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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)

  • An enquiry is to be welcomed; but an internal enquiry is unlikely to inspire confidence in the findings, particularly if the enquiry reports the GMC to be entirely blameless.

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  • If someone acts out of freewill and commits suicide why blame the GMC?

    Troll comment but on that basis we would happily sell alcohol to 13y olds and not set speed limits on motorways. The GMC are a factor in this and have to be held accountable.

    'Patient safety has to come before anything else.'

    Agreed but doctors are also patients and not immortal as some sections of the public and press seem to believe. The GMC has a duty of care to all parties involved in complaints and should act responsibly. It is inappropriate to behave threateningly to doctors when a mediation approach would have much better outcomes all round.

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  • Sudheer Surapaneni

    Criminalising health professionals' mistakes and dealing them through regulators' bodies is a way for the all the others to escape the real issues which are at the heart of the problems. Convicting doctors on 'manslaughter' charges does not look fair when the managers at the Mid Staffordshire dscandal walked away with big handouts.

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  • Is this another important debate about to be hijacked by trolling?

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  • Psychotherapists need to come under a GMC-style Fitness to Practise regime.

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  • Why all the whinging?If you don't like the system then leave.No one is forcing you to stay.

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  • 'If you don't like the system then leave.No one is forcing you to stay.'
    A bit defeatist don't you think? Medical advances happen by slow incremental improvement over the years. That includes medical ethics too.

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  • When you have invested so much in a career and have a mortgage and children it is very difficult to leave. Remember it is not just a career but a way of life.

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  • Agree @3.29 pm - no confidence in internal review. We need a confidential enquiry as per the petition.

    Re patient safety, for any non-medical readers, the GMC is where whistleblowers - or those who simply raise concerns - dread to find themselves. Most doctors will advise each other, 'keep your head down'. This benefits no-one -patients, doctors or doctors-as-patients but it is a reality.

    I raised concerns about patient care that led to the staff turning against me, as did seniors in the organisation. They simply wrote false reports about me that is so easy to do. You cannot prove you did not say or do something. I was branded unprofessional and suspended. The investigation was a sham made credible by including a few accurate facts. The inappropriate patient care was whitewashed over: it never happened. The cost to me is a lifetime of fear, let alone the career and financial implications yet I did the right thing.

    I was not subject to GMC proceedings but the equivalent within my organisation and by people who are part of the GMC machinery (the GMC is not an isolated cell).

    Remember that many of those involved are not doctors and are completely unregulated, the same as hospital managers. The title 'prof' may not be of medicine. I was subject to bullying on a grand scale - intimidation, a whispering campaign, veiled threats, lies and verbal aggression such as I have only seen in films when confessions are extracted. At one point I was even told I was 'lucky'. I was shunned and isolated by staff and colleagues, some of whom have never been back in touch while others meet but not in public.

    The Police advised me to keep my curtains closed and to take care at night. Sadly I was too scared to sue for harassment and the reason they win is, of course, because we want to remain doctors, despite all this, and we need to work. We say to ourselves that it is wrong to give in to bullying.

    Let us not think that this is a new phenomenon. Many readers will know it is little different from years ago. Sociopaths are employed in all walks of life and sadly are good at climbing the greasy pole from where they effect more damage (why? - to bolster their own position and because they get their kicks from it). Don't underestimate the power they have to create a smokescreen in which the majority of decent people will simply believe what they're told.

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  • Approximately 300 of their staff were involved so far in my case since 2006 sometimes sending two or three letters per day, constantly assuming other functions within the hierarchy and making décisions that they were not alloowed to make according to their job-descriptions.

    Evidence gets distorted or withheld right from the start of the "investigation" up to the endless chain of IOPs and FTP-Panels. Lawyers are hindered to speak up and transcripts are "edited".

    It does not help having been set "free" by the first panel. They simply go on and on. For years. That is how they make their living.

    Mr. Dickson is wrong to assume that only "vulnerable doctors" would be at risk and need special attention during the "investigation". This is not a problem of "choosing the right wording" in order not to frighten these vulnerable colleagues. The point simply is to obey to the law, to their own policies and guidelines and display some sort of decency and honesty occasionally. I guess that the GMC is the most inefficient and also the most verocious corporation east of the Ural.

    Mr. Dickson really gets it very wrong to suggest that it would be "vulnerable doctors" who are at risk.

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