Following the
Jane Barton fiasco, I remembered a set of documents handed over to me by a ex committee member. I felt that these documents had got lost within the quagmire of information about the
GMC.
I thought it was time I brought them out again. These documents make interested reading. They were part of an inquiry into the General Medical Council. Dr Richard Coleman was a rebel in his day before he went underground somewhere. In the old days, I was educated on the ways of the General Medical Council by a number of people. Like every innocent doctor, I thought our regulatory body was fair, just and fought to maintain integrity. As time went on, I discovered the shady structures, the various columns, the disgusting personalities.
I read the memos they had written about me again - after about 9 years. I still remember when the parcel landed in my hospital accommodation in 2003. I must have cried for about 6 hours. After that, history tells us I did fight the
GMC to
preserve my employment status.I still believe Mr Peter Lynn of the General Medical Council is a sad excuse for a human being. His efforts at collecting material I had written, his snide efforts at effectively silencing me, his condescending attitude. What it is to be judged by a clerk. Apparently, he did all this in the public interest. Peter Lynn has been involved in legions of cases compromising good doctors and failing patients and their relatives. I still remember my friend Joel who is still a fugitive. I miss Joel Branch a lot and I live in the hope that one day he will find his way back to contacting me again. Branch was a
braveheart who fought the General Medical Council until the very end. Joel was witty, charming, intelligent and a decent human being. As friends go, I really liked Joel. I often think about where he is, whether he is well etc. Joel disappeared one day and never returned.
Joel Branch has the
GMC reference number
4625771. Joel remains suspended. There were never any patient concerns about Joel. He was a competent and intelligent SpR in Medicine before the General Medical Council ruined him. We can compare Jane Barton's sanction to Joel Branch and we can ask the question, what was the General Medical Council doing? I wrote about Peter Lynn and his dealings with Branch sometime ago here. Joel tried to litigate against the General Medical Council as a litigant in person. This litigation brought him bad luck and ultimately a contempt of court issue drove him out of the United Kingdom. Peter Lynn and the General Medical Council destroyed a good British doctor's career and they did not bat an eyelid when they behaved in this manner. I can assure everyone that Joel's allegations had nothing to do with hospital medicine.
I told Niall Dickson recently by email that the first action as new chief
pongo [ copyright
Dr No], should be to fire Peter Lynn. Of course, I write about these cases because it is important for all of us doctors never to forget our colleagues who are lost in the suspension
blackhole of the General Medical Council. No one should ever forget the injustices meted out on honest hard working doctors. In an era of oppression and controlled media, it is the
internet that will dictate the General Medical Council's demise.
We call the General Medical Council - Crackpot Towers. If anyone wishes to see a psychopathic regulatory body, please feel free to be shown around the
GMC buildings by their henchmen.
GMC DOCUMENTS - STATEMENTS GIVEN BY COMMITTEE MEMBERS
CLIENT:
GMCMATTER: Independent External Review
FILE REF:
MLS/G3352/18/
EWSDATE: 12 September 2002
Richard Coleman said that he was a member of the
GMC for 5 years until 1999, so he had some views and experiences of the
GMC. Richard Coleman questioned whether the profession was in fact self-governing. Was it right for the medical profession to pay for its own regulation in such a case? He was less concerned about who sat in judgment on doctors, so as long as the process was robust.
He considered that it was not robust enough to hand out the sort of heavy sentences which it did. Richard Coleman had written an article in the
BMJ which questioned that process. The profession would do better if it opted out of the judgment side of the
GMC's work and dealt more with the representation side. It was odd to have
BMA members sitting on the regulatory body.
