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while browsing the HPC site I came across a suprising number of 'Fitness to Practice' hearings, involving Podiatrists http://www.hpc-uk.org/complaints/hearings/ Some are quite straightforward, but as you read others, it seems that the HPC is being used in place of an internal discipline procedure by some employers. For example, is convening a fitness to practice hearing on an employers allegation of 'viewing websites during working hours' a relevant way to spend our fee's?, with all the undoubted costs of so doing. Should the HPC send cases like this back to employers and instruct them to set their own houses in order? Or, are NHS administrators not capable of this.
It is far easier for an NHS Manager to report a Podiatrist directly to the HPC.
That way, the Trust does not have to become embroiled in possible litigation.
Sadly, our fees will be spent any way the Government wants.
Cheers,
davidh
This is a serious issue for the profession and it is not just restricted to NHS employees. The HPC is legally bound to investigate all complaints against registrants, whatever the source of the complainant. I think initially it was thought that this process would facilitate the public in cases of malpractice in making redress against an errant practitioner, however the fitness to practice mechanism is being (ab)used more widely - with the example you cite whereby employers are circumventing their own disciplinary process (which can prove onerous and costly in legal fees should the case be unfounded). It can also be used to "settle old scores" between practitioners where there is a history of "bad blood". I have experience of the latter.
Almost two years ago some of my personal papers were interfered with and some contents of my own domiciliary case had been removed (business cards, dental needles, local analgesics) when I was absent from a clinic in which I was working. The following day I discovered that two members of staff had carried out a medical equipment audit in my clinic when I was away (no other employees had access to my room). As these papers contained correspondence from government Ministers and officials from the DOH, I was extremely concerned given that one of the members of staff was a union representative and, for obvious reasons, I didn't wish the contents of the correspondence to be further divulged.
When I learned the identity of the employee I contacted them by telephone and asked directly whether they had read my papers. They were extremely evasive and denied all knowledge of my file - something I found difficult to believe given that I had left it on top of my computer keyboard and it had been moved. The employee's log-on details were also on my computer when I returned. Although I was direct with my questions, I was also courteous and professional, but I finished the brief conversation by telling them I didn't believe what they said. As a result of that conversation I was notified by the PCT a few weeks later that the employee had lodged a claim of bullying and harassment against me.
Subsequently that claim was investigated by the PCT management and was proved to be unfounded. An external diagnostic review of the podiatry service, undertaken later that year, found that there was an established history of abuse of the Trust's grievance procedures by the Union representatives in making malicious and vexatious claims against colleagues and management.
Last December - a year later - I was informed by the Trust's Chief Executive that they had received a request from the HPC for information regarding myself as they (HPC) had received a complaint against me through the fitness to practice procedure. I was not notified by the HPC. This complaint primarily related to the bullying and harassment claim made previously, but also a complaint was made that an out-fo-date POM (topical antibiotic) had been found in the surgery, which I was not entitled to prescribe or use. This antibiotic had been left by a patient for disposal. The Trust initiated another investigation which also concluded (in March this year) that the claim was without foundation and a copy of their report was forwarded to the HPC as requested.
I contacted the HPC fitness to practice division when I was made aware of the complaint but was informed that they would only contact me if, as a result of their preliminary investigations, the case was to be forwarded to a formal hearing. I was not given a copy of the complaint, nor would they disclose the identity of the complainant - although I am aware that they are the same person that made the complaint to the PCT in the first instance.
The HPC holds the report from the Trust. They have not yet dismissed the complaint as they have written to the complainant inviting them to make comment. If the HPC decides there is no case to answer, I am advised that will be the end of the matter, but I will not be entitled to receive a copy of the complaint, nor will they be bound to disclose the identity of the complainant to me. To date, some eight months after I first became aware that I was being investigated and four months after the Trust formally concluded their second investigation, I am still awaiting the outcome of the investigation by the HPC. If this goes on much longer I am seriously considering changing my name by deed poll to 'K'.
Speaking generally, I am concerned that the disciplinary process at the HPC can be abused by people making unfounded, malicious and vexatious claims against colleagues - for whatever reason - without it seems, any redress being taken againt the complainant by the regulator - when such claims have been proven to be so. My feeling is that this should not only apply to fellow registrants but also members of the public. If a woman makes an accusation of rape againt a man, and that accusation is found to be malicious and unfounded, she will herself be prosecuted. The same principles do not seem to be applied to the complaints procedure at the HPC.
