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Review of Louis Theroux’s ‘Mothers on the Edge’

‘Mothers on the Edge’ was broadcast last night.

Thanks to the anonymous* source in the South London and Maudsley Hospital Trust PR department for reporting the following conversation, which took place about eighteen months ago:

‘Great! Louis Theroux is interested in filming on the perinatal unit.’

‘Is that really a good idea? His 2010 programme on ‘America’s Medicated Kids’ received quite sceptical reviews about psychiatry and medication from the Guardian, and Mumsnet readers. Louis got the children and teenagers to open up quite a lot, undermining the idea that their behaviours were merely ‘symptoms’. He even filmed a Pittsburgh psychiatrist admitting that drugs were often used in preference to psychosocial interventions.’

‘Relax. The Jimmy Savile thing blew up not long after, and Louis has been eating humble pie ever since.

Theroux-Savile-DM

‘So he won’t stray from the script of psychiatrists doing their best to be psychosocial, and only using medication if absolutely necessary?

‘We have already agreed the consultant will not be challenged on claims about ‘trauma’ being addressed in all patients. No awkward questions about #Pharma COI involving SLAM, or personality disorder, either.

‘I am still surprised they want to film at one of the best-funded perinatal units in the country, rather than somewhere that is struggling and likely to use even more drugs.’

‘The BBC are much less interested in challenging the medical establishment than they used to be. Of course we want to be discreet about ex-BBC journalists now working in PR, but unfortunately some, like the RCPsych’s Kim Catcheside, can’t resist bragging occasionally about their influence.’

Screenshot_2019-05-13 Kim Catcheside on Twitter RCPsych team worked tirelessly to get responses hopefully in Telegraph and [...]

* and fictional.

 

 

 

 

 

 

Both complainants to the GMC are supporters of Dr Paul Morrison FRCPsych and Dr Samei Huda MRCPsych

(See my piece of 19th March for a brief background. The issues have always been wholly public. Most of this piece was made available to the GMC a day in advance. The GMC has informed me that ‘the complainants are being well supported and have regular update and contact’.)

I have no problem with the supporters of those I have criticised making anonymous complaints. It is up to the GMC to take that into account. The GMC have known for weeks that the second complainant is a supporter of both of these ‘Pharma-psychiatrists’, as I sometimes call them: my term includes those who are not significantly funded by Pharma, but ignore, deflect from, or minimise such conflicts of interest. However, given the UK’s lack of compulsory disclosure, it is impossible to know who is truly unfunded.

The first complainant focused on the issue of registered-but-unlicensed practice. This Twitter account has now identified itself, but still appears to be

190322-RAF-1-of-7

essentially anonymous. Again, I have no problem with that, but it is relevant to the question of whether these complaints reflect the general concerns of ‘patients and the public’, as the GMC has implied. More on that in later blog pieces. On the issue of ‘vulnerable patients’, see my notes to the Decision, 1/3 down.

Two (undeleted) tweets by the first complainant are supportive of Dr Morrison. The first is just four days after my blog piece of September 6th on Dr Morrison. Hundreds of this complainant’s tweets have been in Twitter threads with Dr Samei Huda, who has been closely aligned with Dr Morrison.

Screenshot_2019-03-24 RoseAnnieFlo on Twitter It's very odd peterkinderman made such a song dance about his complaint re Pa[...]

In the second, ‘Lucy’ is Lucy Johnstone, who complained (with Peter Kinderman and others) about Dr Morrison’s alleged ‘bullying, harrassment and misogyny’ in February 2018 (see my same September 6th blog piece). ‘DCP’ is the British Psychological Society’s (BPS’s) Division of Clinical Psychology:

Screenshot_2019-03-24 RoseAnnieFlo on Twitter SPECIAL PLENARY SESSION How to retract a power-point slide Special BPSOfficia[...](1)

Screenshot_2019-03-24 RoseAnnieFlo on Twitter SPECIAL PLENARY SESSION How to retract a power-point slide Special BPSOfficia[...]

