Friday, 6 May 2011

The GMC is not fit for purpose

Via (DNUK, the site where doctors go to bitch) I came across this story:
"A YOUNG doctor who tried to sell her staff pass for free hospital parking can only work as a medic again under strict conditions, watchdogs have ruled.
"...a foundation year doctor, put her free permit to park at Southampton General Hospital up for sale for £5 on the website Gumtree, the Fitness to Practise Panel of the General Medical Council (GMC) was told.
NHS fraud investigators found out she later claimed a senior colleague made a sexual advance in exchange for ''looking more favourably'' on the problem.
"During the meeting, on October 14, 2008, Dr White alleged she was firstly warned she could get the sack by her employers, the Southampton University Hospital NHS Trust. 

"But the more senior colleague is then alleged to have gone on to say: ''I can ensure that the trust looks on your case more favourably'' and put his hand on her knee before adding: ''What will you do for me?''
But Brian McCluggage, counsel for the GMC, told the hearing in Manchester the allegation had ''no basis'' and was a ''defence mechanism'' to counteract her difficulty over the parking permit.
The doctor, who is in her 20s and qualified after completing her medical degree at the University of London in 2007, was not present or legally represented at the hearing.
She was also accused of breaking a ban on her entering the hospital and failing to attend an examination by a psychiatrist as requested by the GMC." 
Now obviously what she did was naughty - you shouldn't be selling your free parking permit, even for just £5, but this is a trivial matter that should have been dealt with between employee and employer with a slap on the wrist. This is the consensus amongst the DNUK commenters.

So what are we to make of her claim that she was sexually propositioned by her educational supervisor? Most of the senior doctors on DNUK think this is highly unlikely and agree with the GMC that this is probably a "defence mechanism". Well I am not so sure. Medicine is stuck in some kind of 1950s time warp where casual racism, sexism, and sexual innuendo are commonplace. Many female junior doctors of my acquaintance have been sexually propositioned by senior doctors (usually their clinical or educational supervisors) and several have been offered inducements (e.g. authorship on publications or attendance at conferences). Even I've been questioned about my sexuality by a consultant on a ward round in front of patients.

The GMC is commonly used as a tool by hospital trusts and senior doctors to keep juniors in line (paying over £400/yr for the privilege) - how many employees making an allegation of sexual harassment against a senior work colleague are required to to attend a psychiatric evaluation? It wouldn't be possible if this was a simple employer-employee industrial dispute where this kind of punitive action would be illegal, but is just fine when it becomes a 'fitness to practice' issue.

But compare and contrast:
"...had all restrictions lifted on his ability to practise after a General Medical Council panel reviewed his case.

"The former Royal Navy surgeon was convicted at Manchester Crown Court in 2003 of making indecent photographs of children, ordered to sign the sex offenders’ register for five years and given an 18-month community rehabilitation order."
Or here:
"...admitted making inaccurate records after the operation and was slammed by the GMC panel yesterday for “significant departures from good medical practice”.

The panel cleared him, however, of serious misconduct and found that his fitness to practise was not impaired.
The panel also decided against issuing the surgeon with a warning."


Anonymous said...

There's a simple solution to sex discrimination by doctors. Forced sex change operations for those who discriminate against the other sex. Let them share in the suffering.

(a male non-doctor)

Neuroskeptic said...

Hmm. The parking ticket thing is obviously a minor offence and I can't see why the GMC need to be involved at all.

The claim of sexual harrassment though - that's tricky. The NHS found her guilty of making a false claim. That's a serious thing to be convicted of. If she really did that, then I'd say that certainly is a matter for the GMC... but it's hard to know with a case like this, and considering that the whole thing should never have been a disciplinary matter in the first place because it's all about a £5 ticket, I have a lot of sympathy.

pj said...

"That's a serious thing to be convicted of"

The problem is that the NHS or even the GMC are not people who should be making findings of fact in cases like this.

Unless there was previous history on either side then we have no way of knowing if it is true or not - certainly it is far from inconceivable that either she would lie (although it isn't clear what she is supposed to be getting out of this lie) or that he would make a sexual advance.

But the asymmetry of the case is clear. They couldn't prove that he did or didn't make a sexual advance, neither could they prove if she did or did not make it up. However she was the one facing the GMC. If the accusation had been true it seems on the evidence presented she would still have been sent to the GMC as 'unproven = untrue' under this fallacious reasoning while he would always get away with it. By not only dismissing her accusation (which in any other area of employment would be taken much more seriously) but also then calling her a liar and taking professional misconduct proceedings against her they have basically opened the door for every single senior doctor who fancies taking advantage and sent a very bad message.

The GMC and medical/NHS establishment have form for this kind of action. Juniors who have complained about things like harassment or standards of clinical care have often faced subsequent professional misconduct complaints (initiated after the fact for behaviour that had never previously been commented upon and preceded the initial complaint) and been subject to psychiatric assessment and psychiatric labelling. Having talked to GMC psychiatric examiners, while they are well meaning, they are simply not qualified to be making findings of fact in these cases - this is not Cracker!

Fitness to practice hearings are frequently used as a unique strategy for managing employee relations that bypass all the usual employment protections - and because they do so they also prevent these doctors having recourse through the usual industrial dispute channels - and potentially losing their livelihood.

Frances Garrood said...

What worries me (as a prospective patient, and, incidentally, a retired nurse) is the sheer cost of an action taken against someone who had at the most committed a petty fraud. Have these people not got better things to do (and more important things on wich to spend their - ie our - money?)

pj said...

Frances - fortunately the GMC is funded by doctors and their compulsory 400 odd quid subscriptions.* So there is no interest on the part of the GMC and their employees to avoid frivolous cases.

* For which their employees get bloody private health insurance!