Figure 1. GMC Guidance improved with a Fig Leaf
|The General Medical Council (the UK licensing body for doctors) maintains its purpose is to protect the health of the public by ensuring proper standards in the practice of medicine. But the GMC has an accumulating credibility problem (1-5). Now an important article by Peter Wilmshurst (1, PDF version) adds to the voices (2,3,4,5,6) calling for the Council to be stripped of it's regulatory functions.|
The GMC is accused of failing to act in a plausible, timely and consistent manner when ethical guidance is ignored (1-6). It appears to apply its ethical rules in a selective way - depending somehow on ethnicity and membership of a mysterious old-boy's club (1,2,3). The Shipman enquiry reported that the GMC failed to deal properly with Fitness to Practice (FTP) cases, particularly involving established and respected doctors (2,4). Most worryingly, it is accused of assisting in victimization of doctors raising concerns, instead of dealing with those concerns. Sir Liam Donaldson, the Chief Medical Officer, echoes concerns about FTP procedures. In his view, "complaints are dealt with in a haphazard manner, the council causes distress to doctors over trivial complaints while tolerating poor practice in other cases".(2, 5). Former President of the GMC, Sir Donald Irvine, called for the current Council to be disbanded and re-formed with new members (2, 6)
Some extracts from the Wilmshurst paper (1, PDF version)
On the private club mentality in dealing with concerns about doctors"The purpose of the GMC is to protect patients, not doctors. "adjudications by the Professional Conduct Committee were frequently inconsistent, arbitrary and unjust."
"Justified criticisms have led to changes in the GMC in recent years. ..I believe that many of these changes are cosmetic."
"the obligation GMC members feel to those who elected or appointed them represents a conflict of interest that prevents the GMC from working for the good of the public." "the evidence suggests that the medical profession cannot be trusted to regulate itself."
"I can provide many examples of inconsistency in the adjudications of the GMC. One case involved a professor who had falsely claimed an MD research qualification. .... The GMC decided that this dishonesty of the professor required no more than a private warning."
"Some may ask why the Professional Conduct Committee publicly suspended or erased from the Medical Register a number of doctors, all of whom had African or Asian names, for claiming qualifications that they had not been awarded, but the GMC decided that in the case of a white British professor at a major academic institution only a private warning not to do it again was required."
"Another case illustrates the problems of conflicts of interests and the strength of the 'old-boy' network within the GMC. I reported a doctor to the GMC for financial misconduct. Evidence presented at his hearing before the Professional Conduct Committee showed that the senior management of the hospital at which he worked had discovered his dishonesty and reached a severance agreement with him so that if he left without legal challenge, the hospital would destroy documents related to the fraud....The chairman of the Professional Conduct Committee hearing .. had been the medical director of the hospital at the time the deal to conceal the misconduct was agreed. ... The GMC refused to take any action against its member. Contrary to its rules, the GMC refused to tell me why they were unwilling to take action against the GMC member. The GMC member subsequently returned to chairing hearings of the Professional Conduct Committee.
Can one imagine a situation when a judge stood down from hearing a case because he had helped to conceal a crime and then was allowed to return to the bench?"
GMC Victimisation of those raising concerns"doctors have a responsibility to speak out if they have concerns about behaviour that might endanger patients. A doctor who fails to bring his concerns to attention may be guilty of serious professional misconduct and may be erased from the Medical Register." "However, rather than investigate my concerns, the institution reported me to the GMC for disparagement".
"A more junior doctor, who had serious concerns, effectively had her medical career destroyed by the GMC. Members of the GMC made unfounded allegations that the doctor suffered from mental illness and made it difficult for her to gain employment. The doctor sued the GMC and some GMC employees maintaining that the GMC broke its own rules and failed to follow its own procedures when blackening the reputation of a person raising legitimate concerns...His Honour Judge Harris likened the GMC to a "Stalinist regime".
On creative accountancy"...one could suggest that it was not in the interests of GMC members to lose these lucrative expenses by upsetting those who elect or appoint them. This only ended recently when public knowledge of this widespread and condoned practice eventually forced the GMC members to behave in a way more in line with normal accounting practices."
JUDGE HARRIS: For myself I don't really see why somebody complaining about the behaviour of doctors or the GMC, if that is what they are doing, why that should raise a question about their mental stability, unless anybody who wishes to criticise "the party" is automatically showing themselves to be mentally unstable because they don't agree with the point of view put forward on behalf of the GMC or the party.
MISS COLLIER: That in itself certainly would not be enough.
JUDGE HARRIS: It is like a totalitarian regime: anybody who criticises it is said to be prima facie mentally ill - what used to happen in Russia.
MISS COLLIER: My Lord, that is very far from the circumstances of this case.
JUDGE HARRIS: Of course it is ...
- Wilmshurst P. (2006) The General Medical Council - a Personal View. Cardiology News Oct/Nov 2006 14-15 http://www.pinpointmedical.com/article_read.php?id=57&publication=cardiology-news&link_id=2
- http://en.wikipedia.org/wiki/General_medical_council (14/11/2006)
- Shipman inquiry. Safeguarding patients: 5th report, 2004. Online version
- Donaldson, L. Good doctors, safer patients: a report by the Chief Medical Officer. Department of Health, 2006-07-14. [Link]
- Current GMC should be disbanded, says former President. Report by The Royal Society of Medicine.[Link]
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