Richard Coleman had trained as a General Practitioner . He worked as a locum GP before developing his own practice in occupational medicine. He had been elected to the
GMC after he had gained some publicity in relation to doctors and advertising issues. He had judicially reviewed the
GMC on the basis that the advertising rules at the time were an infringement of his rights. He lost that case and he also lost the appeal. Subsequently, however the Monopolies and Mergers Commission looked at the issue of
GP's advertising, saw sense and insisted that the
GMC changed the rules. He gained, therefore, an ultimate victory. The case which he had wished to take to the European Court of Human Rights as a result of the failure of his domestic appeal, therefore did not happen. In the end that case was settled for £12,000, of which Richard Coleman gave half to his counsel. . When Richard Coleman left the
GMC, there was a core of disgruntlement with the
GMC of which he was aware. That was particularly focused on disgruntlement with Sir Donald Irvine and his management of the
GMC, and a lack of transparency. Things were manipulated and put through Council. Donald Irvine had had a goal and insisted that it was achieved. He was very emollient in the way in which he put things across, but when the minutes came round issues had been hardened up in a way in which it was not possible to fully support. Things seemed to be manipulated in a preset direction. Richard Coleman had crossed DI about the Professional Conduct Committee (
PCC). He had thought that the committees of the Council were being used as a tool to achieve a specific end. Doctors were being scapegoated to engineer political and public opinion by the
PCC and that seemed unjust to Richard Coleman.
One particular area of difficulty was the idea that doctors should be punished in the
PCC in a way which would provide a deterrent. Donald Irvine was also very influential in the selection of chairman for the
PCC. It had got to the point that counsel appearing before a
PCC could walk into the room for a doctor's hearing, look at the members sitting on the committee, and know the outcome. Some members became known as
GMC men or women, others were more open-minded. This could be said of both lay and medical members. Some members had sought patronage and power and that was how the thing was able to happen. Donald Irvine worked with an inner circle of members who were extremely influential. Richard Coleman had not felt too extreme, because after he had spoken in meetings people would come up to him in, e.g. the toilets and say that they were very glad he had said what he had. However, they appeared not to be prepared to follow that through with their votes.
Shortly after Richard Coleman had arrived at the
GMC, a doctor wrote to all members of Council with a complaint. Two or three members raised this with the President who said that if members felt concerned they had a duty as members to look into the matter. Richard Coleman had written some questions to Finlay Scott and received very unsatisfactory answers from him. He communicated with the doctor who had raised the issue. In the end, Finlay Scott had tried to suggest that Richard Coleman was acting as an advocate for this particular doctor.
The issue concerned a report which was quite lax, contained factual errors but was very influential. The doctor concerned questioned the quality of that report. Richard Coleman had asked whether he could see the papers which went to the
screener of the case. Finlay Scott had said that Richard Coleman was acting as the doctor's advocate. Richard Coleman was a member of the council and had legitimate concerns about the process. He was not questioning the substantive decision, just teasing away at the process. Later a handbook had come out giving guidance on how the
screeners should and could conduct their enquiries. This was not done sufficiently rigorously in this case.
Richard Coleman had been refused access to the papers, although he had asked about three times. So in the end, Richard Coleman had had to write to the doctor concerned and say that he could not help him. The excuses which Finlay Scott had given were not strong. Richard Coleman had sat on a case concerning a psychiatrist's report on a nurse, where the doctor concerned and put in something, in good faith, which turned out not to be true. That doctor had got hauled up to a hearing even though he had had no intention to deceive. That had struck Richard Coleman as being a similar case. This had all led Richard Coleman to begin to question things more. He realised that there was a barrier between him as a member and what the
GMC wanted him to know. Finlay Scott had once told him that transparency was like a greenhouse - you could look in but not enter the room. To RC, that was not transparency at all.
The particular case which Richard Coleman had just mentioned was an example of how things worked. He was a Council member and the President had given him the impression that he had the authority to question things. However when he did so and it got to the President, the door was slammed shut in his face. After that, Richard Coleman thought that Finlay Scott had seen him as a member of the "awkward squad". That was slightly tied up with Richard Coleman’s comments on freemasonry. The
GMC had been discussing a code of conduct. They were discussing the issue of relevant interests which needed to be disclosed. He had asked Donald Irvine and Finlay Scott, in the presence of Lady
Tumin, whether Finlay Scott was a
freemason. Finlay Scott had said that he was not prepared to tell Richard Coleman. Richard Coleman had then been concerned because the President had said that he would put Finlay Scott in charge of dealing with the code of conduct and working out what interests were relevant and needed to be disclosed. Richard Coleman felt that that was not appropriate in view of the Home Affairs Committee saying that those who acted in a judicial capacity they should declare their interest as
freemasons.
