC internal review on doctors who commit suicide while under GMC fitness to practise investigation.
It is a sad document although it makes some very sensible suggestions to improve matters. But there is no getting away from the fact that increasing numbers of doctors are being referred to the GMC, often on very flimsy grounds. All that is required is a few clicks on the GMC website. Although most cases do not progress to a full FTP hearing the stress on individuals can be huge, adding to the current clinical pressures which most are now facing. It is acknowledged that there is a higher incidence of substance abuse and suicide among doctors than in the general population and that stress is now a significant factor in the health of doctors.
From time to time I browse the MTPS website to read the published reports of completed FTP cases.
Obviously there are those doctors who should never be allowed near a patient again and who probably should not have been registered in the first place. But most of the cases are simple accounts of human frailty – silly deceits and deceptions which make you wonder why they could be so stupid! Nevertheless a full account of their misdemeanours is published for all to read – the ultimate in “naming and shaming”, a privilege which seems peculiarly reserved largely for the medical profession.
The saddest cases are those where a generally competent doctor has made an error of clinical judgement in a specific case resulting in a poor outcome for the patient, and the ensuing complaint has generated a FTP hearing.
I was fortunate enough to have never fallen foul of the GMC during my career, but my own little brush with the non-statutory psychology regulator was unpleasant enough and I can still taste the anger and bitterness more than a decade later.
But what happened as a result of this episode? Absolutely nothing – it was all forgotten after a short time. The charity suffered no negative consequences whatsoever and has continued to grow in size and reputation. Sadly not so for those judged wanting by the GMC, and even if acquitted the emotional damage can live on.