Thus it begs the question - who regulates the regulators?
Mark Russell
__________________
"citing an indisposition due to special circumstances"
Mark, That is MOST disturbing and can I express my sympathy. I don't, nor will ever in the foreseeable future, work in the NHS. But, as all registrant Podiatrists are, I believe, perceived as one profession by the Public, if a scenario is evolving where members of the profession are repeatedly accused of 'unfitness to practice' then does it not tarnish our entire group image in the eyes of the Public?. Guilt by association, no smoke without fire, mud sticks etc - all the usual homilies. Public perception being what it is, the accusations will be remembered long after the innocent or not proven verdicts. The fact that this mechanism is apparently being abused, in all the ways your post highlights, should be ringing very, very, loud alarm bells throughout all the professional associations who collect our annual subscriptions and promise to represent our rights as individual practitioners. Until reading through the HPC site's list of hearings last night, purely from curiosity, I had no idea that such an astounding number of alleged 'unfit to practice' cases were in the system.
Certainly the Society is aware of the complexity of the registrant hearings now being tabled and of the ramifications for the wider profession and the general public. We were asked to consider last year, in a consultation document on regulation, the possibility of the HPC extending their regulatory clutches to students! Can you imagine? Such is the present climate I would have second thoughts on getting rat-faced in a public place; making aggressive comments to colleagues online (who, me?); engaging in a spot of playfulness al fresco; swearing at traffic wardens - indeed anything that the HPC, government or popular press would consider unbecoming of a health professional - even though it may not have any bearing on your ability to treat patients. God knows what they would do if they found out about my twice-weekly cocaine-fueled S&M parties....
......just kidding of course (regrettably it has to be said), but on that particular subject you may recall a post on the JISC Mail site some years ago by Maire Murphy about an enquiry she received from a dominatrix who used to suspend her clients by their toes. http://www.jiscmail.ac.uk/cgi-bin/we...0tiscali.co.uk
I thought this was an interesting post for two reasons - firstly there is an issue about how long to apply tourniquets when the digit has not been adequately exsuanginated, and secondly, what ramifications are there for clinicians who give advice to third parties - in this case a dominatrix - who may then go on to cause grevious harm to themselves or others by maladministration of the original advice. It was also an unusual post on a podiatry website, so I copied the link to JISC Mail to my colleagues in the NHS department and asked them for their opinions.
Subsequently, on the basis of that email, I was reported to the PCT management for inappropriate sexual advances by the Union representative as Marie's post contained the word "dominatrix"! Crazy or what?? That too was dismissed as unfounded.
I cannot comment further at this point on my own investigation for obvious reasons, but suffice to say that professional relationships within the NHS are, in some areas, quite dysfunctional, which is just one of the reasons I am now in full-time private practice.
Mark
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"citing an indisposition due to special circumstances"
Just to add another point to the previous; I know I should not be suprised at anything in my fifth decade, but the Star Chamber connotations of what's going on are very disturbing. And most of us apparently have no idea! This subject really needs dragging out of the woodwork - if employers, and others, are (ab)using this system, how long until the public catch on and see it as a gateway to c-o-m-p-e-n-s-a-t-i-o-n?. If negligence claims rise dramaticaly, we will all see our insurance premiums rise, because win or lose such claims, it costs money to defend them.
I've received a number of emails from correspondents who enquire to the relevance of 'K' - as a prospective change of name. This relates, of course, to the story of Joseph K by Franz Kafka in 'The Trial', as I'm sure most of you literary fiends will be only too well aware.
Kafka's The Trial follows a man, K., as he is arrested and released for an unknown offense and attends a series of bizarre trials. He tries to comprehend and extricate himself from an outrageous course of events, which transpire suddenly in his life. K. is persecuted by this unimaginable court, which seems to hold a quasi-authoritative place in society. K.'s life seems to spiral out of control while he and the reader struggle to understand what is going on. Kafka uses this piece to criticize bureaucracy, even in a seemingly democratic society. Kafka believes that bureaucracy is endangering the freedoms of the individual in modern society and that it is extremely detrimental to society in the long run.