Richard Coleman had mentioned this whole episode in front of the whole Council. He discussed this with a member of the
GMC staff who had agreed with him that all interests should be declared. But after this incident, Finlay Scott had turned on him. Finlay Scott had refused to tell Richard Coleman whether he was a
freemason even when it was relevant to the case which Richard Coleman was looking at at the time.
The rules had now changed and freemasonry was in fact something which voluntarily should be disclosed as a relevant interest. Richard Coleman had wondered at the time why Finlay Scott should not declare it. When the
GMC had taken out an injunction against Richard Coleman, in a statement which Finlay Scott made to court, he made Richard Coleman out to look like some sort of radical anti-freemasonry campaigner. He thinks four members of the
GMC now admitted to being
freemasons. The code said that it was a relevant interest, but it was only voluntary for members to declare that. Before this was agreed, Finlay Scott had said in a newspaper that members had to declare any interest as a
freemason. Richard Coleman had telephoned the paper and told them that that was not true. At that time only some months later did it change. Andrew
Ketteringham had then written to the press saying that Finlay Scott was not a
freemason. Richard Coleman had written to Andrew
Ketteringham at that point asking why he had done so and whether he had checked with Finlay Scott whether he was a
freemason or not or whether Finlay Scott had simply refused to tell him and he had assumed something. It turned out that the latter was the case.
RC had stood for re-election in 1999. He came fifty-fourth and so just missed out on being elected. He had been disappointed to go at the time. Being on the
GMC was exciting and it made you feel important. People had told him that they were on his side. Finlay Scott had, however, painted Richard Coleman as a bit of a stirrer. He did not think that the other doctors at the
GMC had held that view. He simply came from a different perspective as he had chosen a different way of life. He had a fascination with the knowledge base of medicine and thought that it was a very fascinating world to work in.
In Richard Coleman’s view, General Medical Practice was a good document. It had, however, started as guidelines and then become hardened up to a dogma so that lawyers would use it against doctors. Members had accepted it as a gentle guidance to doctors and then accepted it as dogma.
Richard Coleman had been the only one who had voted against it on those grounds. When the minutes of the Council meeting had come out, his name had not been put down as objecting to it. Finlay Scott had told him that that was not possible. Anthony Graham who was the
BMA representative had thought, along with Richard Coleman, that this was disgraceful as there should have been a proper record of his dissent on that particular issue.
Donald Irvine used to threaten the
GMC with the fact that he had the Government on his back, following
Shipman and the Bristol enquiry etc. Richard Coleman did not mind who governed doctors provided it was done fairly. It was not every doctor who wanted to work for the
NHS. There are many branches of medicine not within the
NHS Occupational medicine for example. The problem with medicine was that it had been mucked about with by the Government. Doing the things which the Government wanted were not always worth doing. The
NHS was a system at its knees and the
BMA did not look after the interests of doctors. Richard Coleman likened doctors working in the
NHS to pilots working in an unsafe aircraft. Bad for their and their patients' health. It was easy for the Government to ask what the
GMC was going to do as it was not going to have to produce any results. The Government abused its power and the profession by promising things which it itself could not deliver. There was something weak about the
BMA, because it had strong ties with the
GMC. The flaw of doctors themselves was that they loved to be loved. As a result, they were prepared to roll over to government and were not hard-nosed enough to look after their own interests (and those of their patients).
Richard Coleman’s main concern related to the process of the
PCC committee. He had sat on a
PCC for two years. It had come to ahead when he was sitting on a panel which erased a coloured doctor. He had felt very uncomfortable about that on the way home. He had written to the defence barrister and said to him that he hoped that the doctor appealed the decision. He had written expressing concerns about the Chairman of the panel (To Donald Irvine) who had been associated with a number of controversial decisions. The Chairman concerned, in Richard
Colemans opinion, used
PCC as a way of making a sop to public opinion. He had felt unhappy about the in camera discussions. He felt that the panel was manipulated.
