Council of Despair
I'm afraid that many doctors - perhaps most - have lost their faith in the whole system.
The 'system' seems to be only concerned about their own interests and 'we' the front line staff have to look after ourselves.
It's simply the law of the jungle now and it's just about survival now for most of us.
saying and doing are two different things.
I've lost count on how many 'red lines' have been crossed and how often people have stated 'this is the final nail in the coffin' but yet the same system carries on. The job now is just about survival - you hope you don't make a bad error and hope you can make it to retirement or a career change.
There have been opportunities for change but at every turn, we back down or bottle it.
The pattern has been the following for the last few years;
1. people will moan
2. the government will come up with a shiny superficial policy with no clinical merit
3. the RCGP, BMA will back it once it says 'good for patients'
4. demand will increase
5. supply will decrease
6. absolutely nothing changes
7. back to 1
I think the Lion King called it the circle of life
Vinci Ho | GP Partner/Principal17 Sep 2018 9:39pm
it's an interesting perspective
GMC vs MPTS
the MPTS seems to have the support of the state indicated by the ruling that the GMC will have the power to challenge the MPTS removed. also reading in between the lines from the comments on PULSE it appears that doctors are more supportive of the MPTS. So it appears that the GMC has alienated itself - but for what purpose?
in addition - is the GMC actually fulfilling its aim of protecting patients and restoring confidence - where is their evidence on this? I have not seen any patient groups come out in support of the GMC - if anything the GMC has been criticised by the public eg Nick Ross' letter.
I think the GMC needs to be challenged on their decision making and questioned more carefully as to why they are making the decisions they are making and on what evidence they are making those decisions.
This is an interesting statement
And Pulse revealed in March that 23 GMC appeals brought to date had all sought stricter sanctions, or to block a doctor from being registered to practise in the UK, while no appeal was for more lenient treatment.
As I'm sure that I read a statement from either Stephenson or Massey that claimed that the GMC had also appealed decisions they felt were too harsh? I'm sure this is worth looking into as if it is the case that the GMC is seeking tougher sanctions all the time it indicates their (the GMC's) thinking re sanctions. I'm not saying they are right or wrong but it suggests that the GMC views the sanctions on doctors as too soft. This will be useful for young doctors to know if they are contemplating a career in the UK.
I'm trying to look at things from the GMC's perspective - they have a duty to protect patients but are they going about this in the right way?
- Keeping the public happy should not be the GMC's objective, for example, I'm sure some members of the public want Doctors who upset them to be put in front of a firing squad but that would not be legal or morally correct. In the same token - what is Public Confidence? The GMC says it wants to maintain public confidence but they haven't defined it and how do you measure it? The vote on Brexit and some of the comments from the public in the media such as the Daily Mail make it clear that some members of the public are at best ignorant and at worse racist - so if those members of the public decide that they don't like foreign doctors - should the GMC for 'public confidence' be harsher on foreign doctors? This is effectively the GMC's argument that they want to maintain 'Public Confidence' and it is a weak argument as they - the GMC have not said what public confidence means.
- The expectation by professionals and it appears even by the government is that the GMC should be impartial, balanced and fair and be prepared to make thoughtful decisions that can be backed up with sound logic and arguments i.e. one would expect the GMC to make decisions that make you think - 'that was a reasoned, logical, well thought up, even evidenced argument that the GMC has made'. It appears that the GMC is not doing this at present and even worse than that they don't have insight into the fact that their decision making doesn't make sense and alienates professionals and even the state. The GMC may not care about this as they feel their main prerogative is to protect patients BUT they also have a duty of care to doctors and equally to look at educating and supporting doctors. If they can't see that their actions are actually alienating doctors and they haven't actually demonstrated that they have gained public confidence then this is worrying. Overall this reflects a complete failure of leadership in the GMC.
The GMC is basically saying - 'we are going to do what we think is right, but we are not prepared to explain our decision making or provide any sound evidence, and we really don't care what doctors, the state care and we are not going to even evaluate if we have gained public confidence'. It's an odd state of affairs and I don't see how the GMC can continue on this track? do you?
On the homepage of the GMC it says '
We help protect patients and improve UK medical education and practice by supporting students, doctors, educators and healthcare providers.'
The GMC went out of its way to reject its own tribunal decision.
Massey went on pulse and other outlets to justify the reasons why the GMC took that decision.
Sir Terence Stephenson was wheeled out on Pulse to basically apologise for the way we were feeling but backed the decision.
No medical professional could understand the decision that the GMC made - hence the anger.
Even Jeremy Hunt of all people could not understand the decision and launched a review.
There were even articles in legal journals questioning the decision.
The political decision was to take out the option of the GMC rejecting tribunal decisions.
Now the GMC sole role is to balance these decisions and to be aware of the impact to doctors and to patients but they took a very one-sided decision and had no thought or insight on the impact on the profession. If a non-legally educated front-line doctor could see the errors of the GMC' decision then why could the GMC not see it?
After the recent verdict the justification given is that 'the GMC has to make difficult decisions' and there are lessons to learn.
What about the difficult decision we make every minute of the day for which we carry huge risk?
Given the above - I can not see how Massey has the gumption to remain in his post and there has to be a hard look at how the GMC is run as no one in the GMC had the insight to anticipate how bad a decision they had made.
There needs to be a detailed investigation into how the GMC is run and how they make their decisions.
