Written Evidence submitted by St. George St. Strategic Consultancy (CRC0063)

 

Executive Summary

 

  1. This submission is particularly about malicious and unlawful handling by the NHS-managers, of concerns raised by staff about care given in the health and care sectors; the consequences of raising concerns for the employment prospects of staff and nexus between the NHS & professional regulators with regard to complaints and concerns.

 

The UK National Health Service (NHS):

 

The Medical Act, 1983 (as amended aka serially molested & deformed):

 

The General Medical Council (GMC):

 

Evidential facts:

 

  1. Today GMC is the ‘monopoly statutory regulator’ of medical practitioners in the UK, governed by the Medical Act, 1983. GMC had a motto: “Protecting Patients, Guiding Doctors” On 17.12.2002, ‘The Medical Act 1983 (Amendment) Order 2002’ (S.I. 2002/3135) inserted s1(1a): “The main objective of the General Council in exercising their functions is to protect, promote and maintain the health and safety of the public.” This was the same objective as that of the NHS!

 

  1. The GMC is inextricably intertwined with the government-monopoly employer the NHS so as to a part of the DoH & other state machinery. It is not an independent regulator.
  2. The Council of the GMC that once had 104, then 35, 24 and now 12 members have serious conflict of interest with the NHS. All members of the Council-of-trustees are wholly appointed by the UK Government. Most, if not all, GMC members have a background with ‘NHS management and law’ or are connected to the Government establishment like police, judiciary, church and some are or have been MPs in the ‘expenses-scandal parliament’. Thus everyone connected with the GMC is invariably in direct & grave ‘conflict of interests’ to be neutral or independent; particularly when dealing with (i) doctors working as NHS-employees of the monopoly-NHS-employer, and more so (ii) doctors working privately outside the NHS and (iii) those doctors who have some ongoing or had a previous employment-conflict and/or litigation involving their UK-NHS ex-employer /colleague(s) as the respondent /defendant(s).

 

  1. On 31.1.2000, Harold Shipman was convicted of murdering 15 of his patients, a public inquiry found him having killed over 200 his patients over previous 20 years in formal knowledge of the GMC and under its administration of the ‘old’ Rules. None of the relatives of Shipman’s >200 dead victims could obtain any redress by compensation from the GMC’s for its negligence over previous 2 decades.

 

  1. In March 2001 GMC published a document “Acting fairly to protect patients: Reform of the GMC’s fitness-to-practise procedures’. Section 5 was entitled: “Separation of functions within the fitness to practise (‘FtP’) procedures.” The ‘reform’ continues!

 

  1. Although GMC’s publications, website and press-releases always seem to say the right words public and media expect to hear or read; the disciplinary sanctions “if any” are discretionary to subjective arbitration, for any panel decisions to be fair, consistent or lawful. To date the GMC has failed to publish or ‘declare standards’ of professional conduct that are clear, based on objective criteria, thresholds, grades of misconduct without mutual conflict; and with mandatory tariff of consistent sanctions similar to e.g., traffic speeding offences. GMC has failed (i) to ‘declare’ to doctors, by setting out the specific standards of professional conduct expected from doctors, any objective criteria, thresholds, grades  of misconduct or definitions of ‘impairment’ vis-à-vis specific consequences for any breach(es) of the same, so that GMC could ‘uphold’ the same by disciplinary regulation, (ii) institute and operate procedures and processes which are fair, objective, transparent and free from discrimination; (iii) bring its procedures in line with ‘current and emerging equality legislation’, or (iv) to adhere to the letter and spirit of this legislation, namely Race Relations Act, 1976, Defamation Act, 1996; Harassment (Protection From) Act, 1997; Data Protection Act, 1998; Human Rights Act 1998 and Equality Act 2006.

 

  1. Additionally, the GMC’s current fitness-to-practise [sic. ‘complaint-handling’] procedures, practices, the statements on the GMC website & other publications ‘guidance-documents’ are all arbitrary, ambiguous, subjective, biased, circular, non-standardised, confused, conflicting, inconsistent, irrational, absurd, and thus in direct violation of other UK Statutes, in the main the Harassment [protection from] Act, 1997; Human Rights Act, 1998; Data Protection Act, 1998; and the Equality Act, 2006 as well as the Sex, Race & Disability Discrimination Acts of the 1970s, consolidated in the Equality Act, 2010. GMC continues to breach its statutory duty pursuant to contravene ss1(1A), 35, 41 Medical Act and deceiving the general public and doctors who are forced to fund it.