There were only five members on the panel and the legal assessor had possibly have been a Mr Rogers. Richard Coleman had written to his defence society as a result and had been prepared to speak to the defence barrister. As a result the
GMC tried to
injunct him. That case went before
Pumphrey LJ and was successful. Richard Coleman’s solicitor had not been interested in the matter at all. He had sent Richard Coleman’s counsel a copy of a draft of his witness statement before Richard Coleman had even had the chance to look at it.
Pumphrey LJ had said that he would not stop the injunction, but he would not preclude the Privy Council from having access to the minutes of the in camera discussions if it wished. The case did go on appeal to the Privy Council which decided that there was no case to answer in respect of some of the accusations. The decision of the
PCC was quashed and the doctor concerned later had his sentence lightened to a six-month suspension. The
PCC decision had been split and gone on a majority. When a panel of 5 members splits 3:2, if a chairman had a particular view he could simply close the whole case down in a way that he wanted. It was not as if the Chairman was trying to seek unanimity before a majority decision was made and enough.
In the Appeal by
Roylance in the Bristol case his side had sought access to the in camera minutes as they felt this would show bias by the Chairman. Permission was refused. Richard Coleman was with Donald Irvine when he was told of this decision by Finlay Scott and he seemed very relieved. Later the suggestion to stop recording the in camera minutes was made. The necessary changes to the law were put to the Privy Council along with a raft of other legislation. In July 2000 the
GMC looked at the issue but did not as a body consent instead asked to revisit it in November 2000. However the day after the
GMC July meeting Donald Irvine consented to the changes on behalf of the
GMC (without their consent).
In November 2000, item 9B looked at it again. Finlay Scott gave such a one sided argument to the
GMC members that to Richard Coleman’s mind they were not
sufficiently informed of the facts to be in a position to decide. Council was misinformed. Finlay Scott had said that there was no purpose in having the minutes available, because the discussions of the Panel in camera would always remain
confidential. Richard Coleman had written a critique of that statement using the decisions in
Roylance and the comments of
Pumphrey LJ in his own case to show that was not always the case. Richard Coleman believed that Finlay Scott had deceived Council about the potential importance of the minutes of such discussions. He thought there would be no problem of recording the minutes or of them being used for all appeals.
On the 14
th December 2001, Richard Coleman had written to Mrs Sarah
Bedwell about Donald
Irivine’s behaviour. There were two complaints. One was about a change of rules before council had agreed it. The second was that Donald Irvine sanctioned Finlay Scott's
misrepresentation of the facts. Sarah
Bedwell had said that there was no
jurisdiction for her to look into the matter. Richard Coleman could not understand why Donald Irvine acting as a manager was not subject to the fitness to practice procedures when doctors in
NHS management would be subject to them. He had written to Sir Cyril Chantler about this, as Chairman of the Standards Committee. He had said that he did not want to make a judgement about whether the President should be included within the procedures or not. Sarah Bedwell had said that there was no question of serious professional misconduct on the part of the President but had not looked at the evidence. Graham Catto was not able to do anything either. Richard Coleman considered that the President appeared to be above the law.
Richard Coleman also made an official complaint about Finlay Scott on the 17th January. Richard Coleman had been told that the person to make this complaint to was Prof. McDevitt. The complaints included the handling of the debate about the in camera minutes by Finlay Scott and his deception of council members. This did not seem an appropriate referral as Prof. McDevitt had spoken strongly in favour of stopping the recording of the minutes. Understandably, Prof. McDevitt saw no grounds for complaint.
Richard Coleman had written to the Charity Commission complaining about the treatment of these two complaints by the GMC. They said that they had no authority to look into the matter and that the GMC had written to them to say that they might be setting something up soon to resolve the matter. That appeared to mean GWS's review, which clearly was not true because GWS's terms of reference did not cover Richard Colemans complaints. The Charity Commission had said to Richard Coleman that if the GMC did not set up the right systems, he should let them know. However, he felt that the issue of the in camera minutes needed to be looked at as the process was not robust. That little extra knocking away of protection had not been necessary. During the debate in Council members had expressed some comfort that the minutes had been taken. In Richard Coleman’s case, production of the minutes would have proved that he was right or wrong.
