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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)

  • Agreed with above - it happened.
    I hope that there will indeed be an open and transparent review with ALL findings made available to the medical fraternity. I also would expect that in keeping with present activity people and committees who were involved will be named, if serious enough then suspension of thei role should be standard until the investigation ahs been carried out completely . It would be unlikley that such investigation would find them entirely correct in any actions /communcations taken and this would result in them being tarnished no matter how innocent.
    Common sense is required and the GMC needs to be made answerable - crerdible organiosations who could do this would be 1) a group of politicians 2) The Daily Mail.

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  • Having been and still going through the GMC process I can only state it is to be categoricary avoided at all costs. Hence the anonymous post due to the way the process is currently viewed as a whole by the profession Having faced them for mental health issues they decided initially with psychiatry advice I was OK so then they moved on to fitness to practice a sort of "double jepardy" type issue I felt. So far the process has been running for > 2 years and when at work I almost permanently have one eye on the "consience monkey" on my shoulder. If there are benefit sfrom the process I'm a happier person because I've confronted "burn out," wiser to the inner workings of the system and above all extremely fortunate to have an extensive private/personal support network. I did offer my inner thoughts to be printed but it was declined.

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  • The GMC has started running but it can't hide any more.
    Corporate Manslaughter is a serious offence.
    A Private Prosecution will give the Beast a taste of it's own medicine.
    This has been coming for some time:
    The wheel of Justice may turn slow... but turn it does!
    Woe to the perpetrators in it's path!
    What are the odds on whose head is going to fall first?

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  • When huge amounts of money are at stake, like £90 million per year collected by compulsion from doctors, the GMC will use all the devices it can to show the public and the doctors by using media effectively. Daily mail headlines,Channel4 documentaries create as much fear and loathing among the public of the 'alien' / 'dangerous' /'pervert' doctor who need GMC to weed out. We have the criminal courts for to deal with them. Atleast they get proper legal defence there. At GMC hearings half of the doctors do not have representation.legal aid does not cover. no legal funds or charities do the work. Legal fees amount to 60k to 100k for a four week FTP hearing. Remember, the FTP hearing happens after so many Interim hearings, where 'wild ' or 'vague' allegations are used to suspend your registration without making a finding. Each IOP legal cost will be 2.5k . This in top of your loss of employment, career destruction, loss of public standing, Tabloid demonization, peers turning against you and all the rest. Is this what the public really like to do to doctors? NO. GMC and the media want us to believe this is all nec essary for 'patient safety' What about managers and medical managers who are involved in all sorts of scandals ? Well they are immune.

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  • I am staggered that as many as 96 doctors have died whilst waiting for fitness to practice hearings.This is a real tragedy in the true sense.If the GMC is responsible ,in any way, for even one of these deaths then they should be held to account.Can you imagine the media uproar if doctors ,by their actions,we're responsible for so many deaths?
    Doctors ,when they are Ill ,deserve to be treated as patients in exactly the same way as anyone else.
    This is a story which would have major coverage in the media if it involved any other group in society.

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  • Public believe the media-fed details about GMC's role and it's necessity. The GMC utilises doctors money to prosecute doctors in the above manner. Our leaders refuse to take any action.

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  • From my personal experience, I do not believe the "GMC launches internal review" is true. The GMC would hush up the truths. There is no reason not to investigate the GMC as per " e petitions direct.gov.uk/petitions/54034. I urge all to please sign.

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  • The problem is that for anyone unfortunate enough to find themselves targeted by the GMC it's a real David vs Goliath fight. They are too well resourced and have too much influence for there to be any scope for justice or proper scrutiny as more often than not it is one persons word against another. When you think of how many slightly odd people who come through your rooms, the odds of a malicious allegation against you are disturbingly high and yet there is a worrying lack of due process in what is after all a quasi judicial process that goes on behind closed doors in the name of 'patient safety'. The GMC have blood on their hands now and have created a monster which is not going away any time soon.

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  • The painful irony is that we already have law courts and well established legal principles which could easily deal with most of the GMCs work. Why we need an enormous institution to sacrifice doctors on the alter of patient safety is anybodies guess.

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  • 96 deaths in 10 years!! That is 96 too many. If these doctors were curmudgeons swindling the system, they would scarper or resign rather than snuff themselves out. If they had mental health issues or financial issues that pushed them over the edge they needed help and not persecution. The coleagues who bring shame on the profession by real crimes get away sometimes, or do not end their lives, and throw their families into turmoil forever, by stepping into that dark, lonely night on their own. We should hand our heads in shame that it has come to this. We would be the laughi8ng stock of the world and the general public, if they knew that we pay 90 million in subs every year to an organisation, that instead of ensuring all doctors are good , persecutes many this way.

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