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‘Accusatory’ GMC leaves sick doctors feeling worse

The GMC’s treatment of doctors undergoing fitness to practice (FTP) proceedings as a result of ill health is daunting, confusing and anxiety-provoking, according to a new study.

The report, published this week in the BMJ, was based on interviews with 19 doctors who had been on sick leave for six months or more with physical or mental health problems, including drug and alcohol dependency and were undergoing a FTP investigation. The doctors were asked to comment on their perception of the GMC as a whole, as well as their perception of GMC processes.

While all of those questioned acknowledged the necessity of the GMC’s involvement, particularly in terms of protecting patients, many found the process almost as challenging as their illnesses. Of the 14 doctors who had had interactions with the GMC, only seven made positive statements about the role of the GMC in their return to work.

Doctors described the GMC as ‘uncaring’, ‘unfriendly’ and ‘impersonal’, singling out communication between the GMC and individual doctors as being particularly unhelpful. In some cases, this negatively impacted on doctors’ mental health, affecting their ability to return to work.

Some participants criticised the ‘accusatory tone’ and legal jargon that littered the one-size-fits-all correspondence they received during proceedings - including letters referencing ‘allegations’ that did not in fact exist. One doctor quoted by the report said: ‘It puts you as if you’ve done something wrong but actually I’ve done nothing wrong. All I’ve done is been ill and made a statement to that effect in accordance with good medical practice so what have I done wrong there?’

The report also raised concerns around GPC panel members’ understanding of the difficulties faced by doctors suffering mental illness and addiction. 18 of the 19 doctors interviewed had suffered from some kind of mental illness, and most felt that the GMC lacked understanding of their condition, tending to conflate it with misconduct.

One participant said: ‘I don’t think that the panel have sufficient understanding of mental health issues to draw their own conclusions… they would see it as black and white. You’re either ill or you’re not ill, and you can’t be somewhere in between.’

Much of the positive feedback about the GPC’s role in FTP proceedings was in connection with individual GMC supervisors who were described as supportive, kind, or fair. Many participants said that the process should be more ‘personal’, with some suggesting it could benefit from doctors being able to choose a supervising consultant.

Other suggested improvements included having clearer, less impersonal explanations, more flexibility regarding undertakings, and separate pathways for doctors with pure health issues.

GMC chief executive Niall Dickson said that while he was pleased the study recognised some of what his organisation had done to make procedures less stressful, he recognised that there was more to be done.

He said: ‘We must always act first to protect the public and that can involve taking immediate action when we believe patients may be at risk. But at the same time, we have a duty of care to the doctors who are referred to us.

‘We are doing everything we can to identify ways to speed up the process and, where possible, avoid a hearing in cases relating to a doctor’s health. Whenever possible our aim must be to enable them to return to safe, effective practice.’

Readers' comments (15)

  • It was certainly bemusing to be " accused " of not being able to stay in control whilst drifting into a manic episode - if I had maintained control I would have not gotten manic. One assessing consultant psychiatrist ( lead consultant for the region !!) told me " you must be so embarrassed " on reading about my pre-admission crisis !! Must I ? Would she tell so to a patient with epilepsy who lost bladder control or crushed their car ? Hmm- guess not ...and the same consultant told me I would get more and more depressive episodes - that was her experience. Really ? It is good that had am truly unipolar ( go a bit flat at times but not depressed) so zero times many more still means zero . The GMC moved with glacial speed - I would have preferred to go to work within a month ( have done so before - in a different country ), but no - their speed dictates recovery - so yes, they are hindering recovery - and one other thing- an illness episode is called " complaint "- excellent- so at that time I never had a single complaint about my work now the GMC had received a complaint ( via email !!!) of my admitting consultant that I had been ill- fair enough, but why call it complaint, why not notification ?

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  • when are we going to hear the results of the GMC's internal review of the the doctors who comitted suicide whilst under fitness to practise investigation?

    will there be accountability as Niall 'kings fund' Dickson mentions a duty of care?

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  • Internal review hmmm, how about a public enquiry ? we seems to not have enough of those- could we put some FoIAct pressure on them I wonder - just numbers ,no names. My clinical governance of our the PCT lead sent a letter to me but addressed to the wrong surgery (the all sound so similar )- don't they - the admin staff opened it - obviously " private-addressee only "could be a letter from a health visitor for all we know and then forwarded it tome ( walking distance to my practice 10 minutes top ...surely faster via internal mail ). I send some expletives towards the clinical governance lead-> very apologetic ,Must never happen again bla-bla and then... his letter of apology failed to turn up- I chased it six months later by phoning him up - he assured this had been written..I helpfully suggested it may have been sent to the wrong surgery again ....

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  • John Glasspool

    You have to remember that the GMC is a lay-led doctor-hating quango. Then it all is clear.

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  • Hmm, quango - sounds about right, although I think their mission is to " reassure " the public/daily mail that " patients always come first ", obviously with the exception if the patient were to be a doctor, or worse, a GP - the public actually trusts GP and is happy with the access - remember that MORI poll about over 85% of the public being happy with their GP and the access to Primary Care....this raises suspicion amongst the Politician and various Health Secretaries...remember the one that stated with outrage : " it is a scandal that 50 % of all GPs are below average"....or the other Health Secretary stating " I don't care which GP I see in my Practice " neatly disclosing that he either has no chronic or complicated medical issues ( or goes straight to Harley Street )....

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  • Cobblers

    No apologies for this. It is well worth an in depth read or a skim, as you prefer. In fact page 37 'Conclusion' should be a must read for all.

    Stick it in as a 30-60 min PDP entry for appraisal.

    http://www.civitas.org.uk/pdf/GMCFittoPractise.pdf

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  • 4:24pm
    thank you very much for the pdf link
    depressing and interesting read

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  • Its high time that the functioning of GMC need to be reviewed / appraised. Losing doctors, who are waiting to have their cases heard (quite often more than 6 months), is not reasonable. Its not a bad idea to appraise & re-validate the functioning of GMC, to see if it cost effective and if it doing its job in a correct way to reassure profession and public at large. It shouldn't shy away from full / honest / independent review of its functioning, if it has nothing to hide.

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  • If at a later date damaged doctors successfully sue the GMC for the GMS's actions who will pick up the compensation bill, the Government or other doctors in their increased "retention" fees?

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  • John Glasspool

    Blimey! I am amazed that someone actually has decided to think of the DOCTORS in all of this!

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