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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)

  • It is true that most Doctors fear ther GMC. The perceived aggressive style from the GMC is counterproductive. It specifically discourages GPs from any interaction with the GMC either as whistleblowers or if help is needed. Any POLICEing activities should be done sensitively. The public want supervision not retribution.

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  • The GMC prodcedure I went through was abusive, intrusive, overly drawn-out and incompetent. Whilst accepting it was right for the GMC to investigate the process pushed me over the edge. The response of the GMC was to add the allegation of unfit to practice due to health as well, and to insist on two independent psychiatric reviews. Neither of the psychiatrists even asked about suicidal ideation let alone anything more significant.

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  • You are told to go and get your own support (and there is not a lot out there) and then left to it....its very easy to see how suicide risk could arise and go undetected with the tragic consequences that have occurred.
    The exercise of the GMC investigative function is deeply troubling - you should be innocent until proved guilty but their whole approach tends to be the other way round.

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  • Maybe if the constant monitoring and evidence based practice trend continues to increase in complexity, then GP's will have more compassion for sick and disabled people who have to undergo endless ATOS examinations and constantly fill in forms with accompanying evidence that is very hard to obtain.

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  • Are their any Suicide figures for Doctors undergoing NCAS Assessment. They usually are pressurised into taking part in the assessment under the joint threat of GMC Referral and Breach of Contract.It would be interesting to know how many take part Truly Voluntarily

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  • Sudheer Surapaneni

    GMC procedures show most of the targeted are the International graduates. They get referred by the NHS employers for smallest of the reasons, which they would not do in case of the White/British graduates.NHS racism comes to the fore when the doctor in question suffers indirect discrimination at the work place, and he is further discriminated by the process of GMC referral. And the doctor finds himself suffering double whammy of loss of work,career and legal help, as the Defence organ isations refuse to help because of the costs involved.http://www.bmj.com/content/346/bmj.f4088

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  • Maybe if the constant monitoring and evidence based practice trend continues to increase in complexity, then GP's will have more compassion for sick and disabled people who have to undergo endless ATOS examinations and constantly fill in forms with accompanying evidence that is very hard to obtain.
    ----

    How utterly disgraceful to use this topic to swing things around to your agenda. You should be ashamed of yourself.

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  • Dear "Anonymous", there is nothing shameful about my comment and I have no agenda. I am a retired GP so am not affected by developments in the profession or DWP. My policy has always been to examine both sides of any situation and look for similarities rather than differences. What ruffles your feathers in others is often what is unexamined/unacknowledged in yourself so maybe you need to put the spotlight on your own issues and bias rather than projecting them onto others where one way or another, now or in the future, they will only reflect back at you and bite you on the ass.

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  • Sudheer Surapaneni

    The Independent expert psychiatrists do not examine you as a patient, but you they are asked to give a medical report. In the process, you do not have patient-rights, s you are not their patient.
    The expert assessors and witnesses brought by the GMC are protected by the GMC.They can do any number of basic/serious mistakes but they will not be investigated for their fitness. If you complain, you will be branded 'wexatious'.

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