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Independents' Day

Fitness-to-practise process is 'threatening the lives' of doctors, think-tank warns

The purpose and the scope of the GMC’s fitness-to-practise process needs to be ‘re-appraised’ as it is ‘threatening the lives and livelihoods’ of doctors, according to a new think-tank report.

The authors of the report by Civitas, The General Medical Council: Fit to Practise?, said they question the regulator’s current process for fitness-to-practise issues and highlight that almost 100 doctors are reported to have died between 2004 and 2013 while undergoing investigation.

According to the report, 10,347 complaints were made to the GMC in 2012, while 3,943 were submitted in 2002.

The authors of the report said the GMC’s process for handling the increased volume of complaints made against doctors is not adequate.  

The report states: ‘The GMC is aware that its procedures are not appropriate to deal with the vast majority of instances in which doctors’ capabilities come into question, let alone the wider healthcare and management contexts that are usually significant contributors to patient dissatisfaction.

‘Medicine is an extraordinarily complex discipline, and its regulator appears often unable to interpret cases in the context of the real working lives of most NHS doctors and in the wider context of what gives rise to complaints and motivates complainants.

‘In this paper, we analyse how the GMC has arrived as its current state, and how practice by the GMC is threatening the lives as well as the livelihoods of doctors. We believe that, yet again, it is time to re-appraise the purpose and scope of the GMC.’

The report also notes that 96 doctors are reported to have died while undergoing fitness to practise investigations between 2004 and 2013, although it is unknown how many were suicides.  

Last year, the GMC launched an internal review of cases where doctors have committed suicide while under investigation, and the findings are expected to be published in September.

The Civitas report comes in the same week as a new study commissioned by the GMC showed the increased access to the internet and social media and negative media coverage could be behind a huge increase in the number of complaints made against doctors, while another study has suggested the GMC’s treatment of doctors undergoing fitness-to-practice proceedings as a result of ill health is anxiety-provoking.


Readers' comments (13)

  • It is a manifestly broken system that even in straightforward fitness to practice cases can take years not months to process.

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  • What an absolute tragedy for those doctors whose lives where lost during this process. We are so heavily regulated. Large organisations incl GMC cannot match or endure the expectation and prompt action us GPs have to DAY IN AND DAY OUT. Yet WE HAVE TO- that is why our profession is on its knees and we are looking at other options of a way out.

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  • Vinci Ho

    Plainly by figures, shocking.
    96 died in 9 years while under investigation by GMC,
    just over 10 per year died.
    More than interested in GMC internal review in September .

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  • So many appraisees said they received a shocking letter on a Saturday ,and have not slept for weeks withno support

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  • The more disturbing aspect here is that, despite being made aware of the shocking statistics of the doctors who died, the GMC continues to exercise little evidence of compassion in its regulatory processes. I make this statement using myself as a case in point. I am a senior neurosurgery registrar with autism who attempted suicide last year following four years of bullying (reported serially but never resolved). Having survived the suicide attempt, I reported my Postgraduate Dean to the GMC for bullying and misconduct (through abuse of position of authority) offering to provide hard evidence. The GMC dismissed my complaint within 2 weeks and instead used my complaint to subject me to an investigation claiming 'health impairment'. The fact that autism is a neurodevelopmental condition (albeit, a disabiity) but not an illness has been completely ignored by the GMC in its rush to punish my suicide attempt with an investigation in full breach of its on threshold guidance on health impairments. Doctors like me, who have had no conduct, capability or patient safety issues, who attempted to end our lives from despair need to be supported when we survive, not further punished.

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  • Let's see if the Daily 'Hate' Mail decides to do an article when GMC report published in September. Somehow, I doubt it.

    Vino, so sorry to hear what you've been through. Do hope things are better for you now.

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  • Vino Apok | Specialist registrar | 22 July 2014 9:06pm

    sounds like you need to get a good lawyer (no win no fee?) and take action.

    not sure if remit of ?ECHR as it looks like they are targetiing you for your disability.


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  • On the basis of this article, it seems like an excellent piece of work by Civitas, which should cause grave concern to the GMC.

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  • unbelievable ! we are now actually dying through our micromanaged performance and I bet the gmc do not take into account the horrendous workload we are under day to day when assessing performance( which is no doubt contributing to the mistakes).We are such an integral part of the nhs our leaders need to grow a pair and protect us more ! and the fact that i'm posting this anonymously speaks volumes about the scrutiny we are under today

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  • I had dealings with the GMC when I was severely depressed and had been under so much stress at work that I had intended to kill myself. Instead I went off sick and sought help. I survived and was punished. The sense of shame is awful and I can't begin to explain what it was like to go through the GMC process when suffering with mental health problems. I already felt that I had let everyone down and then the GMC process reinforced my sick view. I shall never get over it. A proper legal process would have been fairer. At no point did anyone question the motives of the referrer, indeed the GMC specifically said that was not within their remit. I had to attend an interim orders panel pending investigation and later worked with undertakings. The investigation took 9 months and then I had to serve a 'sentence' of over 2 years before the final procedure to let me go started. The case examiner deciding on the timing of this applied guidance to me that was relevant for doctors with drug and alcohol problems though I had neither and did so despite recommendations from my medical supervisors to the contrary. The GMC letter telling me I had at least another 6 months to serve ended with 'if you have any questions etc' . I broke down in tears and shouted 'Yes, I have a question, What about me?' I had already learned though, as the presumed guilty accused, not to phone the GMC. My medical defence union gave me advice at the outset to keep my head down and jump through the hoops in order to get out of the other side as quickly as possible. When I signed my undertakings for continued supervision I had been advised by my solicitor that if I asserted that I was now well then the view would be taken that I must in fact be ill and lacking in insight and would therefore most likely be referred to a Fitness To Practice panel. I could not have survived that. Today I read the Civitas report and BMJ article on the GMC and found that my experience was not unique and a bit more healing has happened. I am here to write this- many are not.

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