A Christian GP based in Kent has been given a new formal warning by the GMC’s independent fitness-to-practise tribunal in relation to praying in a consultation.
The doctor, who has been in hot water on a few occasions over the years regarding his ‘spiritual’ methods, was found not guilty of serious misconduct in a fitness-to-practise tribunal that concluded yesterday.
The tribunal heard Dr Richard Scott made a 19-year-old patient battling mental health problems feel ‘uneasy’ after he not only talked through counselling and antidepressants before asking permission to try a ‘third, spiritual angle’.
The incident happened at the Bethesda Medical Centre in Margate, Kent, on 25 January last year.
Dr Scott, who has been a GP since 1983, began to discuss religion with the patient, known as B, who had a history of ADHD and poor mental health.
He talked about his own faith before he clasped his hands in prayer.
It emerged during the Medical Practitioners Tribunal Service (MPTS) hearing that he also gave the patient, who had his mother with him, a Bible on leaving the consultation.
The situation led the teenager’s mother to make a complaint to NHS England about her son’s consultation with the doctor and the teenager told the tribunal he was taken aback by the advice after the doctor declined the use of antidepressants.
He further claimed that the GP, who previously ran two mission hospitals in Tanzania, had told him he needed to ‘reconnect’ with God.
But Dr Scott told the hearing he does not pressurise anyone into a spiritual discussion but instead he ‘offers and encourages’.
Patient B was found to have consented to having a spiritual discussion but Dr Scott was found by the hearing to have ‘then overstepped the boundaries’.
The tribunal ruled that the doctor should have ensured the teenager was ‘comfortable’ with carrying on the discussion and did not feel under pressure to do so.
GMC guidance underlines that doctors may practise medicine in accordance with their beliefs as long as they do not cause patients to be distressed.
It also states that GPs must not impose or express personal beliefs or values, including political, religious or moral beliefs, to vulnerable patients or if it will lead them to be distressed.
In fact, the GMC updated its guidance specifically related to an incident involving Dr Scott over a decade ago.
Findings from a 41-page ruling following the latest case, which got underway on 21 August, led the MPTS to find that Dr Scott’s conduct amounted to misconduct.
But the ruling added: ‘However, in the context of these events, it did not find that Dr Scott’s conduct could be considered deplorable or disgraceful.
‘Therefore, it concluded that, although this amounted to misconduct, Dr Scott’s actions did not cross the high threshold required to be considered serious misconduct.’
The MPTS’ warning to Dr Scott said: ‘Dr Scott conducted a spiritual discussion with Patient B, a vulnerable person. He discussed his own spiritual beliefs with Patient B to the extent it was not patient centred, and which caused him distress. Dr Scott also failed to establish Patient B’s consent to having his hands clasped and to Dr Scott facilitating a prayer which was not welcome.
‘This conduct led to Patient B feeling pressurized which caused him further distress. In doing so Dr Scott breached paragraph 54 of Good Medical Practice and paragraphs 4, 29, 30 and 31 of the GMC’s Personal Belief and Medical Practice Guidance. This conduct does not meet with the standards required of a doctor and his actions have undermined public confidence and the public’s trust in the medical profession. It risks bringing the profession into disrepute, and it must not be repeated.’
It added: ‘Whilst the conduct in itself is not so serious as to require any restriction on Dr Scott’s registration, it is necessary in response to his misconduct to issue this formal warning.’
This is the second formal fitness-to-practise warning handed to Dr Scott. Back in June 2012, he was given a warning following a patient complaint that the GP had abused his position to put forward his religious views.
There was a further incident in 2019, which led to a complaint from the National Secular Society that a ‘highly vulnerable’ patient ‘felt discomfort at the use of prayer’ by Dr Scott.
Meanwhile, last year Dr Scott was ordered by NHS bosses to attend a course designed for doctors facing allegations of having sex with patients, although he had never faced such accusations.
It led him to accuse health bosses of an ‘outrageous’ attempt to ‘humiliate’ him and was cleared following GMC investigation.
But NHS England took the step of holding its own inquiry and ordered him to take part in the three-day £1,800 course at his own expense as it also covered a ‘wide range of professional boundaries’.
GMC guidance relevant to the case
The GMC said that in this case paragraphs 54 of Good Medical Practice and paragraphs 4, 29, 30 and 31 of the GMC’s Personal Beliefs and Medical Practice Guidance were ‘particularly relevant’.
Good Medical Practice; 54:
‘You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.’
GMC’s Personal Beliefs and Medical Practice Guidance; 4:
‘Doctors may practise medicine in accordance with their beliefs, provided that they act in accordance with relevant legislation and:
• do not treat patients unfairly
• do not deny patients access to appropriate medical treatment or services • do not cause patients distress. If any of these circumstances is likely to arise, we expect doctors to provide effective patient care, advice or support in line with Good medical practice, whatever their personal beliefs.’
