The GMC’s treatment of doctors undergoing fitness to practice (FTP) proceedings as a result of ill health is daunting, confusing and anxiety-provoking, according to a new study.
The report, published this week in the BMJ, was based on interviews with 19 doctors who had been on sick leave for six months or more with physical or mental health problems, including drug and alcohol dependency and were undergoing a FTP investigation. The doctors were asked to comment on their perception of the GMC as a whole, as well as their perception of GMC processes.
While all of those questioned acknowledged the necessity of the GMC’s involvement, particularly in terms of protecting patients, many found the process almost as challenging as their illnesses. Of the 14 doctors who had had interactions with the GMC, only seven made positive statements about the role of the GMC in their return to work.
Doctors described the GMC as ‘uncaring’, ‘unfriendly’ and ‘impersonal’, singling out communication between the GMC and individual doctors as being particularly unhelpful. In some cases, this negatively impacted on doctors’ mental health, affecting their ability to return to work.
Some participants criticised the ‘accusatory tone’ and legal jargon that littered the one-size-fits-all correspondence they received during proceedings – including letters referencing ‘allegations’ that did not in fact exist. One doctor quoted by the report said: ‘It puts you as if you’ve done something wrong but actually I’ve done nothing wrong. All I’ve done is been ill and made a statement to that effect in accordance with good medical practice so what have I done wrong there?’
The report also raised concerns around GPC panel members’ understanding of the difficulties faced by doctors suffering mental illness and addiction. 18 of the 19 doctors interviewed had suffered from some kind of mental illness, and most felt that the GMC lacked understanding of their condition, tending to conflate it with misconduct.
One participant said: ‘I don’t think that the panel have sufficient understanding of mental health issues to draw their own conclusions… they would see it as black and white. You’re either ill or you’re not ill, and you can’t be somewhere in between.’
Much of the positive feedback about the GPC’s role in FTP proceedings was in connection with individual GMC supervisors who were described as supportive, kind, or fair. Many participants said that the process should be more ‘personal’, with some suggesting it could benefit from doctors being able to choose a supervising consultant.
Other suggested improvements included having clearer, less impersonal explanations, more flexibility regarding undertakings, and separate pathways for doctors with pure health issues.
GMC chief executive Niall Dickson said that while he was pleased the study recognised some of what his organisation had done to make procedures less stressful, he recognised that there was more to be done.
He said: ‘We must always act first to protect the public and that can involve taking immediate action when we believe patients may be at risk. But at the same time, we have a duty of care to the doctors who are referred to us.
‘We are doing everything we can to identify ways to speed up the process and, where possible, avoid a hearing in cases relating to a doctor’s health. Whenever possible our aim must be to enable them to return to safe, effective practice.’