Kafka is trying to relay a message of criticism that he hopes will make society wake up to the injustices that threaten individual freedoms. Kafka holds an important place in literary history himself. "He is considered one of the most significant figures in modern world literature; the term Kafkaesque has, in fact, come to be applied commonly to grotesque, anxiety-producing social conditions or their treatment in literature". Kafka's style and message lives on through his literature to this very day. His message to beware of unwieldy bureaucracy and tightly guard our personal liberties is still valid to this very day.
__________________
"citing an indisposition due to special circumstances"
Mark said "Iwould have second thoughts on getting rat-faced in a public place; making aggressive comments to colleagues online (who, me?); engaging in a spot of playfulness al fresco; swearing at traffic wardens - indeed anything that the HPC, government or popular press would consider unbecoming of a health professional - even though it may not have any bearing on your ability to treat patients. God knows what they would do if they found out about my twice-weekly cocaine-fueled S&M parties...."
Never mind about "K". Where are the parties held and can we all come....
I have yet to go to party and receive a negative reply to my question "have you got Brandy" so can only assume your previous question was a deliberate attempt to deceive the 'Watchers' about your constant attendance at these functions (can I legally use that word?)
Just out of interest.....has anyone else received duplicate certificates from the HPC in recent weeks? I received my renewal cert four weeks ago and another arrived this morning. Any similar experiences?
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"citing an indisposition due to special circumstances"
The 'identity card' that came with mine, bearing a swanky hologram with my 'secret number' on the back has me puzzled. Can I use this to withdraw funds from the HPC............. Oh, sorry, thats already been done hasn't it? The way they are printed also suggests I can use the title LA as well as C & P. This has always puzzled me. "Today Matthew, i'm going to be a LA". Is anyone forming a Society of LA's, if I study really hard could I become a Consultant LA? So many questions, so little time.
Martin
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Darn it Jim, I'm just an old country Chiropodist - not a miracle worker
Martin Harvey LA...you go for it. Phooar get those fees up with an honour like that. My words the HPC is making this private practice thing easier by the day....
Mind you, I'm a little concerned that the HPC sent me a subliminal message on my "identity card" cunningly disguised as an HPC password. Did you get one as well??
My message starts with the word "SUE" followed by a 6 figure sum.
Wooaaooww....I'd better start watching my back given my reputation.
Just wanted to give an update on my own case with the HPC. Readers who have followed this thread will know that I have been under investigation by the HPC Fitness to Practise division since December 2005 following a complaint by a colleague in a NHS Trust. As stated previously, her complaint was citing inappropriate behaviour (bullying & harassment) towards her and others together with the illegal use of prescription only medicines on a patient. These complaints were previously investigated by the PCT and an outside agency who concluded that the allegations were without foundation and that some were of a malicious and vexatious nature.
Unperturbed by these findings, the complainant then made the same allegations to the HPC which was supported by selective documentation and the regulator then commenced a 14 month investigation of its own. I was invited to comment at the end of the FTP investigation, before the matter was sent to an investigative panel who would decide whether or not to proceed to a formal hearing.
The panel met on 24 January and concluded there was no case to answer and no hearing would be required. Given the previous history I was concerned that the complaints process could be open to abuse by registrants or the general public who sought to manipulate the disciplinary process in order to settle old scores, by subjecting practitioners to an investigation by the regulator, and in this regard I wrote to the HPC to enquire what mechanisms could be considered to discourage malicious or unfounded allegations. The correspondence with the HPC follows, but I would be interested to hear the views of the forum as to whether in cases of malicious complaints, the costs of the investigation should be recovered from the complainant - especially in light of the increase in fees proposed by the HPC to cover the projected expenditure of future investigations/hearings.
Mark Russell
Quote:
Dear Mr Russell
Health Professions Council Investigating Panel
I am writing to advise you that following its meeting on 24 January 2007, the Investigating Panel determined that there was no case to answer in relation to the allegation that had been made about your fitness to practise.
The reasons why the panel reached this decision are as follows;
“The Panel considered all the information before it today, including the response from Mr Russell.
The Panel note that the Trust carried out detailed investigations in relation to Mr Russell, and the matters that have now been raised with the HPC. The Trust has no complaint in relation to Mr Russell’s fitness to practise and is fully supportive of him.
The Panel acknowledges that Mrs D and some of her colleagues may have considered the working environment to be difficult, and may have had differing opinions with regard to the management style adopted by the Trust.
