Tom Goodfellow

Troubling times call for good representation

Earlier this year I was approached by a consultant in my trust who was obviously quite concerned. He had refused to sign off a medical student who, for a number of reasons, he felt was performing significantly below standard.

The individual responded with a bullying and harassment charge against him. Now we would both be the first to admit that he is not exactly a shy retiring violet, more a ‘first fifteen’ type as it were. But I know him to be a dedicated hard working consultant, passionate about teaching and deeply committed to his patients, the students and the juniors working with him. Fortunately he had taken my advice a year or so ago and joined a union, the HCSA as it happens, and received excellent professional advice and support resulting in him being fully vindicated. However it was a difficult and stressful time for him.

On a similar vein I have been told of two SHOs a year or so ago who were so poor they were regarded as actually dangerous by the consultants they worked with. However their (mild mannered) educational supervisors refused to write anything to this effect in their e-portfolios for fear of the same hostile reaction. I am not in a position to know personally whether or not this is a common scenario but the name Harold Shipman comes to mind!

Another colleague had an identical experience with a junior several years ago. The doctor was regarded as failing, and he was asked to mentor and supervise her for a period. Despite his best attempts he did not feel able to sign her off, and was also subsequently subject to a grievance claim.

Over the last 12 months or so I have been involved with several other colleagues who suddenly found themselves completely unexpectedly in the firing line. All were sensible hard working consultants and not part of the ‘usual suspects’ brigade if you get my meaning. One, a quiet modest man, became involved in a discussion with a junior manager which became rather heated. This was completely out of character (and in my opinion he had been significantly provoked) and he returned the next day to apologise. Despite this the manager initiated a formal grievance against him. Again this proved to be a very stressful process for him.

In another case the trust received a letter from the CEO of an external NHS body making a number of very serious allegations against a senior consultant. If these had been true (which they were not) he would likely have ended up before the GMC. He was an HCSA member and was represented at the hearing by one of the officers. The trust found (I suspect with some relief) that there was no case to answer.

Another consultant was subjected to a disciplinary process because management claimed he had failed to respond to requests from managers to come in to the trust and ‘act down’, that is do a junior doctor’s work in addition to his responsibilities as the on call consultant. Again the issue was resolved, but not without a lot of stress for all concerned. Others fell foul of the job planning process and ended up in serious disagreement with their clinical directors. Fortunately all these were HCSA members and were able to get professional help and advice.

I quote the HCSA because they are the cases with which I have been personally involved. However I am sure that the BMA IROs have similar problems to deal with and that the issues are similar in trusts throughout the country.

Please do not misunderstand me: this is not an anti-management tirade (a favourite blood sport in the NHS). The behaviour of some doctors (fortunately relatively few) is quite atrocious and responsible employers have a duty to protect staff from harassment and other forms of bad behaviour, and to ensure that doctors fulfil their contractual duties to an acceptable standard.

My point is that even for the very best of us the brown stuff may suddenly hit the fan quite out of the blue. If you are not a member of a professional organisation then this is a very lonely place to be. On a weekly basis the HCSA office receives calls from highly distressed consultants who are not members of any union but who are in conflict with their employers for a variety of reasons. They wonder if they can join and get professional support. Although the officers will frequently give them informal telephone advice, they cannot legally take on a case in such circumstances. It is rather like trying to take out insurance after you have crashed the car!

All doctors need to be a member of a professional body. We are heading for very uncertain times in the NHS and many may well need the advice of experts as trusts slash and burn, trying to achieve Lansley’s £20bn savings over the next few years.

Don’t delay, join today. It is well worth the money.

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6 Responses to “Troubling times call for good representation”

  1. Bob Bury says:

    That’s interesting Tom. In today’s Times we see the following report on the latest instructions from the Commons health committee (I’ve had to cut and paste, because the site is now behind a paywall):

    Report colleagues who accept second best or face sanctions, MPs warn hospital staff

    Doctors and nurses must face disciplinary action if they do not blow the whistle on failing colleagues, an influential committee of MPs will say today.
    Medical regulators need to show professional leadership and send a “clear signal” to doctors and nurses that they could be struck off themselves if they turn a blind eye to poor-quality care, the Health Select Committee believes.

    So we’re damned if we do, and damned if we don’t. I feel a letter coming on!

  2. Bob Bury says:

    Beat me to it, Tom!

  3. Paul says:

    “He had refused to sign off a medical student who, for a number of reasons, he felt was performing significantly below standard.”

    On the basis of what you’ve said, wasn’t the student justified in making a complaint? If the consultant hadn’t raised his concerns with the medical student prior to the sign off, then refusing to sign off isn’t acceptable. Any reasonable manager knows that you need to provide feedback prior to any appraisal so that the person has time to improve their performance. If your report is complete, then I find it difficult to understand how the consultant could be vindicated.

  4. Tom Goodfellow says:

    Obviously I am not party to most of the detail, but I know that he did provided feedback on an on-going basis! However feedback is not always accepted as I know well from my own dealings with colleagues!

  5. Malcolm Morrison says:

    A frightening tale, Tom.
    We live inn strange times. It seems that if one criticises a junior, this is ‘bullying’. So, what is one to do? Let him/her kill a patient?
    It seems that if a patient thinks things have not gone as (they) expected, then they sue on the baisi that “something has gone wrong so someone must be to blame (never them for not obeying instructions!) and someone must pay”
    I’m glad I’m retired!

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