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Independents' Day

GMC launches internal review of suicides among doctors facing fitness-to-practise investigations

The GMC is conducting an internal review of cases where doctors have committed suicide while under a fitness to practise investigation, in an effort to see if it can do more to support vulnerable doctors.

The move comes as it emerged that at least 96 doctors have died while facing a fitness-to-practise investigation since 2004, though it is not clear how many of these cases were suicide.

The GMC said that it would consider for each case ‘whether our current process for reviewing each of these cases can be improved’.

But the GPC warned that such cases represented the ‘tip of the iceberg’ and called for the whole process - from GMC letters to hearings - to be reviewed.

The regulator has already said that it will adjust its communications with GPs involved in fitness-to-practise proceedings if they are deemed to be at high risk of self-harm.

But now a report from chief executive Niall Dickson to the GMC Council, published this month, reveals that: ‘[The GMC] will examine those cases where a doctor has committed suicide while under a fitness-to-practise investigation, and consider whether there is more we can do to support vulnerable doctors in our procedures.’

The review will be led by Sarndrah Horsfall, formerly interim chief executive of the National Patient Safety Agency, Mr Dickson said.

He added: ‘I have also asked her to consider whether our current process for reviewing each of these cases can be improved.’

The GMC was not able to say how many cases it would be investigating, or how many cases it was aware of which involved the suicide of a doctor under fitness-to-practise investigation. Figures released by the regulator in response to a Freedom of Information request from Dr Helen Bright, of the campaign group Doctors4Justice, show that between 2004 and 2012 some 96 doctors died while facing a fitness-to-practise investigation. However it is not clear how many of these cases were suicide and how many deaths were from other causes.

Dr Bright has launched a petition on the Government’s e-peititon website based on these figures, calling for a confidential inquiry into the deaths of doctors subject to fitness-to-practise investigations. It has 1,176 signatures to date.

GPC chair Dr Chaand Nagpaul told Pulse there was a ‘pressing need’ for a wider review of fitness-to-practise procedures.

He said: ‘GPC does receive complaints about the whole process and there’s a need to look at this to ensure these tragedies don’t happen. It’s the smallest issue that can make a huge difference.’

‘We need to look at the entire process, from the tone of letters to the fitness-to-practise hearing. There’s a real pressing need to do that. Even the wording of a letter can have a dramatic impact on a doctor’s life. We need to have a system to support doctors.’

He added: ‘Most GPs live in fear of a GMC complaint. There’s a culture of fear. It’s important this review looks at the entire breadth of concerns.’

‘I think suicide is the tip of the iceberg, because we have many doctors suffering stress, depression, distress to their personal lives. In addition to suicides, we should not forget the distress as a result of fitness-to-practise proceedings.’

Mr Dickson said the GMC had already introduced an ‘ambitious programme’ to reduce the anxiety of fitness-to-practise proceedings.

He said: ‘Our priority though must always be to protect the public whilst at the same time being fair to the doctor - sometimes that does mean having to take immediate action when we believe patients may be at risk.’

‘When we do take forward concerns about doctors, we aim to do this as quickly, fairly and as sensitively as we can. To reduce the anxiety of fitness-to-practise proceedings we have in place an ambitious programme to speed up the process and we have set up the Medical Practitioners Tribunal Service, a separate adjudication service headed by a judge which is committed to fair and effective decision making.’

‘At the same time we are piloting meetings with doctors to hear their side of the story earlier and we have commissioned the BMA’s Doctors for Doctors service to provide confidential emotional support to any doctor involved in a fitness to practise case who wants it. We have also set up a support programme for witnesses, whether they are appearing for the GMC or for the doctor.’

He added: ‘Some of the doctors are referred to us because they have serious mental health problems, including severe depression and various forms of addiction. We recognise that these can be very vulnerable individuals and that being part of a fitness-to-practise investigation is almost always a stressful experience for everyone and especially for the doctor involved.’

‘Doctors with mental health problems in our procedures all have a supervising doctor in their place of work. They are also regularly examined by two practising psychiatrists. Our aim is to get them back to safe effective practice whenever that is possible.’

A Department for Health spokesperson said: ‘Regular fitness to practise reviews bring increased trust in doctors, safer care, fewer claims for clinical negligence and positive cultural change in the profession.

‘The General Medical Council is conducting an internal review to examine whether the process can be improved.

‘Fitness to practise investigations must be robust but fair and doctors should receive support throughout.’

Readers' comments (79)

  • Turkeys paying for christmas-doctors paying for GMC crucifixtions.

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  • The problem is the GMC presides over a toxic mix of fear and blame for which it is in part culpable. It is in desperate need of reform to something less destructive where lessons can truly be learned without fear of reprise and we are encouraged to develop a safer more constructive culture.

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  • The solution is dissolution

    The Corporate Manslaughter and Corporate Homicide Act 2007.

    An organisation found guilty of such an offence receives the 'death penalty'. An eye for an eye...

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  • 6.06 Quite right. When I graduated, I could never quite work out why we were paying so much money for the privilege of being able to get struck off! The idea that we are self-regulated is clearly nonsense when you look at the composition of the GMC a political creation which is used to beat the rank and file into submission. The government are taking doctors for a ride on this one. If they want a punitive regulatory system it should be paid for by the beneficiaries of that system, i.e. the taxpayer not the poor sods at the sharp end of it. The best option would be to refuse to pay the subs en-mass. If you want to put a fire you starve it of oxygen...

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  • See my letter

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  • I agree with Dr.Surapaneni's observation that the victims are mostly of foreign origin ethnic minority doctors.

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  • The GMC had done a lot of unlawful acts, deceptions, fraudulent acts and the evidences are in the transcripts of the proceedings. Normally, a decent organisation would be willing to reinvestigate that. But the GMC would not. The reason many doctors committed suicide under the GMC investigations - is because they knew they will never be able to come out unscathed - once the GMC took on case against them - however flimsy the ground may be. A doctor may be reported to the GMC for demanding for remuneration for extra work, or for contractual reasons from his employer who may then report to the GMC making false allegation. In my case, the GMC actively pursued a false complaint in spite of knowing that there was supportive evidence in the case notes. So, it denied me those notes by stating lies that those could not be found. This is only a tip of the ice berg of the GMC's deceptive acts.
    Similar experiences had been reported by other doctors in the D4J web site.

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  • 5.32 - I am so sorry. I can't imagine what you have been through. I am not currently in any proceedings but I am suffering from having raised a concern and currently cannot work due to various procedural issues. I keep thinking this hell will end if I give up medicine but I don't know if it would just haunt me with regret.

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  • I note all the buzz words and phrases in the article.
    facts are- this happened. GPs tragically ended their lives due to or in past due to GMC contact

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  • Sudheer Surapaneni

    Thanks Stephen Mcminn for not using the anonymous identity. Most doctors have extremefear about putting their name in even acknowledging the establishment abuses. It shows the level of bullying and harassment prevalent in our profession. The petition got only 1197 signatures in over two months because of the same reasons. We are divided, apathetic, terrified and most importantly suspicious.

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