Mr Russell’s approach in the work place may have come across or been perceived as aggressive by colleagues, however, this does not indicate that Mr Russell has behaved in an inappropriate manner.
The emails that Mr Russell sent were anonymous and were permitted by the Trust and the patient concerned. The content of one email could be considered inappropriate, however, the Panel considers that this alone would not be enough refer the matter, or to amount to impairment of fitness to practise.
With regard to the particular relating to prescription only medicines, the Panel is satisfied that there was a credible explanation for the storage or this.
The Panel has also taken account of the references and letters of support provided by Mr Russell and in particular the letter dated 23 January 2006 from Mrs X, the Assistant Chief Executive of Wyre PCT. The Panel has formed the impression that the allegations made, seem in part, to be a reflection of the quality of management of the Wyre PCT as much as any failing on the part of Mr Russell.
Having considered all the information the Panel does not consider that there is a case to answer in relation to Mr Russell’s fitness to practise.”
I am also obliged to inform you that the Health Professions Council (Investigating Committee) Proceedure Rules 2003 provide that, in determining whether there is a case to answer in relation to a complaint, the Investigating Committee may take account of any other complaint made against the health professional in the previous three years. I therefore have to inform you that this case may be taken into account (if relevant) in the consideration of any subsequent allegation.
If you need any further information please do not hesitate to contact me.
Yours sincerely
Eve Seall
Fitness to Practise Manager
Quote:
Dear Ms Seall
Health Professions Council Investigating Panel
Thank you for your letter of 24 January which outlines the deliberations of the Investigating Panel in respect of the complaint made against me by Mrs D. Although I am grateful with their conclusion, I would like to take issue with some of the comments made.
The Panel writes:
“The content of one email could be considered inappropriate, however the Panel considers that this alone would not be enough [to] refer the matter, or to amount to impairment of fitness to practise.”
As none of the investigations carried out by the Trust or its agents came to the same conclusion - i.e. “could be considered inappropriate” – I would be grateful if the Investigating Panel could direct me to the guidance for registrants on what is considered appropriate in terms of clinical and ethical debate between colleagues.
and
“The Panel has formed the opinion that the allegations made, seem in part, to be a reflection of the quality of management of the Wyre PCT as much as any failing on the part of Mr Russell.”
If this sentence had read “rather than any failing” instead I would have no complaint, however it suggests that there has been failings on my part and this was certainly not the conclusion of any investigation by the Trust or its agents. Could you clarify exactly what is meant here?
Finally, I am a little disappointed that the Panel did not comment on the veracity of this allegation. From the documentation, which was made available from Wyre PCT, it was clear that there was an established pattern of malicious, vexatious and unfounded allegations made by Mrs D and some of her colleagues, against myself and others, over a considerable period of years.
Whilst I fully understand the role of the regulator and its responsibilities in investigating allegations made against registrants, I am concerned that this process may be open to abuse. In that respect I would offer the opinion that some form of mechanism should be considered to discourage unfounded or malicious complaints. This particular investigation was conducted over a twelve month period and will have cost registrants dearly in terms of time and expenditure by the FTP team, not to say anything for the emotional distress suffered by myself during this period.
I look forward to hearing from you in this regard.
With kind regards
Yours sincerely
Quote:
Dear Mr Russell
Thank you for your email.
As I explained to you on the phone, I am unable to answer all of your queries in detail as I played no part in the Investigating Panel’s decision making. The Investigating Panel meets in private and the outcome of the meeting is documented in the decision which has been sent to you. I am therefore unable to expand further on the specific points you have raised. I am also unable to seek further clarification from that panel that sat and considered this matter on 24 January 2007 as our panel’s are made up from HPC’s partners and the same panel will not reconvene as constituted on the day on which they considered your case.
There are no specific guidelines issued by HPC as to what is considered appropriate in terms of clinical and ethical debate between colleagues. When considering a case the panel will take into account HPC’s Standards of Conduct, Performance and Ethics, however, these are not exhaustive.
Whilst I acknowledge your concerns about abuse of process, HPC has an obligation under the Health Professions Order 2001 to investigate all complaints that are received with regard to fitness to practise. We review our processes regularly, but are bound by the legislation under which we operate. It is rare that HPC receives a complaint that could be considered as malicious.
