The GMC’s false and misleading evidence to the IMMDS Review

Mesh campaigners have recently focused on the IMMDS Review’s false claim that GMC complaints are ‘not within the scope of the Review‘. This piece mainly deals with the related issue of surgeons and other doctors failing to declare industry payments: something that many patients are likely to have complained about.

Screenshot_2019-11-19 Dr Neil MacFarlane MRCPsych on Twitter MaryRMcLaughlin neilfindlay JeaneF1MSP gmcuk miJemima susancol[...]

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In December 2018 the GMC provided written responses to the IMMDS Review Panel’s written questions. They followed with oral evidence in January and March 2019. Patients and parents repeatedly expressed concerns about adequacy of information provided by doctors, consent, and the failure of NHS Trusts and the GMC to investigate complaints properly.

The GMC was asked, and it replied, in page 11 of the written evidence:

Registry-no-comment

This appears to be false and misleading, because the GMC in fact carried out its own consultation on providing more information about doctors’ clinical practice, and about their potential conflicts of interests, in 2016. Such information could be linked to the ‘Medical Register’, or even be part of it.

The consultation started in early July (2016), almost the worst time of the year to engage the public, and ended in early October. Most of the responses were from doctors, and most doctors were against further information being provided. Many responses were anonymous, leaving open the possibility that a lot were from particularly industry-involved doctors, or directly from industry itself.

Giving oral evidence on 10th January, Dr John Smythe, the Assistant Director of Fitness to Practice and himself a registered GP, stated (31 minutes, Smyth at the right of the image) that ‘I am not aware personally’ of the consultation, when asked about it by Cyril Chantler, the retired Professor of Paediatrics on the Panel.

190110-Smyth

That appears to be an astonishing claim, given that the Consultation was thoroughly considered by the GMC Council (link above), and that conflicts of interest are covered in Good Medical Practice, to which Dr Smyth referred several times.

However, the GMC ignores its own guidance in Good Medical Practice, which clearly states, under the subheading

‘Honesty in financial dealings’:

77 You must be honest in financial and commercial dealings with patients,
employers, insurers and other organisations or individuals.

78 You must not allow any interests you have to affect the way you
prescribe for, treat, refer or commission services for patients.

79 If you are faced with a conflict of interest, you must be open about the
conflict, declaring your interest formally…’

Any reasonable person would interpret this guidance as meaning that all payments, and payments in kind, from industry, must be declared to all patients in every patient consultation. This does not happen, and I am not aware of any GMC complaint about this issue which has succeeded. Even patients, and professionals. who attempt to actively discover such payments are blocked, and at some point encounter the contradictory statement from the GMC that such declarations to patients are merely ‘voluntary’. The GMC guidance on ‘financial honesty’ is itself dishonest.

 

Did the GMC’s most senior lawyer, Anthony Omo, give a false and misleading legal opinion, on whether Conflicts of Interest can be included in, or closely linked to, the Medical Register?

On 14th March the GMC returned with Anthony Omo, and its Director of Education and Standards, Dr Colin Melville (who joined in 2018).

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By this time, Chantler had clearly discovered and read the 2016 consultation, and his first question was reasonably forceful (36 minutes): ‘The majority of respondents [to the consultation], by a long way’ were doctors. The number of members of the public was ‘very small and the majority of them were in favour of it [including potential conflicts of interest on the Medical Register].’

‘So it does seem to me that given the main responsibility of the GMC, as set out in the 1983 [Medical] Act, is the protection of the public, that maybe the views of the public should carry more weight than the views of the profession, in this instance.’

Mr Omo responded: ‘I would not disagree with you…’

But Chantler failed to point out that the GMC had disagreed, in 2016. Or ask whether Omo was expressing a personal opinion.

‘…the profession was in an unhappy place [in 2016]’ Omo went on.

Chantler, again, failed to ask the obvious, ‘So what? What about the rather more ‘unhappy’ place of patients and parents affected by these three products?’

‘The slight wrinkle’, Omo continued, ‘is that what goes on the Register is in legislation, so if we want to add things on it can only be done in legislation.’

Once again, this appears to be false and misleading. The GMC had already ‘added things on’ in early 2016 (link above):

1702-registry

Mr Omo was not submitting his client’s (the GMC’s) case to a court. His opinion on these legal issues was therefore not protected by legal privilege. Although ‘independent’, the Review had been set up and funded by the UK Government, and the GMC is an agency of that Government.

So, Omo had a primary duty to the public, and especially the patients and parents directly concerned by the Review, to be fully honest. The Government was and is his employer, and had chosen to make his legal opinion public, therefore the public was in effect his client.

Campaigners have the basis for a complaint to the Solicitors’ Regulatory Authority about his dishonesty, to them.

 

Mr Omo’s further serious omission: an interest register can be introduced as a ‘regulation’, for licensed doctors.

Doctors who prescribe medication, or who work in the NHS, probably make up well over 99%. They have to be licensed as well as registered.

The GMC is given wide scope by the Medical Act 1983, Section 29a to introduce regulations for those licensed doctors. It could introduce, at any time, an interests register (not the ‘Medical Register’, but linked to it), as a regulation, for licensed doctors without new legislation.

It is inconceivable that Omo and other senior GMC staff were not aware of this. It is a further example of serious dishonesty.

I will be preparing a GMC complaint about Dr Smyth, and consulting with campaigners on an SRA complaint about Mr Omo.

 

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About Dr Neil MacFarlane MRCPsych

Independent Psychiatrist providing culturally informed mental health opinion, advice, and a few new facts. Based near London, UK. Main qualifications: BA MBBS MA MRCPsych.

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