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Burning Bad News

Posted by Dr No on 19 December 2014

gmc_review_2.jpgOnly yesterday, Dr No was working on a post noting that the GMC had still not published its internal review of doctors who died while under Fitness to Practice investigation. He noted that publication was originally slated for July 2014, then November 2014, and, as of earlier this week, possibly sometime in 2015. He even noted that at the very time the GMC is consulting on doctors’ duty of candour, it was showing a striking lack of candour in its own conduct. The last sentence of the first paragraph of the post said ‘In the absence of certainty, it is not clear whether the review is still incomplete, or is complete, but currently too hot to handle, with Stilton’s PR goons waiting – sorry – for a good day to bury bad news’. It now seems they were: the review has been published today, the last Friday before Christmas.

Dr No didn’t publish his post yesterday for two reasons. The first was the inverse of ‘a good day to bury bad news’ – it was a bad day to ask awkward but important questions. The post would get forgotten over Christmas, and be old news by the New Year, something that may still happen - but then we can always return to it in good time. The second, and more important, reason was sensitivity to both doctors currently under FtP investigation, and the friends and families of doctors who have died while under investigation. It’s Christmas, FFS, the season of goodwill. It takes a particularly toxic – or perhaps not, perhaps they are all like that – lawyerly GMC type to dump such difficult material in the public domain less than a week before Christmas. Now that it is unavoidably out, Dr No expresses his sympathy to any so affected who may happen to read this.

What the timing shows is the GMC still doesn’t get it, still doesn’t care. This is not entirely surprising. The organisation is malignly legalistic, not to mention infested with lawyers, and we know the legal profession is second only to that of chief executives in harbouring psychopaths (if you fancy a bit of light relief spotting psychopathic traits in lawyers you know, look no further than here). Even a quick read of the review, available here, reveals many examples of insensitive uncaring overly legal behaviour typical of the conduct to be expected of both individual psychopaths and psychopathic organisations. In passing we might also note another psychopathic trait, covering up the truth. A 2012 FoI reply suggested the GMC was aware of only small numbers of suicides (a number of three, cunningly worded, was mentioned); the review makes it clear the Council knew about far more, perhaps as many as ten times more.

This over-reliance on legalism points to a greater, even fundamental, flaw in the GMC machinery. Law is by its nature a binary apparatus (innocent/guilty, find for the plaintiff/find for the defendant), incapable of comprehending subtlety. However complex the problem, the answer has to be yes or no. This binary nature is right there literally at the top or bottom of the page, in the GMC’s current slogan, ‘Working with Doctors Working for Patients’, and gives rise to the constant harping on by the Council about the paramountcy of protecting patients. Sorry, guys, it ain’t that simple. Of course protecting patients is always important, often vital, but what you have forgotten is that sick doctors are also patients. Sick doctors, including those caught up in the GMC’s ghastly machinery - and many caught in the machinery are sick - deserve exactly the same decency and care that any patient deserves. They deserve the same protection from harm the GMC ordains for all patients. That the GMC should then fail those patients by not protecting them, and, far, far worse, actively engage in harmful conduct, sometimes even to death, is a disgrace.

There is but the tiniest sliver of hope. Though most doctors working for the GMC will adopt either the Nuremberg defence (just doing my job) or the Denning defence (best to bang up a few innocents than let the bad ones go free) to defend their conduct, it is clear from quotes in the review that some GMC affiliated doctors are at the very least uncomfortable with the GMC’s conduct. These are the cracks in the cogs of Stilton’s apparatus. Where there be cracks, they can get bigger, and where there be big cracks, machines can break up. Time, then, to start working on those cracks. It will be intriguing, when the time comes, to see how the GMC, arch defender of whistleblowing, responds to whistleblowing from within its own ranks.


Greetings fellow troublemaker, and happy Winterval!

I was wondering on your thoughts on this spot of trouble in Nottingham. It seems the peasants are revolting:

I see my spot-squeezing colleagues have given a clear demonstration of the efficacy of market forces by voting with their feet. Are we serfs to be sold by our masters? It seems not!

You are not Boots. Be off with you!

For those not familiar with Dr No/Bad Medicine:

Stilton is Niall Dickson, Chief Pongo at the GMC. You can work out for yourselves why he's called Stilton. Clue: part (most?) of it is PGW.

For some background, Dr No's first assessment of Fitness to Practice mortality is here: Dropping Like Flies.

Boots is/was an esteemed colleague of Dr No, sometimes also known as Dr Phil, or even Dr Phil Yerboots The above comment is not in style, ergo not Boots.

Also noted: the other Boots home town has something to tell us. But it's not the peasants revolting...

It is actually me,

The release of the report at this time does indeed smack of burying bad news.

The table on p22 is interesting. It seems that 13 of 28 suicides were in 2012-13, while in the early noughties there were several years with only a single death by suicide. Something seems to have changed and it seems that the external factors would not have altered over this time period.

I have a friend who was recently up before the GMC, very instructive and a major cause of anxiety. Despite his inner resilience, social network (and the referral being by a malicious colleague out for revenge) he did not sleep for months.

I can see how the GMC could break anyones soul.

The Nottingham debacle is perhaps for another day.

Happy Christmas.

Yes, it definitely is (in this morning's comment). DN may be talking complete nonsense, but he has always had a sense that most people who write more than a few occasional words have a personal writing style, such that just as with a speech pattern, we can recognise a writing pattern. Just as an example: "I was wondering on your thoughts on this spot of trouble..." (above) is a looser construction than say "I wonder what your thoughts are..." (perhaps more in normal style). Neither is right or wrong, just a matter of style, and as in many things, most of us have habits, with the latter being more in the Boots way, but then again there's nothing to stop anyone from putting the foot in the other boot, so to speak.

The year on year variation in the numbers of suicides is striking, but (in statistical sample number terms alone) these are small numbers so we should expect year on year variation. More generally, this touches on the question of identifying an epidemic when numbers are small. Has there been an epidemic of FtP suicides, with (to keep to the epidemic idea) a common 'source' (the GMC's behaviour? Overall increase in complaints => overall rise in number of FtP cases => overall rise in number of suicides?), or are we simply seeing random variation?

More generally, having had twenty-four hours to reflect on Stilton's choice of when to release the review, Dr No finds it stinks even more. It's the classic (and so deliberate - and don't even think of suggesting it didn't occur to him - you know what DN's reply will be - its in the original post and that Telegraph article) release bad news on a Friday before a major public holiday stunt. However, it hasn't worked. Pulse are already collecting data on individual doctors' experiences of GMC (mis-)conduct, and most doctors now have colleagues who have suffered at the GMC's hands even if they haven't themselves, such that very soon enough pressure will build up to mean considerable weight can and will be brought to bear. As hinted above, DN's current preference is to implode the GMC, by turning its rules on itself. He also strongly suspects the GMC's, or rather its staff, main defence when the time comes will be the Nuremberg defence, so we can be ready for that when it comes.

Dr No has no plans to spend Christmas diddling figures, but come the New Year he will fire up the main frame and get to work. In the mean time he wishes you one and all -

A Very Merry Christmas and a Happy New Year!

Nice country where crime is committed by top officials. Check out HONG KONG.


this country is such a fail comunity :)) officials are doing only what they want and only what brings them money and power. they don't have any interest in making population happy. burn the bad news! Andone