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GMC to spare doctors with mental health problems from a full investigation

Exclusive Doctors who have mental health problems will be spared from full GMC investigations 'wherever possible', under sweeping new proposals around investigations announced today.

The proposals - to be ratified by the GMC board - will see investigations against GPs with mental health conditions carried out  'only where necessary' and treatment begun instead.

The GMC has revealed a raft of new proposals in a bid to make its fitness-to-practise process more ‘sensitive to the needs of vulnerable doctors', following recommendations by Professor Louis Appleby – who was appointed by the GMC in December last year to carry out an independent review of its fitness-to-practise (FTP) process.

They come after Pulse has published a series of articles about the pressure that GMC procedures put on vulnerable doctors, including a report that found that 28 doctors had died by suicide while under investigation and that 13 additional doctors died while the regulator contemplated action. Another study showed that complaints against doctors ‘may do more overall harm than good'.

Pulse has also revealed that thousands of complaints were being held secretly by the GMC and that only one anonymous complaint about a doctor has been upheld in two years.

In a statement, Professor Appleby said the high number of investigations but the low number of imposed sanctions 'do not justify the impact on individuals.’

In future, he said, doctors going through FTP who are ill ‘need to be treated, not punished’ and that ‘investigations in which health is the root of the problem should avoid full investigation whenever possible, and move instead to early treatment.’ 

Professor Appleby looked at ‘every stage’ of the investigation process as part of his review, and assessed how it could be more caring towards vulnerable doctors. 

He had earlier claimed that there is currently ‘too many investigations’ – a claim that has been vindicated after his review found that only ‘13% of investigations lead to a sanction being imposed’.

Under the proposals, the GMC said it would:

  • Ensure investigations are only carried out where necessary, particularly in cases involving concerns about health;
  • Come to a swift conclusion to those cases that relate to a doctor's health and are deemed necessary, being as supportive and consensual as possible, and pausing the process where appropriate, to allow particularly unwell doctors to get treatment;
  • Raise awareness of the need for commissioning arrangements to be developed to support all doctors (not just GPs) in accessing confidential mental health treatment;
  • Engage with Responsible Officers to ensure that concerns are dealt with at the right level, and resolved locally where possible;
  • Develop a co-ordinated approach in health from start to finish and greater co-ordination of correspondence from the GMC in all types of cases;

A GMC-commissioned review at the end of 2014 found 28 doctors had died while under investigation and concluded that doctors could become ‘marginalised’ during the FTP process and receive little support or compassion from the regulator.

But with these new proposals the GMC aims to make its FTP process more 'sensitive and compassionate’. 

louis appleby v2 SUO

louis appleby v2 SUO

Writing in his blog today, Professor Appleby, said: 'Two principles have guided my approach to this work. First, doctors who are ill need to be treated, not punished - investigation is frequently punitive in effect, even if that is not the intention. Secondly, suicide is not confined to those who are known to be mentally ill - it can be those who are thought to be coping that are most at risk - so reducing risk is a task for the system as a whole.

He went on to add that there is a 40% chance that a doctor will be invesigated, but many of these do not lead to a sanction. 

He added: 'There should be fewer investigations - the current rate of 2,750 per year translates into a 40% chance that doctors will come before the regulator at some time in their careers.

'Yet only 13% of investigations lead to any sanction - such a low figure does not justify the impact on individuals. Most complaints from patients about a doctor's performance could be dealt with by the doctor's employer.' 

 

Readers' comments (32)

  • So why can't the NMC do the same for nurses!! Instead they treat you like a you have committed a murder, even when you have done nothing wronge except be ill .