Until there are some real changes the GMC will not be trusted and I suspect has lost the trust of the majority of doctors - in that scenario how can Massey stay?
I'm still confused as what actual mistakes were made?
It would be useful for the profession to know about the 'mistakes' as how are we going to ever 'learn' if we don't agree on what went wrong?
My understanding is an 'expert' thought that it was obvious sepsis but pretty much most people would have done what the doctor did - so where was the error as I thought that if you made a decision in which a similar colleague would have made then it was one of those unlucky clinical incidents which could have happened to anyone?
The outcome raises a lot of questions;
1. The conduct of the initial trial?
2. Use of lay jury to decide on professional decision making.
3. The use of experts
4. Why was the use of the ACE not explored?
5. Why is there no learning for the legal counsel that made their errors in the initial trial - why is it that only doctors have to learn?
6. If the Dr had received no support from her colleagues what would have been the outcome? Why was her defence union and the BMA so useless - this should worry all of us.
7. why does Massey have a job? Imagine if any doctor had made such a feeble decision as Massey and come up with such an excuse 'it was a difficult decision' what would have happened to them? Say what you like about Dr Arvind Madan but he had the decency to resign.
8. The role of the GMC? Is it now purely political as it can not claim to support doctors - if so why should we fund it?
so many more questions than answers
sadly I suspect we will continue to get repeated episodes until the GMC is dissolved.
I recently had a haircut - it took about 10 mins and the charge was £14.
Out of interest, I calculated my income per patient and it works out to... £15.60 per patient.
forget day rate, hourly rate and look at it from a per client basis - we are currently valued as no different to cheap hairdressers.
I'm in favor of an exit from the NHS with the market dictating our rate and it will be a lot more than £1400 a day. I'm thinking the rate will be £500 per hour.
I'm not anti-NHS - I like the idea BUT the public as a whole don't value us and I'd like them to see what the true costs to them would be if we left - only then will they start valuing us again.
And no technology will only do so much as we are effectively taking on the risk - Babylon doesn't - it passes that risk on to its clinicians. As good as AI might be - it will never take on the costs of risk.
I really liked him - he was so close to finishing his mission of destroying the NHS and freeing us.
I hope he leaves his skin to medical science as nothing ever sticks to him. How he got away with things was amazing - he would make a great future Tory PM.
where my family comes from we have a saying ...
people don't treat you bad, you LET them treat you bad.
there is a very simple solution to the problem but alas there is not the will - that is the mystery - with our backs to the wall why are we accepting our fate?
this was the article
You were critical of the recent government announcement that the GMC would lose the right to appeal MPTS rulings. Why do you believe this was a wrong move?
Sir Terence Stephenson:
The Health Select Committee pressed the government for legislation change before we were granted the right to appeal decisions in December 2015. We also called for the change because patient safety is at the forefront of the GMC's work. Doctors have a right to appeal decisions. However, previously the GMC was powerless to challenge decisions when we thought they were too lenient, too severe, and could undermine the profession or put patients at risk.
I'm just curious if the GMC has ever challenged a decision that they thought was too severe - if not then he should be held to account and explain his answer above.
I read an article somewhere where Terence Stephenson claimed that the GMC appealed an MPTS decision that was too harsh - does anyone know if there is such a case?
All for one ? | GP Partner/Principal03 Jul 2018 5:33pm
hopefully, the appeal will look into these matters
there are wider issues,
- professionals being judged on technical matters with a lay jury
- the 'expertise' of expert witnesses
- the GMC defaulting to the decision made in criminal courts without thinking through the wider implications i.e. if you are always going to side on the decision made by the courts then why do we need the GMC at all? It then defaults to a rubber stamping mechanism of 'you were convicted in court, we don't need to see the evidence or balance the ramifications so we will automatically strike you off'
Massey is paid 250k a year to lead - if he is just going to abdicate his duties he should go.
I thought we were learning from Babylon? i.e. charge and cherry pick?
who are the leading doctors? I know the same ones that have led us for the last 10 years - with friends like that who needs enemies?
one of the things that is never mentioned is that the local population don't want foreign doctors - so it seems wrong that a branch of the UK government i.e. NHS is trying to encourage innocent enthusiastic professionals into the UK knowing that the British taxpayer doesn't want them AND if you upset the local British taxpayer the very same organisation that has recruited you will hang you out to dry.
do yourself a favour and stay clear of the UK.
should change it to ' Welcome to UK penal system '
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sorry, but how does she know, where is the evidence and research to back up such a claim?
it sounds as though she is trying to get a job with them??? let's wait and see....
I know this is not very pc - but thank god no BME was involved or the daily mail would have had a field day.
I'm sure the outcome will be to heap more pressure on us and I'm so glad that I'm on my way out.
whenever I think of 'expert' witnesses I've reminded of the Oscar Pistorius case in which two of the best psychiatrists in South Africa had different opinions based on the same information. If the 'best' experts can differ then which expert do you trust?
If you want a fair trial then you need a jury of peers to make a decision - not as in the Dr Bawa-garba case a lay jury.
This aspect has not been discussed but if this is not remedied we are going to see more cases such as the Dr Bawa-garba's. I hope the appeal looks into that.
babylon must be rubbing their hands with glee.
we won't see a penny of it BUT it will be implied that frontline staff have taken the money so we can be blamed for a failing service.
follow the money - who will actually get this money?