Richard Coleman had heard people saying words to the effect of "he will have a lot of trouble trying to get out of this one". But that had not come out in open court. It would be very interesting to read the whole transcript of the in camera discussions in the case he was concerned about. He had the feeling right from the second day that the other members on the Panel in which he sat had thought that the defendant doctor was going to have to prove himself innocent. Richard Coleman had once spoken to somebody on a PCC panel in relation to another case. The case destroyed the doctor's life.
The member on the Panel to which Richard Coleman had spoken had recounted similar concerns about the Chairman of the Panel in that case. Richard Coleman had telephoned Rani Atma on the Saturday in his case after he had finished the hearing on the Friday. He wanted to tell her about his concerns. She confirmed similar feelings to his about some of the members on that particular panel.
GWS asked whether it was easy for an erased doctor to get back onto the Register. Richard Coleman thought it was very difficult to reinstate someone. It was rather unsatisfactory and Richard Coleman thought that it should be possible to reinstate a doctor with some limited powers so that they got back into the swing of things and were able to be monitored. If a doctor disputed that he was guilty he was almost never going to get back onto the Register as that was said not to show remorse. Restoration was difficult. There were no real averages as all the cases differed. For example, in sex cases there was a difference between inappropriate touching of patients and inappropriate meeting with patients after they had come off a doctor's list.
Dr Alex Freeman said that she had been involved in the medico-political scene since 1990, initially in relation to the doctors' hours campaign. She had a pedigree through the BMA junior doctors' committee in that respect. She had always had an interest in the GMC, in the sense of getting young doctors to be heard. She had stood in the 1999 election as an independent candidate and a bit to her surprise had been elected. Her election address was light-hearted but she said that she would represent the interests of doctors on the GMC.
She was at the time of her election a Registrar in general practice. Since qualifying she had become a part-time principal in general practice.
When she was first elected to the GMC she was invited to attend for an induction day. She met the President and the chairs of the various committees. Alex Freeman had started at the GMC in November 1999 and her membership lasted until the end of October 2004. However, the recent suggested changes at the GMC which would be voted on the next day might bring that forward to June 2003. She would vote against those proposals as she thought they would curtail the amount of representation which she could offer to her electorate.
The GMC had various unofficial groupings. One was a grouping of general practitioners. They went to dinner at the Royal College of General Practitioners and it was a completely informal affair. Another group which Alex Freeman was involved with was the Womens' Group, which she organised.
Alex Freeman could not recall who was present at the meeting of the General Practitioners informal grouping. She thought that Donald Irvine was there, Dr Goss, Sir Denis Pereira Gray and Dr Rennie amongst others.
Alex Freeman was not politically-motivated to speak before her peers, she felt that she spoke for doctors who had elected her. She had the impression that Donald Irvine had tended to listen mostly to lay members and appointed members, rather than elected medical members in any event. In order to speak to a Council meeting one had to try to catch the eye of the President or the Chief Executive. The Chief Executive would then write names on a list, who were then called upon to speak.
Alex Freeman said that she and Dr Edwin Borman had been good friends for some time.
Alex Freeman had sat on the ARC, PPC, the Interim Orders Committee, had been invited to sit on the Registration Committee (although she had never actually sat) and the PCC. She had been asked to sit on panels of all the fitness to practice committees except the Health Committee. In relation to other members there was never a question of whether somebody should be co-opted. People were just asked whether they were available or not.
When Alex Freeman had been elected, there had been a 50% turnover of membership. She had been sent a pack containing the rules and other documents. She had not really been trained in how to sit on Committees, but simply learned while she sat on the job, as it were. She was in a sense thrown right in at the deep end. However, when external associates were appointed, the GMC organised some training for them including about cultural awareness etc. However, Alex Freeman had still not received cultural awareness training although she had participated in training for the new associates as an ‘experienced’ PCC panelist. The same system appeared to operate with other committees, such as interim orders where, again, Alex Freeman had never received any formal training.
Alex Freeman had been elected to the ARC and sat on that committee. The oddity was that every member had to put a preference either to sit or not to sit on any particular committee or whether they were indifferent about the matter. It was possible that a person could be voted onto a committee even if they had positively said that they were not interested in sitting on it. All the forms were returned to Peter Pinto de Sa.
