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This is an issue of race

This is an issue of race

Editor Jaimie Kaffash argues that non-white doctors facing tribunal are experiencing unconscious discrimination

Reading the judgement from the recent tribunal hearing for Dr Redouane Lammali left me aghast. If you haven’t read it, you might not think it is real. The Algerian-born emergency medicine locum was working at Lincoln County Hospital and was accused of lying to a healthcare worker about having asked the patient if they had taken paracetamol before attending A&E. The patient was then put on IV paracetamol, which the healthcare worker claims was prescribed by Dr Lammali.

The tribunal found that there was no evidence for any of this. There was no evidence Dr Lammali administered the IV paracetamol – it was likely done by an agency nurse – or prescribed it. There was no evidence a conversation along those lines had taken place with the healthcare worker, who didn’t mention it until hours after Dr Lammali’s shift had finished (and this alleged conversation didn’t form part of the Trust’s initial investigation).

There are some snippets throughout the ruling that make for interesting reading: the healthcare worker (referred to as ‘Ms H’) described Dr Lammali as ‘very obstructive and rude’; it was a particularly busy night in A&E; and the patient has described the care he received from a doctor as exemplary.

With all this in mind, I can’t fathom a reason why this case was brought to tribunal. It seems like there was no attempt by the Trust or the GMC to determine whether the healthcare worker was accurate – a quick look at the rotas would have strongly suggested her recollection was inaccurate. A quick look at the prescription chart would have told them he hadn’t administered or prescribed the IV paracetamol.

But I’d say there is an even more important point here: even if all the allegations were correct, this still wouldn’t warrant a tribunal. This was a drug error, there was never any issue of potential overdose. It was a busy A&E. And it seems there was a personality clash between Dr Lammali and Ms H. Such matters could have been dealt with at a line manager level. Instead, we have a stressful tribunal hearing, and Dr Lammali hasn’t worked another shift at the Lincoln County Hospital since. And he was in limbo, waiting for the hearing, three years after this non-incident.

This is not the first egregious example of pointless tribunals. You might remember the case of Dr Manjula Arora, the GP accused of dishonesty after telling her IT department she had been ‘promised’ a laptop. Or, of course, the suspension of Dr Hadiza Bawa-Garba, which – although a tragic case – resulted in a huge backlash from the medical profession for holding an individual doctor responsible for systemic failings.

It is impossible to ignore the elephant in the room when discussing these cases: these are all non-white international medical graduates. And – although I expect backlash for this – I am going to say something I believe with all my heart: none of these cases would have got to this stage if these doctors were white and UK-born.  

This is not to say white UK-born doctors do not face spurious complaints, or don’t have to go through ordeals way out of proportion. But the checks and balances are more likely to click into gear – at one of the pre-tribunal stages, someone will point out that ‘rude and obstructive’ is likely to really be ‘stressed and overworked’; that a ‘dishonest’ action is more likely to be a mistake or an irrelevant white lie (excuse the unfortunate term); and that escalating to tribunal is wildly disproportionate.

The figures back this up – the GMC’s seminal report on this found that 1.1% of BAME doctors were referred to the GMC by employers 2012-17 compared with 0.5% of white doctors. They are more likely to be face fitness-to-practise hearings, too.

I am not smart enough – nor have enough time – to go through what leads to non-white doctors facing this unconscious discrimination. Solving this is not easy, and it is in my opinion a societal issue first and foremost – the disproportionate number of complaints from employers and the public suggest this.

But the regulator can do itself a favour and all parts of the organisation need to think carefully before escalating cases such as Dr Lammali’s. Because at the moment, it is impossible to escape the feeling that race is a factor.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at



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

Centreground Centreground 14 July, 2023 6:19 pm

The point regarding racism is accepted but there is a further elephant in the room and another taboo subject which affects all medical professionals regardless of background . In such large organisations as the NHS, in my opinion generally and not related to this case, there are employed many individuals of varying personality and some much smaller numbers who may even border on personality disorders.. It is becoming increasingly evident whether based on racism or just simple malice, that certain organisations or individuals within the NHS now use regulatory organisations such as the CQC, GMC and NHSE complaints (in the recent past-now ICB manage complaints I believe ) as weaponised forms of conducting vexatious attacks against certain individuals including the medical profession . This is based frequently on poor evidential grounds. It is different if evidence is available.
Worse still the CQC and GMC appear to be encouraging such malicious attacks by holding this information which should be only with the knowledge of the person concerned and the organisations need themselves to be held accountable to a civil and possible criminal level if they choose to proceed with such complaints based on insufficient evidence or background due diligence if later proved to be unfounded.

David Church 14 July, 2023 6:37 pm

Professor Baksi and team at ‘Justice 4 Doctors’ ( J4D ) have worked on a paper recommending reform of the ‘Maintaining High Professional Standards’ system and HOW IT IS MISUSED, at great cost to Clinical Staff and patients, and the NHS, and could do with widespread support throughout the Medical and Nursing professions to push for Government to consider this paper and root out discrimination and bullying behaviour from NHS organisations.

Sarah Annetts 14 July, 2023 7:38 pm

Well said Jamie. I think we are ALL (whatever our own ethnicity or backgrounds) heartily sick of this stuff at the GMC. Some of the recent cases are Kafkaesque – who amongst us would recommend their children to pursue a career in medicine, if this is a risk we have to face with every patient encounter?

Sam Macphie 15 July, 2023 11:55 am

Exactly who is the weird name, Centreground Centreground; take ownership of your comments with your real name: why not?
Also, other unreal names used for comments generally are unbelievable or just weird, whatever your views expressed

Truth Finder 17 July, 2023 12:04 pm

Trust in the GMC is at an all time low and once again it is justified as in this case. Regulatory organizations are being misused and they are so unfit for purposes they do not even realize they are being misused.

Hank Beerstecher 17 July, 2023 1:41 pm

Even false allegations of dishonesty are passed automatically by the GMC to MPTS. No questions asked, no reprisals or investigation of whomever passed the false allegations. It is a tool made available by GMC for NHS organisations Medical Directors and RO to have doctors struck off, no questions asked.

David Turner 19 July, 2023 12:17 pm

Well said Jamie.
The GMC’s own data suggests a racial bias against non-white doctors.

If the GMC were referred to itself, can it honestly say it would be found fit to practice?

It is an outdated anachronism long overdue for replacement by a massively slimmed down, fairer regulatory body that is fully independent and not an arm of the government.

Sujoy Biswas 24 July, 2023 8:16 pm

Spot on!
They (GMC) will probably send some heavies round now because I am brown, was nice knowing you,