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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)

  • @ 11.09 and 8.09, these are frightening stories that make me feel like leaving medicine. There should be an enquiry into what exactly the GMC gets up to. Surely efforts should be concentrated on dealing with doctors who pose a threat to patients? It sounds like falling into a spider's web. I have heard similar stories people being sent to the GMC yet they pose no threat to anyone.

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  • I have just undergone a gmc investigation as a result of a vexatious individual. It took them 4 years! The experience was harrowing and medieval. It would have been more humane to burn me at a stake. It culminated in a botched set of findings as minor as poor medical records for failing to record a batch number on drugs used. I was suspended.I consider myself as a good and caring doctor but i have lost faith in the system and profession. My family have suffered and my career in tatters. I don't even know if I am employable. Yet when they complete their investigations having dragged you through mud and put you through nothing short of torture they expect you to return to normal life. Shame on them ! !

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  • I'd like to hasten to add that when they published the FTP findings - which they do all in the spirit of public interest, they managed to selectively print what they wanted, use language so fierce that they managed to make me look like some sort of serial killer. All fair and just in the regulatory world of the gmc.

    I used to respect them. Be warned - unless you have the pleasure of experiencing their company you will have no idea of how they operate.

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  • If you can stitch up a Cabinet Minister on a 45 second encounter at the gates of Downing Street, you can stitch up any doctor on one days work ? Just substitute managers for police - avoid any inconvenient disciplinary processes - and let it rip !

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  • Every review process is outdated and needs debate and change....when will they learn. There is no support for doctors, more so if u r a different colour.

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  • What is interesting and plain from the comments is that all the doctors have a personal tale. A tale of hardship and suffering at the hands of the wretched GmC. Each one has probably trodden a path that felt tortured and unique. Each one felt punished for their misdemeanours. Each one probably felt they were hit hard. Yet when they look around and lift their heads it is clear that each one that enters that forum receives a universally similar lashing. How can there be no variation, no shades of grey? Where is the regulation? And how can they call themselves a regulatory body?

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  • I was unjustly accused of a crime by the hospital I worked at and I fought this in court and won. Throughout the whole process, I felt the GMC treated me in a "guilty until proven innocent" way. Despite me winning my case, they imposed a severe list of restrictions on my licence and made it practically impossible for me to find work. At no point did they offer any support or help, either for finance or emotional. I was left completely bankrupt and I became so depressed I made a serious intent to commit suicide and ended up in a coma for a long time. Somehow, I survived. Even, now, the GMC still seem to just be interested in covering themselves and show not a grain of empathy, let alone realising the strong role they played in my depression and suicide attempt. Their letters are always harshly written and intimidating. It seems to me that they truly are, as someone already said, an archaic institution which should be modernised. I believe that their policy is to handle ALL matters by simply imposing the harshest decisions so that they are completely absolved of any possible problems. They completely lack any humanity in their manner of work. It is as if they simply have too much power unto themselves and don't use this in a fair or controlled way. When you face a court, a decision is left to a jury and this system works, but the GMC seem too afraid to make decisions that show any compassion or understanding. Like I said, they simply have too much power and doctors DO live in absolute fear of them. Is this fair? Is this how it should be? I am a good and hard-working doctor and my life has been destroyed by this experience. I find myself trying to find a way to continue my life now outside of medicine because the idea of returning seems very daunting and riddled with more and more IOP hearings and such; not to mention the long list of, at times, ridiculously harsh restrictions. After having qualified from one of the very top Medical Schools in the UK and working hard in the NHS, I now feel I should abandon all that for my own health and the GMC simply don't care. I am just amazed that they never offered any counselling or help. I do believe that the government should realise that the GMC needs modernisation and revise their attitude towards doctors who face Fitness To Practice issues. The GMC constantly evades issues by stating that they act in the "publics best interest" but they certainly do not act in the doctors best interest.

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  • The process as it exists now is extremely painful and strenuous. One is treated as criminal the minute you are faced with a GMC investigation. During the hearings, you are not allowed to speak and your barrister is not allowed to argue. The whole process ranks of incompetence. There is no body to regulate the FTP panellists - the number of blunders caused by both the panelists as well as investigators is pushed aside. They appear to be immune from prosecution and can and will do whatever they please. The law of the land - "innocent until proven guilty" is thrown out the minute you enter the hearing room. You are "guilty until proven innocent" in the eyes of FTP.
    Read about my trauma in the book "A Kangaroo Court: Triumph of Mediocrity"

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  • Hi 'Inner thoughts 6:41 pm',
    I agree somewhat with you. 'Inner thoughts' are probably best kept private.
    I wrote mine down in a book: ' Lecture notes from the dungeons of the gmc'.
    Let me put it this way: ' it is a long road from betrayal to trust. At the moment it is a system of betrayal and paranoia. This is a very sad state of affairs.
    It is particularly sad as it had been created or allowed into existence by the medical profession.
    This betrayal culture needs to be stamped out. this is not difficult. It has been done before in WO2.
    You just have to realize what is going on.
    So, hang on there brothers and sisters.

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