 

  1. On 9 November 2001, GMC attained the status as a registered ‘UK Charity’ by misrepresentation of its work before the Charities Commission, reversing GMC v Inland Revenue Commissioners [1928] All ER 252. Almost everything that the GMC does could not ever qualify as a ‘charitable’, seeIts income is exclusively from doctors, by mandatory subscription on penalty of removal from its registers, and income from conducting PLAB tests, by misrepresentation of training opportunities in the UK over which the GMC has no control. The GMC has no jurisdiction over all its beneficiaries “general public / mankind” (!)

 

  1. On 9.12.2004, the Fifth Public Report of the Shipman Inquiry was published (over 9 years ago). The report found GMC had a ‘culture of mutual self-interest’ of protecting dangerous and dishonest doctors by abuse of its ‘fundamentally flawed procedures’ (‘old’ Rules, SI 1988 No. 2255), which were ‘not fit for the purpose of protecting patients’, e.g. in the main, over 200 victims of Harold Shipman over 20 long years; & also of Richard Neale, Jane Barton and several others’ victims of dangerous practice, dishonesty, fraud, rape and murder. Dame (as she then was) Janet Smith, LJ also reviewed the ‘new’ Rules and concluded that they had the same flaws of the old rules, or worse and were not fit for the purpose (of ‘protecting patients’ from bad, dangerous or dishonest doctors). At §25.357 she said:

“But the process of change has been tortuous and piecemeal. It is discouraging, as it indicates to me that, even now, at the start of the new era, there is no real commitment to the underlying principles of good regulation.

In short, I am not convinced that the leopard has changed its spots or ever will.”

 

  1. Hindsight clarifies that the GMC has been registered as a charity only to evade closure post-Shipman scandal that predated GMC’s application to the Charity Commission. However the GMC openly defrauds the HM Treasury of several million pounds every year by exploiting its charitable status. No relatives of Shipman’s >200 dead victims, or other victims of other rogue doctor’s whom the GMC’s proven negligence ‘allowed to rape-plunder-and-murder freely in the society’ have been offered / awarded any compensation from the GMC. No doctor wrongly prosecuted by the GMC has won any compensation either. Every year, increasing number of doctors have suffered detriment, often despite observing GMC’s guidance on ‘Good Medical Practice’ of their safe professional skills; due to the GMC’s arbitrary mis-application of its procedures, without any just recourse to effective statutory remedy to the victims under Medical Act, 1983. Contrary to: “it is the principle that a wrong ought not to be without a remedy.” [Lord Hope of Craighead, in Darker v Chief Constable of the West Midlands Police (UK) HL 2000]

 

  1. Disgraced by the Shipman Inquiry, the GMC staff just changed its motto: from “Protecting Patients, Guiding Doctors” to “Regulating Doctors, Ensuring Good Medical Practice.” No Council meeting agenda / resolution is available regarding this significant policy change by the GMC.

 

  1. No GMC-staff has ever been disciplined by their erors and failures and delibetrate cover-up of Shipman-clan. [On 11.2.2011, GMC formally confirmed:

“…we do not hold any information relating to the [GMC’s internal] disciplinary procedure having been used following a complaint by a doctor who has appeared before a fitness to practise Panel hearing. Similarly, we have no records of staff having been found to be at fault following, a complaint by a doctor appearing before a hearing.”

GMC also disclosed on that day, under Freedom of Information Act, its ‘disciplinary policy and procedure’ for its staff. Its 'scope' stated: "This procedure does not form part of any employee's contract of employment”. This document did not exist before on the GMC website, which displays no formal procedure for complaint by a member of stakeholder public or a regulated a doctor, against any member of GMC-staff or agent.]

 

  1. GMC website falsely claims: “The GMC registers doctors to practise medicine in the UK.” Information to employer in the GMC’s online ‘list of registered medical practitioners’ states: “This person is not on the Medical Register and may not practise as a doctor in the UK.” The information on the GMC website about its ‘statutory powers’ is wrong, false and misleading and deliberately un-amended despite specific alerts: e.g.

