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THE WRONG KIND OF MISCONDUCT

30-12-2008

Remember the old British rail excuse about “the wrong kind of snow”? Well now, as Dr David Nicholl reports, it has an equivalent in the medical world – “the wrong kind of misconduct”.

In January, I reported how I had registered my lack of confidence in the Chief Medical Officer, Sir Liam Donaldson, over his handling of the junior doctors training fiasco, Modernising Medical Careers (or MMC) in 2007.

As we end 2008, I can report that the General Medical Council (GMC) has rejected a complaint from over 1600 doctors including myself into the role of senior doctors such as Sir Liam Donaldson in the organisation of MMC.

The complaint was lodged by Remedy UK, the junior doctors’ pressure group, in October, but was rejected by the GMC as they felt that MMC represented the “wrong kind of misconduct” and did not directly affect patient care.

The fact that the GMC does not feel that the system by which doctors in this country are trained does not directly affect patient care is frankly bizarre. By one estimate, the amount of time being trained to be a consultant has been cut by as much as 75%.

Although even I would feel that the 75% figure is a little steep, and the reason for the reduction is in part due to MMC but the European Time Working Directive also. It is very clear that such a change in training will affect patient care.

The GMC justified their reasons for not investigating as:
"i) the alleged misconduct is not relevant to the fitness to practice of these doctors, and
ii) allegations of misconduct must be concerned with poor performance in a clinical setting.”

However this directly contradicts previous GMC investigations - the medical TV pundit and psychiatrist, Dr Raj Persaud, was struck off for plagiarism and the paediatrician Prof Roy Meadows was initially struck off for his interpretation of statistics as an expert witness (he later had the decision reversed on appeal, but my point is there was an investigation).

Neither of these would relate to direct patient care, but clearly are relevant to the professional role of a doctor. Further the chief executive of the Trust at the centre of the Bristol Heart Scandal was struck off by the GMC, not because of his clinical care, but due to his poor management as Chief Executive.

Thus it should be of considerable public concern that the body responsible for the regulation of doctors is not prepared to investigate those responsible for the organisation and training of our nation’s doctors.

It would appear that the GMC no longer lacks independence where a complaint is laid against doctors who are so closely linked to the government, or is it that the ‘right kind of misconduct’?

That is something that should worry all of us.

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