RACISM STILL EXISTS AT THE GENERAL MEDICAL COUNCIL
Joseph Loze Onwude
Apartment 51 Whitecroft Works, 69 Furnace Hill, Sheffield S3 7AH, United Kingdom.
Email: joeloze@outlook.com
Racism still exists at the GMC: A Personal View Based on Experience
The behaviour of the General Medical Council (GMC) can no longer be hidden as an allegory for doctors undergoing disciplinary hearings if judged by the decisions reached for white doctors and non-white doctors. Racism is still real for non-white doctors but it could not previously be labeled so because of the potential for backlash. But an appreciation of ‘Racism’ is a current issue and doctors are still too polite to say so.
The starting point is whether that doctor has ever felt discriminated against by the NHS. If not, this can soon change after he travels the corridors of the GMC in Manchester. As a doctor who has never felt discrimination in the NHS, after my own journey through the GMC corridors, I can declare that I never met a white doctor at five hearings over five years, each lasting 3-7 days BUT I met many non-white doctors who were ‘guilty but never found innocent’.
A white spinal neurosurgeon who admitted and was found guilty of dishonesty, serious misconduct for any professional and particularly for doctors, was spared any sanction by the General Medical Council Medical Practitioners Tribunal Service (GMC/MPTS)1. Another, a gynaecologic surgeon who did not admit to dishonesty because he was never charged with dishonesty, was found guilty of dishonesty by the GMC/MPTS. He was erased and immediately suspended2. However, the latter was completely cleared of dishonesty on appeal on the basis that the ‘tribunal was wholly wrong to have found dishonesty’3.
These two cases and the decisions on sanctions show what can be described as racial inequality in punishment after a finding of impairment based on dishonesty. Dishonesty with intention, called Mens Rea is especially serious. The dishonest neurosurgeon admitted to dishonesty with intention. He was not punished by the MPTS because he admitted all charges and was judged to have insight into his intentionally dishonest behavior. Subsequent to the index case, this surgeon was again referred for clinical misconduct to the GMC in a situation of consenting a patient wrongly but finding the mistake before surgery and two other situations of not following trust policy when removing chest drains. On the other hand, the gynecological surgeon who strongly refuted all charges of dishonesty was judged by the GMC as lacking in insight into his shortcomings.
Yet the sanction of erasure and immediate suspension pending an appeal was reached when there were no clinical complaints or any evidence of dishonesty, let alone, intentional dishonesty against the gynecologic surgeon. He was severely punished. At statutory appeal in the High Court where he defended himself, His Lordship Mr. Justice Collins summed up the situation perfectly: “that he got up their noses is clear, but still they had an obligation to act fairly, haven’t they”? You will remember that he was a black doctor.
The GMC/MPTS Sanctions Guidance4 does not give the GMC/MPTS the discretion to reach different sanctions for proven dishonesty based on insight. Dishonesty, a very serious misconduct, is always a very serious misconduct. And particularly if this can be shown to be an intentional or repeated offense, as in this case of the white neurosurgeon.
Therefore why would the GMC/MPTS dole out markedly different punishments? What was the obvious difference between these two consultant surgeons? The spinal neurosurgeon was a white man and the gynecologic surgeon was a black man.
Recent experience of these last few months, which have focused on racism suggests that white doctors who are unaware of the plight of non-white doctors with regard to racism and non-white doctors themselves will want to know how the GMC can prove dishonesty and then erase a doctor from the Medical Register in a situation where His Lordship, Mr. Justice Collins states that a finding of dishonesty based on the evidence is “a finding which no reasonable tribunal could conceivably have reached”?3
Secondly, why would the GMC, the supposedly independent legal assessor or assessors that should guide the tribunal on the matter of the law, and the statutory independent adjudicator (the MPTS) collude against registrants? Especially if they are non-white? The GMC has been saddled with issues of racism for some time.
The only possibility is that the GMC assumes non-white doctors are guilty and cannot be proven innocent. This is a problem or a perception that the GMC has to face. This is how non-white doctors feel. That is why non-white doctors commit suicide. Even criminals are assumed to be innocent until proven guilty, as a Human Rights entitlement (Article 6.1, HRA, 1998)6. Yet the GMC does not allow this basic right.
All non-white doctors will want to know why the GMC and Medical Practitioners Tribunal Service (MPTS) are still acting in concert, despite section 60 of the Medical Act 1983 (as amended in 2015) which makes them statutorily independent bodies. Apart from serious illness or death in the line of duty, for example through Covid-19, to erase a black doctor and immediately suspend him is the worst thing that can happen to a doctor, especially without evidence to convince Collins J, yet be lenient to a white doctor for intentional, repeatedly and admitted dishonesties?