When investigating a complaint at this initial stage, HPC is seeking to obtain all relevant information, not only information which supports the complainant’s case. As in your case, where the information presented to the panel does not satisfy them that there is a case to answer the matter is closed. It can sometimes take time to obtain all the relevant documentation to enable the Investigating Committee Panel to reach a decision as to whether there is a case to answer. The time it can take to obtain this information is often outside of HPC’s control as we are seeking information from third parties.
Whilst I have not been able to respond to the points which relate to the panel’s decision I hope that this does explain the process to you further.
Regards,
Eve Seall
Fitness to Practise Manager
Health Professions Council
__________________
"citing an indisposition due to special circumstances"
A friend of mine here when through the same thing. A couple of vindictive ex-employees made a complaint to the Registration Board with a long list of allegations. The investigation took the Board a huge amount of time and resources, not to mention my friends time and resources to respond. At the end of the day absolutly nothing was found and the two vindictive ex-employees get off scot-free .... they should be made to pay for all the wasted resources for the investigation.
Maybe the Board should 'name and shame' the false accusers .... at least word is spreading as to who they are and it WILL affect there future employment prospects .... what comes around, goes around.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
Thanks Craig - and to everyone else who has sent their kind wishes and support over the last year. It is much appreciated.
I wish I could say that the matter has not troubled me greatly, but that would not be true. Even though I had the benefit of knowing previous investigations had exonerated me, being the subject of a FTP investigation by the regulator has caused a great deal of worry, for I was unaware until I had read all the papers just what was being said without my knowledge. A great deal of the material submitted was subjective and a lot just plain lies, however I was fortunate insomuch as the PCT had a documented case history of the character in question and when clarification was sought, it shed new light on her evidence. Thankfully the investigative panel saw this for what it was and the matter was closed once my submission was made, but it is concerning all the same that such spiteful and unprofessional behaviour could be allowed to progress to this stage. Whilst I might expect claims to be made from disgruntled patients, I would have thought different from colleagues, but I guess we all know individuals whose judgement and morals may be questionable.
As you say it should be a matter for the registration boards/regulators to seek recompense for outlays when malicious claims are made, but the present environment is not conducive to protection of the registrant or the registrant body, as we are beginning to find out.
Kind regards
MR
__________________
"citing an indisposition due to special circumstances"
Good to hear you are not down, or out. Once upon a time I complained about an employer to HPC and despite assurances all would be done to investigate the matter thoroughly. I am still waiting years later to hear of the outcome. Obviously HPC find it more convenient to adjudicate over their resgistrants than the nasty employers who engage them.
I think that there is a very disturbing point here mentioned by Cameron. In the iniquitous (IMO) operations of the HPC, Mark was 'named and shamed' for months although he was subsequently found to be blameless. In British law, the accused has the right to be faced by his(her) accuser. Is the HPC above the law? Is the accuser not to be named, at least following the accusation?
Just to clarify, Bill, although I was under investigation by the HPC for 14 months, I didn't suffer the ignominy of being named and shamed on their website - that would have happened though if the investigative panel had decided to place the case before a formal hearing. What was concerning, however, is that the regulator can carry out an investigation without notifying the registrant that a complaint has been made. Indeed I only found out when my chief executive telephoned to advise they received a request for information and asked my permission to divulge personnel records and details of the previous investigations.
In my opinion, the regulator should advise the registrant the instant a complaint has been lodged - most other regulatory bodies do so - the GMC, GTC & etc., so why not the HPC?
Kind regards
MR
__________________
"citing an indisposition due to special circumstances"
I totally agree with the points you make. Even though it was not relevant in your case, I still feel that the accuser should be named where a formal case is to be heard - and the individual supplying the information where an accusation is made by an NHS Trust.
Finally, 14 months! As you will know, there is a television programme named 'Waking the Dead' in the U.K. in which unsolved old crimes are investigated by a forensic team. Some of the closed cases are less than 14 months old!
All the best
Bill
Last edited by W J Liggins : 16th February 2007 at 05:12 AM.
Reason: mispelling
hi fellow pods
i recentley posted on the scp website regarding the podiatrist suspended for 6 months for having a fight with his parents.he ended up with a caution of which the hpc was automatically notified! nothing to do with hs clinical practice! it is becoming a big brother outfit, your private life is no longer your own,and although most of us are concientious professionals, there may well be occasions when we find ourselves in a situation inadvertantly.
on balance, I would now happily renounce my so called protected title of chiropodist/podiatrist for a private life. when the hpc actually look at hands on clinical skills I will have more respect for them.