29: ‘In assessing a patient’s conditions and taking a history, you should take account of spiritual, religious, social and cultural factors, as well as their clinical history and symptoms (see Good medical practice paragraph 15a). It may therefore be appropriate to ask a patient about their personal beliefs. However, you must not put pressure on a patient to discuss or justify their beliefs, or the absence of them.
30: ‘During a consultation, you should keep the discussion relevant to the patient’s care and treatment. If you disclose any personal information to a patient, including talking to a patient about personal beliefs, you must be very careful not to breach the professional boundary that exists between you. These boundaries are essential to maintaining a relationship of trust between a doctor and a patient.’
31: ‘You may talk about your own personal beliefs only if a patient asks you directly about them, or indicates they would welcome such a discussion. You must not impose your beliefs and values on patients, or cause distress by the inappropriate or insensitive expression of them.’
Source: GMC
Note: This article was updated at 15.35 on 6 September 2023 to reflect that MPTS decided to issue a formal warning, not GMC as a previous version had stated.
You do have to wonder if the outcome would have been different if the doctor had a different surname or characteristics?
I am not sure we even have to wonder!
‘Therefore, it concluded that, although this amounted to misconduct, Dr Scott’s actions did not cross the high threshold required to be considered serious misconduct.’
Even though it was the second instance of the same transgression; usually considered as a marker of lack of contrition or learning?
Good job he didn’t say he’d been promised a new laptop.
So sad the GMC has to be involved again. If he had a foreign name then we all know what will happen. I wonder if the GMC can follow it’s own rules.
And I thought antidepressants were relatively contraindicated by age under 21 years and by neurodiversity comorbidities as well, and that we were supposed to offer all forms of ‘talking therapies’ (of which spiritual connections with our god is clearly one!) as first choice in preference to drugs? Perhaps fortunately for me and the GMC, I consider proselytising more the job of Teachers and Ministers of Religion and Parish officials!
Now I’m in trouble! GMC will be knocking at my Labour Card carrying door because I regularly tell patients it’s the Tory’s fault for this NHS Shit show.
I’ll ask our social prescribers to stop signposting to Alcoholics Anonymous then.
Labour created the this shit show of an NHS Dr G, and have no answer other than the eternal spend yetbmore of other people’s money. At some point that stops working.
At the risk of censure ….Sweet Baby Jeebus!
There is so much BS to unpick, both in the text of the article and JG’s comments, it is clear that not just our profession but our very culture is edging closer and closer to the point of either total submission or civil unrest!!!
Managing the ever increasing burden of affective disorders, of all of the skills in general practice, indeed even in Specialist clinics is as much an art as a science.
I offer some totally anecdotal evidence, which once upon a time in the west would have rendered it moot, but now the hierarchy of evidence has been inverted post 2020, I have been able to significant clinical outcomes by integrating my broader life experience into to discussions with patients both male and female. These are non denominational, and rooted in the culture of my community, not gleaned at med school or in VTS training, Therefore this method is not approved by NICE, SAGE, BMA, MHRA or any other corrupt institution in the grip of political ideologues, or lobbyists, donators or sponsors. These individuals who could not run a tap much less a mental health consultation.
As for JGs probably facetious and flippant “Labour Card carrying door because I regularly tell patients it’s the Tory’s fault for this NHS Shit show.”
Try peddling that line here in Wales since dear old Tony devolved power to The Senedd, a quarter of a century of Labour run Welsh Assembly Government and with it NHS …..it really is a tired, lazy and utterly pointless
So if I challenge a racist I could be accused of not respecting their beliefs.
I once had a patient with schizoid PD who was also burdened with a multitude of MUS symptoms many of which she believed were caused by being haunted by her dead husband, she was a devout catholic, I tried everything. Eventually (with consent) I approached our local priest and had a suitably subtle chat about exorcism. He said they don’t do that sort of thing any more. What a pity.
What is not mentioned is that this practice is very open about its Christian ethos. Anyone going there should know that. It might even be of the benefit to some patients. But twice now the same GP has been warned because someone ELSE, not the patient, (at first) didn’t like it.
And for Dr No- try the anglicans; they DO carry it out but only in exceptionally rare circumstances. Each diocese has an advisory board for the “Ministry of Deliverance” as it is now called. It has a priest or two on it, one or two (usually reitred) doctors with psychiatric experience and a couple of lay people. They look at all the requests that come to them very carefully.
I have had two cases of people believing they were seeing ghosts. The first was clearly getting alcoholic hallucinations and I cured the second by stopping her amitryptyline.
@John G above… thankyou! I had no idea about the CofE. How very forward looking of them. regrettably my patient can now take it up directly with her husband. Assuming they’ve gone to the same place of course…
Oddballs will always attract regulatory attention.