 

“The law gives us four main functions under the Medical Act 1983:

 

  1. Thus most of the crucial information & assertions on the GMC website on ‘legal entitlement to practice as a doctor in the UK', or ‘GMC’s regulatory powers’ are wrong, false, misleading & does not reflect the relevant Statutes. GMC ‘passes off’ itself as the regulator of all doctors practicing in the UK, an unlawful misrepresentation contrary to s2, Fraud Act, 2006.

 

  1. On 15.5.2005 Smith LJ gave a talk to an elite audience of to the Clinical Disputes Forum. She spoke about “The role of the doctor in the process of medical regulation”

(‘CLINICAL RISK’ (2006) 12, 96–101 © The Royal Society of Medicine Press Ltd).

 

Smith LJ observed,

My third main concern …the GMC has decided to create only one criterion for action on registration: the undefined ‘impairment of fitness to practise’.

 

… The only standard or threshold is that before the panel can take action on registration, the impairment must be sufficiently serious to justify action on registration. But how serious is that? The test is completely circular! There are no objective standards at all... This will inevitably lead to inconsistent decisions, which in some cases will be unfair to doctors…

 

The panel itself was, in effect, an expert jury. The GMC supplemented their manpower by engaging people specially to sit on panels. ... They are often what I would call ‘cut and paste’ judgments. One sees the same passages from legal authority being cited time and time again, often when they are not at all relevant or appropriate. The same stock phrases appear repeatedly. The decisions frequently leave the reader with no real understanding of why the panel has decided as it has.

 

  1. It has long been recognised that it would be unjust and unlawful for the investigating, prosecuting, executive and adjudicating functions to rest within the same body and would expressly breach the regulated doctors’ human rights.

 

  1. Since the promulgation of Human Rights Act, 1998, “separation of the investigation and adjudication functions in fitness to practise cases” had been overdue, so as to bring the GMC procedures in line with, in particular, Article 6(1) of the Human Rights Act, 1998. This was one of the 4 key recommendations of the CMO’s report ‘GDSP’ (p 189):

 

  1. On 21/2/2007, the UK Government published a white paper: “Trust, Assurance & Safety – The Regulations of Health Professionals in the 21st century.” It accepted the key recommendation to separate adjudication from the GMC, made in the report ‘Good Doctors, Safer Patients’ (‘GDSP’), published on Sir Liam Donaldson published on 14/7/2006. Making a total of 44 recommendations, Sir Liam noted (ch. 10, pp 169-170): “GMC has totally lost public’s confidence in its ability to protect public interest from the bad doctors.”

 

  1. GMC cancelled its elections that were due after the end of the (since ‘indicted’) council-of-trustees’ 4-year term on 30/6/2007. No further GMC-elections ever took place.

 

  1. After a consultation related to OHPA between 20.3.-19.6.2009, on 1.11.2009 the UK Government made statutory provisions for the preliminary appointments to OHPA by S.I. 2009 No. 2722. It was anticipated that from April 2011, OHPA was to take over from the GMC, the role of [‘truly independent’] adjudicating on fitness to practise matters relating to doctors and, in due course, take on the adjudication role in relation to other health professionals from the remaining health regulators.

 

  1. This purported change to ‘make adjudication independent of the GMC’ was also rather cosmetic because GMC had (i) kept the control over ‘who went before OHPA’; and rather quite bizarrely, (ii) a right to appeal OHPA decision! So the unfortunate doctor’s plight may never end within the reasonable time-limit of his/her Article 6(1) human rights (‘pin-balling’). But the DoH made a “U-turn” and scrapped the OHPA and the GMC resumed the status quo ante under the guise of pseudo-independent ‘Medical Practitioners’ Tribunal Service’ (‘MPTS’) under total GMC control, as is evident by the GMC page of ‘GMC-MPTS Liaison Group’ & information on MPTS website.
  2. On Tuesday 10 December 2013, MPTS chair HHJ David Pearl has admitted to the Parliamentary HSC that “at the moment we do not have a statutory base” & your Chair Sir Peter Rubin concurred, confirming receipt of a letter from “the Parliamentary Under-Secretary of State for Health indicating that the ‘section 60* [sic. s56] order’, to which David referred, will not progress in 2014…” (Transcript page 33/38 @ top) Thus both HHJ Peral & Sir Rubin have formally admitted in evidence before UK parliament, before this HSC that they have been [unlawfully] administering a[n illegal] ‘closet-tribunal’ that has no statutory authority.