Look thro the fitness to practise section of the hpc site. it is daunting- but a lot of our members are totally in the dark because they do not keep aware of what is going on in the profession.
Hi All
Is the HPC just another arm of the governments "secret police" ??
We are now told what we can do , say, think, see.
What we can watch ,listen too, where we can go and all the time we are watched our voice, internet usage, lifestyle and personal details / habits are monitored.
The nanny state is all powerful and secretive and the Government so blatantly corrupt.
>What was concerning, however, is that the regulator can carry out an investigation without notifying the registrant that a complaint has been made.
I wonder how that would go if challenged legally? Under the laws which govern freedom of information there may be a very serious breach. It would be interesting to get a legal opinion.
In my own case sometime after I complained about my employer I wrote to the HPC requesting I receive all correspondence referring to my name under the Freedom of Information laws. I received by return copies of communications from my ex employer to HPC (none of which I was aware of previously). The contents of the letters contained both misinformation and innuendo. Until this time I was unaware my professional reputation had been brought into question and by not being so informed (by HPC), was prevented from a right of reply. I wrote back with clear evidence to counteract all allegations.
I am still waiting an outcome of HPCs enquiry nearly 18 months after I contacted them with my concerns. To the best of my knowledge the last meeting on the matter was over 12 months ago.
It must be easier for HPC to police their registrants rather than the employers that employ them. Yet to do so must leave the system open to potential abuses.
There are plenty contentious issues here, Syd. The fact that an investigating team can gather 'evidence' without seemingly any corroboration and submit it for consideration to a panel comprised of partners, which may include lay persons, who will then decide whether or not to proceed to a hearing (and in the process, publish the registrant's name on the website), is deeply troubling. Of course, the registrant is given an opportunity to comment before the panel convenes, however, in my own case, the volume of submitted material was substantial and much of it fabricated. This takes time to rebut and some of it - such as uncorroborated statements from third parties - is almost impossible to do. For example, the complainant who lodged allegations against myself included a supporting statement from a friend - an assistant who was party to a collective grievance - who wrote:
Quote:
"One patient actually asked me if Russell was a pervert because he was shocked by the conversation he had had. I feel if you ha[d] the opportunity to speak to some of his previous NHS patients you would have good reason to be concerned about his practice.”
There was no evidence whatsoever to support this claim and in all the time I worked with this PCT (indeed at any time throughout my 24 years in practice), I have never had any allegations of this nature made against me. This assistant had never previously made any such statement during the previous investigations and it was a blatant attempt to blacken my name. To rebut this accurately would have meant going back to my caseload and obtaining statement from all patients previously seen by myself - a difficult if not impossible task - but instead I had to rely on character statements from colleagues, staff and supporting letters from some patients who kindly wrote during my employment. In my opinion, the regulator should have insisted on evidence from the complainant to corroborate the veracity of her statement, and if none could be produce, I believe they should have been held to account for making false accusations. But it doesn't work that way.
In addition, the HPC are presiding over a considerable number of allegations submitted by employers against their employees. It is less of a risk for PCTs than to instigate the normal disciplinary procedures against staff - a difficult employee or where there has been a breakdown in relations between management and staff - report them to the HPC for ineligible handwriting, poor communication, incomplete case histories or any other minor matter - and they might just get lucky and get the desired result.
Remember - the HPC partners who make up an investigating panel, are ordinary members of the public and some health professionals who are likely to have no experience of presiding over investigative procedures, in what has become an increasingly complex and convoluted process.
Kind regards
Mark
__________________
"citing an indisposition due to special circumstances"
Doctors lose the right to police themselves under tough reforms
Quote:
Doctors will lose their right to police themselves under proposals to be announced by the Government today, The Times has learnt.
As part of reforms aimed at preventing another Harold Shipman tragedy, ministers are expected to curtail the role of the General Medical Council by stripping its powers to discipline and prevent doctors from practising.
The GMC, the regulatory body for the medical profession, is also set to lose its medical majority, putting an end to the professionally led regulation that has been enshrined for nearly 150 years since its foundation in 1858. Ministers will announce the changes to Parliament in a White Paper.
The British Medical Association said last night that eliminating the principle of self-regulation would not be in the best interests of patients.