One explanation is that the GMC and the MPTS do not appear to understand the concept of dishonesty and the gravity of this judgment. Another is that the sanctions for dishonesty are applied differently for white and non-white doctors. Collins J could not find enough phrases to describe the finding of dishonesty with the black Gynaecologist, quoting a few: “an impossible allegation”, “the charge is as close to nonsense as it comes”, “the tribunal was clearly wrong” and “the tribunal was wholly wrong”. So much so that Mr. Justice Collins ruled that the allegation of dishonesty should never be repeated in further hearings.3
On the face of it, this suggests that the GMC/MPTS tribunal might be guilty of dishonesty itself with its decisions. However, the sneering by GMC v Onwude in the 2015-2016 hearing by the Reverend Chairman of the Tribunal hearing was chilling and suggested that he was out of his depth, with incompetent legal assessors. Or better still, supposedly independent legal assessors are also racist because they were dealing with a black man without a lawyer. To say that they did not have the integrity to get up and get out of the hearing will hide the racism.
Mr. Justice Collins also opined that the appointment of a newly retired judge as Chairman of the MPTS would help towards the appointment of competent tribunal chairmen.3,4 The implications are clear that doctors may have been short-changed by the previous chairman of the MPTS, Mr. David Pearl who was an academic specialist on Muslim Law. A Muslim Law expert at the MPTS? – it must have been a job for the white boys.
Absent unnecessary repeated challenges to the High Courts which will show the GMC in a less omnipotent light, the only hope for doctors, apart from dismissing everyone currently involved with the GMC investigation committee and the MPTS, is Dame Caroline Swift, a retired proper judge who has now taken over as chairman of the MPTS.
Equality without racism in how all doctors are dealt with will be an important outcome for doctors. No one has recently suggested that the color of the skin is important in how the GMC and MPTS have dealt with all doctors but when you travel the corridors of the GMC and MPTS or look at the list of doctors who are suspended or erased, some doctors do feel the color of their skin, although most of them are British by nationality. This is pure racism. Unfortunately, the NHS needs these non-white doctors too.
Dame Caroline Swift has been recommended by another senior High Court Judge.3 Non-white doctors must believe that she will feel the pain from the racist inequality of previous or future decisions of the MPTS.
In 1996, Fiona Godlee, then an editor of the BMJ, now the Editor in Chief wrote about ‘The GMC, racism, and complaints against doctors’, There is no doubt that the concerns expressed in 1996 still existed in 2017, on the basis of one clear case or others up to 2020. This seems to be similar to the BAME issue with our pandemic Covid-19. Even Covid-19 seems to be racist!.
In reporting the findings of the GMC-appointed Policy Studies Institute for Racial Equality Group to look at the handling of complaints against doctors, Dr Godlee wrote that when the GMC was asked to define serious professional misconduct, the GMC turned to the words of Lord Justice Scrutton in 1930: it is "no more than serious misconduct judged according to the rules, written or unwritten, governing the profession".8 The report concluded that these rules remained obscure, and as long as that is the case the GMC's proceedings can never be entirely open. This obscurity is especially evident in the screening stage. The two subsequent stages take place in committee and are therefore less vulnerable to subjective interpretation. In contrast, the three screeners currently act in isolation, with limited written guidance in the form of an internal GMC training note describing some behaviors that are considered not to constitute serious professional misconduct.
This obscurity in GMC procedures, summarized in 1996 by Fiona Godlee still allows the GMC to be racist against non-white doctors.
A previous Editor in Chief of the BMJ, Richard Smith, thought the GMC was not fit for purpose for other reasons. There are many publications that show that the GMC is not fit for purpose and there are many historical publications to back this9.
The GMC maintains its entity on the basis of self-regulation of the profession. Not many doctors believe that they can regulate anything.
The GMC is treating non-white doctors in a similar way that Covid-19 has treated them – racist and kill.
References
1. Surgeon who operated on the wrong vertebrae has no action taken against him BMJ 2017; 357: j1817 (Published 10 April 2017).
2. Gynaecologist is struck off for dishonesty and intention to cause distress BMJ 2016; 355: i6828 (Published 22 December 2016).
3. Onwude v GMC [2017] EWHC 601 (Admin).
4. http:// www.mpts_uk.org/dc4198_sanctions_guidance_dec2015_6489662.
5. MPTS. High Court Judge Made New Chair of Doctors Tribunal Service.
6. http://www.mpts-uk.org/about/news/11160.asp.
7. Article 6 Human Rights Act 1998.
8. Fiona Godlee. The GMC, racism, and complaints against doctors. BMJ 1996 (7402), 1314-315.
9. Allen I, Perkins E, Witherspoon S. The handling of complaints against doctors. Report by the Policy Studies Institute for the Racial Equality Group of the General Medical Council. London: Policy Studies Institute, 1996.
10. Richard Smith. The GMC: Approaching the abyss. BMJ 2001: 322, 1196.
Comments
Post a Comment