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  • THE PUNITIVE ATTITUDE OF THE GMC,RESULTED IN FEW GP's AVAILABLE AFTER RETIREMENT TO WORK.ANY BODY COULD SEND A COMPLAINT TO THE GMC,.THE GMC TAKE EVERY COMPLAIN VERY SERIOUS AS IF THE DOCTOR HAVE KILLED THE PATIENT,MANY DOCTORS ARE NOT INTERESTED TO ENTER GENERAL PRACTICE AS A CAREER,FOR THE FEAR OF GMC COMPLAINT,HOWEVER SOME OF THE GMC STAFF ARE NOT HUMAN,THEY WORSE THAN BUTCHERS,THEY TRYING TO SAVE THEIR JOB,BY CREATING A LONG BUREAUCRACY ,AND LONG WAITING TIME.I REGRET BECOMING A DOCTOR AFTER 35 YEARS OF WORK,BECUSE OF JEALOUS COLLEAGUE WHO PUT A COMPLAINT TO THE GMC.

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  • Would believe it when it ACTUALLY happens. I know someone who has been found to be fit to practice without restrictions 1 month ago by both his treating psychiatrist and his GMC Mentor BUT GMC has still put restrictions on his Registration. This prevents him from getting a job. And GMC says that he needs to be assessed by 2 medical examiners.
    He has been going through this stressful process for 3years now with no end in sight.
    Hopefully all the doctors in similar situation unite and take GMC to Court on Human Rights basis.
    Who knows it may actually happen like the Hillsborough case.

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  • And how does the GMC define who is 'mentally ill'? Someone who suffers from mild and relatively unimportant anxiety-depression could easily be tipped over into full-blown depression/suicide simply by the stress of the investigation itself.

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  • As one of the 40% if it actually happens and comes to fruition I will be delighted for my professional colleagues.

    It felt like "double jepardy" to a vulnerable and fragile Dr when quite correctly investigated/suspended for mental health issue and when that was discounted a fitness issue came a long subsequently. From start to finish nearly 4 years and while I was aware GMC were interested it appears some regional team (who I was unaware of)were additionally interested too.

    So bad was even considered/offered medical retirement and given current state of things made the wrong call!

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  • But what about those like me who were perfectly sane until they were exposed to unnecessary investigation following a complaint by a vindictive member of staff that they'd sacked.
    Half way through the investigation I succumbed to severe depression. I couldn't even defend myself properly in the trial as I was a mumbling wreck, their own psychiatrist told me I had songs of PTSD due to the complaint.
    I never worked again. Four years of severe depression followed by too much terror of another complaint to go back.
    Bitter...me?

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  • the GMC has blood on its hands.

    it needs to answer for this.

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  • Anyone who wants to be a doctor in UK has a mental health problem.

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  • Dr David Barrett

    Very sad situation for many doctors. We must support them all better in future. This must be the start of a radical re-think and change of GMC processes. The pendulum has swung too far the other way for too long.

    Remember a lot don't take their own lives. But their personal and family lives are destroyed. Financial hardship. Can you imagine the trauma to a family (perhaps with kids), when a doctor as the main breadwinner loses their house whilst under investigation? Then they may actually be cleared. I think we should all try understand matters better rather the fear the unknown. I can't fully appreciate how this may feel. I suspect local resolution of issues is by far the best way.

    It would be nice to hear the narrative stories of more doctors who've lived to tell the tale.

    Defence organisation should defend their fee-paying doctors at least to the full total of their contribution over the years. Ie £7K x years paid to that defence organisation. No discretion for this please. Even criminals get legal defence and a fair trial and crucially compensation if due.

    Failing to attend to the needs of one group of patients (doctors) does nothing to benefit the wider population. Doctors living in fear doesn’t help either. Time for change.

    I work as a GP in prison and secure settings.
    “You can judge a society by how well it treats its prisoners”.
    Fyodor Dostoevsky

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  • To David, I did write mine but it was declinced for publication. Rest assured I now know who my mates are. Additionally my responsible officer and others were very supportive. I know I'm not alone but guess like many of the 40% they would rather move on.

    As an aside can I enquire how Professor Appleby chose to spoke, even anonymously and sensitively, to those who have been through the process and are prepared to venture a description of the process?

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