The White Paper is expected to contain plans to test doctors with “MoTs” every five years to ensure that they are fit to practise. Doctors will also lose the right to sign off death certificates on their own, without further scrutiny. All deaths will have to be certified by at least two doctors, as is currently the case for cremations but not for other funerals. Patricia Hewitt, the Health Secretary, is proposing that all death certificates should be completed by the certifying doctor but then scrutinised by a “medical examiner”, attached to a local NHS hospital or trust, who will have full access to medical records. The reforms are designed to catch dangerously incompetent practitioners or rogue doctors acting in the manner of Shipman, Britain’s biggest serial killer, who falsified details on death certificates that allowed him to murder up to 250 of his patients.
The proposals come after recommendations by Sir Liam Donaldson, the Chief Medical Officer, made in a broad review of medical regulation after the Shipman inquiry and other recent investigations into doctors’ conduct and standards.
In a move that will further undermine the role of the GMC, the Government is expected to recommend that fitness-to-practise cases be judged on a sliding scale of proof, where the evidence required is determined by the severity of the misdemeanour.
Critics said last night that switching the current criminal standard of proof, beyond reasonable doubt — required to strike a doctor off the GMC register — to the lesser civil standard, the balance of probabilities, could result in miscarriages of justice for doctors.
The GMC declined to comment on the White Paper last night before its official release, but it is understood that its adjudicatory role was one of the powers it had hoped to retain.
It is unclear who will take on that role, but Sir Liam’s original report, Good Doctors, Safer Patients, suggested that the GMC could be responsible for investigating and assessing serious cases of fitness-to-practise, while independent panels comprising legal, medical and lay representatives conducted the actual adjudication hearings.
Another option would be to pass that responsibility to the Council for Healthcare Regulatory Excellence, an overarching quango that was granted the right to appeal against GMC rulings in 2004.
A BMA spokeswoman said last night: “If the GMC was to lose the adjudication process and there was no longer a medical majority of elected doctors on its council, that would drive a nail in the coffin of professionally led regulation for doctors.
“There would be concern that with many doctors working in the state-owned NHS, for a monopoly employer and regulated by a body controlled by Government, the clinical independence of doctors could be threatened.”
The BMA said that it would be opposed to abandoning the criminal standard of proof in fit-ness-to-practise hearings: “When a person’s livelihood is at stake it cannot be just to rely on a balance of probabilities.”
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"citing an indisposition due to special circumstances"
Once we have correctly identified the registrant the complaint is about, and confirmed that it is a complaint we can consider, we will:
ask for more information if necessary (for example, we might ask for further documents from an employer or ask the police for the circumstances of a conviction);
write to tell you about the complaint, enclosing copies of all the documents we have; and
invite you to respond in writing to the complaint within 28 days of our letter.
These quotes are taken from the HPC website therefore it would imply that registrants are informed when a complain is made.
The HPC partners have in fact quite a lot of experience in dealing with investigations and legal work - a number of the Lay partners are GMC partners also, some have been in the judiciary and are also ex lawyers etc. I think that registrants are unaware of who sits on panels both as registrant and lay partners which may go part of the way to allowing confusion - there seems no way of being advised as to what background the partners have when they apply. This year Partners are being asked to reapply for their places on HPC and this will take place some time this month with a ne contract being active from July.
These quotes are taken from the HPC website therefore it would imply that registrants are informed when a complain is made.
That is incorrect. The HPC will inform you when they have completed their investigation and have gathered all the 'evidence'. They will then write to you and invite you to respond. In my case, a third party informed me that the HPC were seeking information and I approached the FTP team who confirmed they had received a complaint two months prior. If my employer had not notified me I would not have been informed by the HPC for 12 months.
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The HPC partners have in fact quite a lot of experience in dealing with investigations and legal work - a number of the Lay partners are GMC partners also, some have been in the judiciary and are also ex lawyers etc.
That is not the opinion of many legal teams who have direct experience of the HPC and its process for dealing with registrants, in fact, quite the opposite.
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"citing an indisposition due to special circumstances"
That may be their case but perhaps if the opinion has not gone their way they are biased. I also am a Registrant partner and have been on Investigative panels as well as conduct and competence therefore I speak from actual experience of events from an 'insider' viewpoint which is something so far none of the parties seem to be able to!
Is this relevant for the HPC?
if I study really hard could I become a Consultant LA? So many questions, so little time.
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