Alex Freeman described the PCC committee room. It was a sort of horseshoe arrangement. The result was that a member of the panel might end up virtually opposite or next to the defendant doctor. That could be very intimidating, especially for a woman.
Alex Freeman had sat on three GMC committees where recusal applications had been made - one in the ARC, and two in the PCC. She herself had offered a recusal when sitting on the Preliminary Proceedings Committee because she practised in the same geographical area as the doctor under investigation. The rest of the panel had asked her to withdraw her offer of a voluntary recusal because she was the only doctor on the panel from the same specialty. She had seen other recusals where a panel member had, for example, taught a particular doctor under investigation. Recusals were not unusual, and nor were applications. For example, the President himself was challenged during the Bristol case.
Alex Freeman was not "pitched against the GMC". That was not the case at all. It was simply that as an elected member of the GMC she felt concerned that it appeared many decisions it made were made before members had even seen them or asked to consider them. The recommendations made in Council papers were rarely defeated or amended. Lots of the items were presented by the Chief Executive or members of staff, although sometimes they were also presented by Committee chairs. Often members were presented with a series of recommendations and sometimes there was very little discussion about them. There were moves to push them through to a vote before they had been discussed sufficiently. There was an ethos of the bureaucracy managing the Council, which in Alex Freeman’s view was wrong.
George Staple asked whether a certain amount of management of the Council was not necessary to get the Council's business done. Alex Freeman said that the problem was that the standing orders were not followed. Some members were quite naive and just voted in the way they were asked to. That applied to both lay and medical members. It was inevitable that some members would simply be lobby-fodder. Elections threw up all sorts of different people.
Dr Borman asked some questions about it and Alex Freeman wanted to know what the expenditure on the President was. Dr Borman therefore asked his questions and also asked about the President's position. It was the first time a lot of members found out about the President's honorarium and the fact that it was equivalent to a consultant's A+ merit award. Alex Freeman had presumed beforehand that the President would merely be reimbursed for his expenses. The award seemed to be high as she imagined that Donald Irvine's annual income before he became President of the GMC would have been that of a GP, possibly around the £80,000 mark and that he would be reimbursed to cover lost earnings. She also discovered for the first time how much was given to screeners as honoraria. All that amounted to £800,000. Consequently there was a gap of about a missing £1 million. She could not understand where the rest of the money had gone as she could do a rough calculation of the expenses involved in running one or two panels of the PCC. The explanation for the accounts only covered half of the £1.7 million expenditure on members' fees and expenses included in it. That had set Dr Colman on the trail of the expenses issue and the whole issue about the GMC being a charity and its members being trustees. Alex Freeman had wanted to find out what was in the accounts because she was now a trustee she would be financially responsible as a trustee for any gaps in the accounts. She was fully behind Dr Colman in finding the root of the expenses issue. She thought it was important. There still had not been a full explanation of the issue. She and a lot of other members had not known about the President's honorarium and how the attendance allowance had appeared out of thin air to benefit lay members.
The whole episode left a very bad taste in Alex Freeman's mouth. GWS explained he did not wish to put words into Alex Freeman's mouth but wondered whether she would agree with the following. The way in which the GMC had been operating was if you kept your head down and your nose clean you were rewarded. If you did not you were not rewarded. People tried to find ways to stop members saying things. One ex-member of the GMC had told Alex Freeman that they had been threatened that if they did not do certain things certain consequences would occur. He was a Freemason and the person who was another member who was also a Freemason had made this threat. Freemasons tended not to declare themselves. That had all been about the Bristol case. The only way it was possible to talk to other members of the GMC was via membership of committees. An awful lot of business was done informally and if you were not in the in-group you were not involved. Alex Freeman found it very worrying that the staff at the GMC knew more about its business than she did. When you had a two-day council meeting and members were presented with several inches of papers to read it was not surprising that they became swamped and did not know everything that was going on. Somebody else had told her that when they first became a screener it became apparent to them that there were a whole load of complaints in respect of practice procedures which had simply been dropped and never considered. That meant that the GMC was taking it upon itself to decide things and that the complainant became immaterial.
Revalidation.
