Why Barton Didn’t Go for a Burton

The Barton case may well come to be remembered as the one in which the General Medical Council lit the fuse of its own destruction. But the fuse that has been lit is not the one that appears to have been lit.

Unlike the Gosport relatives of Barton’s victims, and the multitude of commentators on the web, and in the press, Dr No does not think that GMC stands for ‘Gross Medical Cover-up’. He does not think this is a simple case of a profession looking after its own.

Sure, there are doctors involved. But this is not about doctors protecting doctors. It is something infinitely more troubling. It is The Establishment looking after The Establishment.

Let us consider some of the known facts of the case:

1. The General Medical Council is not a professionally elected body, but a Government appointed quango. Council members are appointed by – naturally – another quango – The Appointments Commission, which is itself accountable to the Department of Health.

2. The Council’s Chief Pongo, Niall Dickson, is an non-medical Establishment man. Before joining the GMC, he was Chief Pongo at the King’s Fund, a thinly disguised pro-market government controlled think-tank. He is also intertwingled with Tony Blair’s ‘Third Way’.

3. The Council now has as many lay members as medical members (twelve of each). The medical members are Establishment members who happen to be doctors.

4. The Fitness to Practice Panel that tried Barton was chaired by a non-medical man Andrew Reid – a lawyer and a JP.

5. The GMC has shown and continues to show great zeal in pulling the wings off non-Establishment doctors. A contemporary list can be found here.

6. Barton, on the other hand, is very ‘Establishment’. Oxford University, and sister to a (now ex-) GMC Grandee.

7. UK medical bloggers – who tend to be non-Establishment doctors who have written about Barton appear to be uniformly of the view that she should have been struck off.

And finally – a bit of conjecture. Barton’s misdemeanours – those which were found to be serious professional misconduct – all relate to a pattern of opiate and sedative use that is now known as the Liverpool Care Pathway. Today’s caring sharing NHS Establishment is rather keen on the LCP, as a way of ensuring the best end-of-life care. Other, non-E­stablishment folk sometimes wonder if the LCP isn’t so much about ensuring good end-of-life care, as providing a convenient ‘Third Way’ to shift expensive bed-blocking Biddies and Gilberts…and erasing Barton would send out an anti-opiate and sedative message that might compromise the usefulness of the LCP…

No Sir, Barton isn’t about doctors closing ranks to protect doctors. This isn’t a failure of professional self-regulation. An FTP panel chaired by a non-doctor failed to strike her off. This is The Establishment closing ranks to protect The Establishment. We would do well to bear that in mind over the months ahead, lest we take our eye off the ball, and let that smouldering fuse of hope be allowed to go out.