 

  1. Thus for nearly 21 months, the GMC has been prepatrating an unlawful charade of the independent the ‘MPTS’ admittedly without the required statutory authority in a civilized democracy.

 

  1. In summary, over 9 years ago, the GMC was publicly found to have severally failed in delivering its statutory objective (negligent in its duty as a public body) to ‘protect patients’, for most of the past 27 years since the Medical Act, 1983. Thousands of members of public have suffered due to GMC’s repeated and scandalous failures: acts of omission through the 104-35-24 ‘members’ club culture’ of mutual self-interest, continuity of ‘wrongful acts’ etc. Over the past decade, despiteclaiming to be undergoing a long process of ‘reforms’, the GMC has shown that it is unwilling and/or incapable of delivering neutral, objective regulation. Today, nobody trusts the NHS or the GMC to deliver its statutory goals of safeguarding patients.

"We have not lost faith, but we have transferred it from God to the General Medical Council."

"Every doctor will allow a colleague to decimate a whole countryside sooner than violate the bond of professional etiquette by giving him away."

George Bernard Shaw

 

  1. Thus the GMC is a dysfunctional body, a ‘Gestapo’-style mafia run to ‘settle-scores’ for the NHS by its vindictive staff, who resist to be held accountable for their errors, negligence & other unlawful conduct at any cost; claiming to be impervious to, above, inter alia in contempt of all relevant UK statutes protecting victims against individual and organisational torts.

 

  1. On 4/12/2008, the following Easrly Day Motion was put before the House of Commons:

 

That this House believes that the General Medical Council (GMC) complaints mechanism fails to comply with standards of fairness and due process required by Article 6 of the European Convention on Human Rights; observes that the GMC's role in investigating, prosecuting and sentencing falls below the standard required of an independent and impartial tribunal; notes that in practice the GMC represents the interests of parents in cases where doctors suspect abuse; further notes that children themselves have no independent representation to present a doctor's concerns; further believes that no published guidelines appear to guide prosecution decisions and that, as prosecutor, the GMC amends and adds charges in an ad hoc fashion; considers that doctors are uncertain of the allegations they face, compromising their ability to mount a cogent defence; further considers that the GMC calls expert witnesses with clear conflicts of interest in the proceedings who are unrepresentative of mainstream practice or opinion, and that the GMC adopts a populist, punitive, deterrent and disproportionate approach to sentencing; further considers that the GMC's apparently arbitrary admission and exclusion of evidence extends to ignoring the findings of previous investigations into a case conducted by an accused doctor's employer; further believes that the GMC values the public perception and integrity of the profession above individual rights; and further observes that, contrary to basic principles of justice, the GMC appears to assume the guilt of doctors before it, and refuses to acquit when a conviction is impossible, instead finding no realistic prospect of prosecution.

 

Brief Introduction of Witness to the HSC inquiry

 

St George Street Strategic Consultancy is an independent organisation conducting investigation research and advisory activities in medico legal regulatory issues of substantial public interest. They are supported by a team of highly qualified, experienced and competent researchers and consultants capable of assisting the people, their clients and the UK Government the UK Government in resolving the biting problems faced by them, by focused research and result oriented solutions with guaranteed outcomes.

 

Recommendations

 

  1. It should be made mandatory for the employer NHS Trust to send a copy, immediately on receipt of each and every formal concern about patient-care, irrespective of whether raised by employee-staff or others.

 

  1. The NHS Trust’s public-funding for ‘defence’ of any employment dispute with ‘an employee who has [as in # 1 above, or any] record of having raised formal concern about patient-care’ must be (a) transferred by the NHS Trust to the NHS complaints handling Service, and/or (b) authorised by an independent body made solely of  patient-representatives.

 

  1. There should be a public inquiry into NHS’s handling of all concerns, where the complainant has been ‘referred to the GMC for any allegation at any stage, with particular scrutiny of GMC’s handling of “stream 1” complaints as compared to “stream 2” complaints.

 

  1. There is also merit (worth £50,000,000 per year) in putting “the process of handling (investigating & prosecuting, but NOT adjudicating on) complaints made against medical practitioners, irrespective of their employment status” on open tendering for 3-5 year contracts.

 

6 March 2014

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