Doctors blast GMC referral of IMG doctor as ‘misuse’ of FTP process

Doctor leaders have criticised the GMC’s referral of a ‘silly’ complaint about an IMG doctor who was recently cleared by an MPTS tribunal.

Dr Redouane Lammali, who qualified as a doctor in Algeria, was accused of being dishonest when he said he had asked a patient if they had taken any medication recently, however the tribunal concluded that no facts were proved and his FTP was not impaired.

The Doctors’ Association UK (DAUK) has said it is ‘deeply troubled’ that this case made it to the MPTS, while the British International Doctors Association (BIDA) said this is an example of the FTP process ‘being misused and weaponised at the expense of an IMG’. 

In February 2020, at the time of the incident, Dr Lammali was working as a locum specialist registrar in emergency medicine at the United Lincolnshire Hospitals NHS Trust and he was treating an intoxicated patient who had been admitted with a head injury.

The complaint, which later formed the GMC’s allegation, originated from a healthcare support worker, ‘Ms H’, who alleged that Dr Lammali had told her he had asked the patient whether they had taken any medication in the last four hours. 

According to the support worker, Dr Lammali made this statement knowing that he had not in fact asked the patient, and knowing that he had earlier administered a dose of intravenous paracetamol.

The GMC alleged that as a result of this conversation, Dr Lammali had been dishonest and his statement was ‘an attempt to avoid criticism of [his] administration of the paracetamol’. 

The tribunal heard evidence that the dose of paracetamol recorded in the patient’s notes constituted a medical error since the patient had taken a previous dose of paracetamol too recently.

However, the tribunal concluded that it was ‘more likely’ that the dose recorded in the notes was administered by an agency nurse rather than Dr Lammali.

In his own evidence to the Trust and to the MPTS, Dr Lammali asserted that he had never prescribed paracetamol to the patient and that no such conversation between Ms H and himself took place.

As part of the Trust’s investigation, the patient could not recall the name of the doctor who treated him but described him as ‘absolutely spot on’ and that he ‘could not have asked for better treatment’.

The healthcare support worker’s first record on Dr Lammali concerned his attitude rather than the issue around paracetamol, describing him as ‘very obstructive and rude’. 

In considering whether the conversation, in which Dr Lammali allegedly made untrue statements, took place, the tribunal found inconsistencies between the timestamps of Ms H’s notes and the time at which the doctor’s shift ended. 

It concluded that ‘on the balance of probabilities, the GMC had not proved that the alleged conversation between Dr Lammali and Ms H had taken place’, and as such the other allegations were also not proved. 

Chairman of the BIDA junior doctors forum Dr Sai Pillarisetti said: ‘It is clear that the basis for the referral was because one person’s opinion trumped that of an ethnic minority doctor.

‘Although the final outcome was positive for Dr Lammali, it does little to compensate for the years of stress and anxiety that this exercise must have caused him.’

Meanwhile, chairman of the British Association of Physicians of Indian Origin (BAPIO) Dr Ramesh Mehta questioned ‘why the GMC should take three years for a silly complaint like this to get investigated and make it to MPTS’.

Dr Mehta added: ‘This is such a simple thing that could’ve been resolved so easily. I have absolutely no doubt that if it was a white doctor instead of this chap, this should not have gone anywhere at all.’ 

‘It’s not just psychological impact, it’s impact on the family, their physical health, mental health, financial health,’ he added.

DAUK co-chair Dr Matt Kneale said: ‘It is concerning to see yet another case where months of scrutiny and hardship were endured by a BAME doctor when it could have been resolved locally without the need for referral to the regulator.’ 

Referrals from NHS trusts need to be ‘scrutinised’ before involving the GMC in order to ‘reduce the risk of inappropriate and prolonged investigation’, he added.

The GMC told Pulse that it is required to investigate all referrals which raise allegations about fitness to practise, and where the regulator’s case examiners cannot reconcile conflicting evidence about a serious allegation, the case is then referred on to the MPTS.

Last week, the BMA declared it has no confidence in the GMC at its Annual Representative Meeting (ARM) and will now call for its leadership’s dismissal.

In June, the GMC said it is ‘likely’ on track to achieve its target of eliminating all disproportionate referrals from employers about ethnic minority doctors and IMGs by 2026.

Its annual report on tackling inequality showed that the differential rate of referrals for ethnic minority doctors and IMGs compared with white doctors had decreased over recent years.

Earlier this year, a medical defence organisation’s survey showed that just over 40% of GPs being investigated by the GMC reported suicidal thoughts, and nearly half considered quitting medicine as a result of the process.