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"Wrong kind of Misconduct" |
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Friday, 26 December 2008 |
GMC rejects call for enquiry into MTAS |  | | In October this year Remedy wrote to the GMC calling for an investigation into the disasters of MTAS and Specialty Selection and Recruitment (SSR) and the role of the senior doctors responsible for it. Over 1600 people supported this call, making it surely the most called-for professional referral to the GMC in medical history. | We asked them to investigate whether their professional and managerial actions and conduct in relation to MTAS/SSR fell below the high standards outlined in ‘Management for Doctors’. We also asked if their deficient performance was so significant that their actions would amount to misconduct or deficient professional performance and would impair their fitness to practice in this managerial field of work.
GMC Response
The GMC have now replied and have rejected the call for an enquiry. Their justification for their decision is that:
i) the alleged misconduct is not relevant to the fitness to practice of these doctors, and.
ii) allegations of deficient performance must be concerned with poor performance in a clinical setting.
Our analogy with the Roylance case was rejected, since it was related to a clinical setting. In fact the entire thrust of the GMC “Management for Doctors” guidance does not apply, they say, since it only applies to doctor-managers connected with the provision of medical services to patients.
| Please note that due to a transcription error an incorrect wording of the GMC response had been posted here earlier. We apologise for this mistake. |
Remedy Response
We dispute that the conduct of the MTAS/SSR architects in their managerial domain is separate from the practice of medicine. Doctors hold certain senior positions in management only because they are doctors – these people were acting in roles that necessarily required them to be medical practitioners. The Crump report on the role and responsibilities of Postgraduate Deans, for example, was explicit that although their managerial responsibilities lay elsewhere then “PG Deans, like all doctors are accountable professionally to the GMC”.
Their response diverges from recent historical experience. Even a cursory glance at the famous case of Meadows shows a very different interpretation of the scope of Serious Professional Misconduct.
"Serious professional misconduct" .... may include not only misconduct by a doctor in his clinical practice, but misconduct in the exercise, or professed exercise, of his medical calling in other contexts, such as that here in the giving of expert medical evidence before a court.."
We set out in our original letter that there are many contexts in which a doctor’s conduct outside of clinical medical practice can be the basis for an investigation. We can think of many instances where people have been “GMC’d” for conduct outside a strictly clinical context. Obvious examples include drink problems away from work, financial misconduct, plagiarism, advertising, presenting hooky research and sexual misconduct
The usual GMC line on cases like this is that they ‘bring the profession into disrepute’. So how much did “the biggest disaster in a generation” bring the profession into disrepute? In terms of column inches the MTAS 2007 fiasco topped any other medical profession story in the last 5 years. Apart from ruining many individual careers this avoidable managerial cock-up did not shower our profession in glory.
Finally if the “clinical context” loophole were true then should we expect a deluge of appeals from doctors who had been brought before the GMC on other non-clinical grounds?
The Way Ahead – judicial review.
Remedy and our legal team believe:-
• that the GMC rejection on such shaky grounds is at best absurd and at worst unfairly protective of an unimpeachable elite.
• that there are unhealthy double standards of accountability between the profession and its leaders.
• that it is the duty of an organisation like Remedy to step up and restore accountability to that leadership,
• that a clear precedent needs to be set pour encourager les autres.
• that far from being an issue from the past, unaccountable leadership is an ongoing problem for the profession which needs to be addressed immediately
We have had preliminary discussions with our solicitors and barristers about ways in which we can challenge this ruling. We will be meeting with them again as soon as the season of goodwill to all men is past.
The obvious path is to seek a high court judge’s impartial opinion of the GMC decision. Such a judicial review would examine the legal principles at stake and the consistency of its interpretation. We have less than 3 months to bring this challenge - we hope we can work to this deadline.
The biggest difficulty for us in bringing any such challenge will be financial. We have started looking at ways of raising the cash we will need. In order to go ahead then we will need to ask for donations from hundreds or thousands of ordinary doctors. We would be bitterly disappointed if our actions came unstuck from a lack of funds.
There is a vital point of principle here, affecting all doctors – even those who were unharmed by the ringleaders of MTAS. Should the people living in ivory towers be considered above the law? Or are they as accountable as the rest of us for their actions in their own individual fields of practice? The accountability question rises above MTAS/MMC and any of the issues that we have faced in the last 5 years. We think it needs to be openly addressed, fairly judged and effectively implemented.
To overturn the GMC in the High Court would be an important moment in medical history. The choice will be yours.
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