This site is intended for health professionals only

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

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.



Please note, only GPs are permitted to add comments to articles

David Church 11 July, 2023 5:27 pm

This case seems to pivot on the point of whether it was Dr Lammali at all, and if he was even present at the time the alleged conversation took place. This seems to be a factual issue that could easily be discovered by suitable investigation.
Even if he was there;
1) would the doctor have administered the paracetamol himself?
2) a single prior dose of 1 gram, would not necessarily totally contraindicate an intravenous dose, so long as total doses is recorded clearly with times, to avoid exceeding 4g in 24 hours.
3) if the doctor had given the paracetamol, then the information that the patient had not ‘taken’ any medication could be considered truthful – in regard to oral ingestion and contents of stomach (eg pre-anaesthetic). An iv dose is not ‘taken’ by the patient. And it would certainly have been recorded on the patient’s drug chart/AE file anyway, so obvious to any clinical staff caring for the patient.
4) was the witness able to say what Dr Lammali HAD asked, seeing as they must have been present the whole time in order to say he had not asked?
5) it appears there has been a poor working relationship between the HCSA and someone, but there appears some doubt as to whom it was. Somebody needs to check in such circumstances, before an assumption does what they do.

Barry Sullman 11 July, 2023 5:51 pm

Its not right that flimsy complaints like this can be made and thereby creating untold stress and worry for doctors. I feel we work in a very exposed environment. Its just not right that we have to work in these conditions.

Jonathan Heatley 12 July, 2023 6:16 am

all you doctors out there beware of your nursing colleagues. They are increasingly making complaints about us medics, and our failure to follow guidelines & protocols to the extent they are now acting as informers. The tail is now wagging the dog.

Trefor roscoe 12 July, 2023 8:06 am

So the GMC is working towards eliminating these sorts of complaints by 2026.

Why is it going to take them three years? Why can’t they stop doing it now? They are basically admitting that they do allow trivial complaints, particularly against Doctors from overseas. It beggars belief that they know there’s something wrong and I’m not going to fix it for three years.

John Charlton 12 July, 2023 8:12 am

Sadly, Jonathan is absolutely correct.

Decorum Est 12 July, 2023 12:35 pm

Agree with all of the above comments.
Disgraceful behaviour by the GMC.

John Glasspool 12 July, 2023 7:04 pm

The GMC hates doctors; it especially hates doctors of colour.

Nasty, racist cabal. The GMC: lower than vermin.

Anthony Gould 12 July, 2023 8:56 pm

Jonathan is correct indeed but we also are occasionally attacked by medical colleagues who seem to have an inappropriate agenda

Anthony Gould 12 July, 2023 8:58 pm

And experienced nurses are occasionally attacked unfairly by a doctor

John Glasspool 13 July, 2023 6:25 pm

Possibly, AG, but the article isn’t about that.

S. Ali 13 July, 2023 10:47 pm

It’s unfortunate and clearly racism at GMC triage, hence the need for annonymisation of protected characteristics at the GMC not in hospitals or other places. I have a strong feeling I can guess the name of the GMC triage jobsworth investigator.

Most of these cases, it is unfortunately easier to be dishonest and admit charges, so the GMC jobsworth gets a win. The sad state of affairs for luxury marble and glass buildings, private health cover for staff as long as they prosecute doctors at all costs. The medicolegal defence often being in cahoots, fail to ask for the original complaint form and disclosure of the toxic discussion between GMC staff leading to these silly tribunals.

I feel sorry for tribunal panels, of they do not tie the GMC line they lose future appointments

S. Ali 26 September, 2023 7:37 pm

Regarding race, having spoken and communicated with over 100 GMC staff, I am increasingly asking myself, if the doctor was White, would the GMC be pursuing the case.

I explored this with a disclosure request about Realistic Prospect Test, the GMC Legal Solicitor responded with: there is a presumption of guilt. Obviously, this is case dependent but if there is a presumption of guilt with misconduct hearings, then obviously you are guilty until proven innocent.