Medical Self Regulation. Crisis and Change. I'm Shocked

Last night, I was doing some light reading. I nearly jumped out of my skin at 4am this morning. I turned over page 258 in the book and discovered this

"For the GMC to still adopt this approach after Shipman, Ledward and the Bristol Royal Infirmary case and other scandals were lack of reporting have been key factors, suggests that the presumption against whistleblowing is still very stongly ingrained within medical self regulation. The message which Cream sends is that the regulations pay lip service to the importance of reporting concerns, but a doctor putting this into practice risks having to traverse the minefield of the disciplinary procedures.

Pal v GMC originated from events in spring 2000 when Dr Pal had raised a number of complaints to the GMC, primarily involving the alleged mistreatment of elderly patients. Dr Pal corresponded with the GMC's solicitors, but was reluctant to meet with the solicitors simply to repeat evidence she had already given in writing. She did express a willingness to meet with them once they had progressed their investigations. She was also reported as indicating in this correspondence that she did not trust the GMC or its solicitors. A stalemate appears to have been reached. Dr Pal refused to continue to correspond with the GMC's solicitors, emphasizing that she had nothing to add and that they should progress their own investigations. The complaint was closed in October 2000. Shortly afterwards, it was said that internal correspondence within the GMC, between a case worker, deputy to the GMC Chief Executive and Registrar and a GMC Screener, began to cast doubt on Dr Pal's mental health: " Those of us who have dealt with the case in Conduct are concerned that the correspondence on file suggests that Dr Pal may have an underlying health problem. A Screener suggested that :" I do think that she could have a health problem. She is certainly intemperate and possibly paranoid. But at the present time I do not think we have sufficient evidence of ill health to proceed.

An extract from the court proceedings in Pal is illustrative

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 anyone 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.

..... It is like a totalitarian regime: anybody who criticises it is said to be prima facie mentally ill - what used to happen in Russia.

In one respect, a proactive stance on the part of the GMC to appropriately consider the potential risk posed to the public by any doctor - however the information giving rise to suspicion comes to the attention - is to be commended. However, the more concerning aspect of this case is the apparent focus of the GMC on the mental health status of the complainant, apparently at the expense of fully investigating the substance of the original complaint. The case suggests the continuation of echoes within the GMC of the belief that "disparagement" by doctors of their colleagues is somehow inherently unsavoury, and that a doctor making a complaint becomes prone to suspicion. Dr Pal's own reported response to these matters was as follows :

"There has been no complaint against me by any patients and my GP verifies that I have not been mentally ill and the judge agreed. The entire point centres on whistleblowing .... If whistleblowers are to be treated with such contempt, then there will be no one who will prevent the next Dr Harold Shipman"

I thanked Mark Davies this week. This is probably the best write up I have ever had. I suggest the GMC buy the above book as they have attempted to silence this case from the national media for many many years.