The second complainant Tweeted in support of Dr Morrison and Dr Huda, a day after my piece criticising both. :

Screenshot_2019-03-26 C1-2141764902 Dr MacFarlane- Documents to be presented to the IOT_Redacted pdf

I discussed the above in the tribunal hearing (it was in the GMC’s evidence bundle): it has been deleted, along with many others. But it is still possible to find evidence of this Twitter account’s support for Dr Morrison by showing its ‘likes’ of Tweets such as this abusive one (also discussed in the tribunal):

181228-Morrison-Bag-of-Sh

181228-Morrison-Bag-of-Sh-Likes

The second complainant also continues to be active in many Twitter threads with Dr Huda, who promotes them both by re-Tweeting, as here shown with consecutive re-Tweets (image made 26th March 13.15 pm):

Screenshot_2019-03-26 Samei Huda ( SameiHuda) Twitter

To repeat again, I have no problem with anonymous complaints, but if it is claimed they represent ‘patients and the public’, then bodies (the GMC and others) investigating them must consider the wider context.

In contrast, Dr Huda and establishment psychiatrists have repeatedly expressed their hostility towards anonymous complainants. This is very worrying, given the fears that many patients and members of the public have that NHS psychiatrists are in positions of power, regularly work with the police, and might be able to uncover the identity of anonymous complainants, or even punish them with Mental Health Act detention and/or forced treatment.

Screenshot_2019-03-15 from SameiHuda anonymous - Twitter Search(1)

Screenshot_2019-03-26 Dr Kate Lovett on Twitter Anonymous accounts (cowards), photoshopping images (lack of respect and dig[...]

Screenshot_2019-03-26 Wendy Burn 🌈 on Twitter Particularly from the anonymous accounts Cowards as DrKateLovett says …

Finally, it emerged yesterday that Dr Wendy Burn appears to have contacted the first complainant privately. I have previously complained about Dr Burn to the GMC, and named her twice in my submission to the MPTS tribunal on March 20th.

As evidence from both complainants was considered by the tribunal both are potential witnesses. Dr Burn must have known that, and must have known that her action was potential interference with a witness and with evidence. I am likely to call on Dr Burn to suspend herself from RCPsych office, or resign, and will be adding this interference to my other GMC complaints about her.

190327-RAF-WB-support-cr-1

[…]

190327-RAF-WB-support-cr-2

 

(Next piece: the GMC’s false and misleading submission on ‘unlicensed practice’.)

One law for Dr Appleby, Dr Burn, Dr Morrison and Dr Huda, another for their critics: the GMC’s double standard.

(30th March: see my homepage for more details on the tribunal, and the piece I published two days later for the 5-page tribunal decision with my notes and annotations)

Today the GMC’s application to the Medical Doctor’s Tribunal (MPTS) to suspend me was allowed, although reduced from 15 to 12 months. A review automatically occurs in 6 months, although I understand I can apply now for a review in 3 months if I consider there were irregularities in this tribunal.

I do.

For now, I will focus on just one: the failure of the tribunal to adequately address (in the 5 pages of its written decision) my submissions on the GMC’s treatment of complaints against senior psychiatrists. I argued that their ‘smears and abuse’ were more serious than the allegations about my own Tweets and blog pieces.

I showed the tribunal this tweet in which Dr Louis Appleby smears me (I was not saying that I am targeted any more than others, but this happens to be a good example):

Screenshot_2019-03-16 Dr Neil MacFarlane MRCPsych on Twitter(1)

and then this expanded image of the Tweeter who ‘liked’ it, Dr Wendy Burn:

wb-cr

I said: ‘This is a Tweet from Dr Louis Appleby to me 11 months ago. Dr Appleby is the government’s lead on suicide prevention, and also a Professor in Manchester.

You can see in the last sentence that he clearly accuses me of being a conspiracy theorist. Now this term can quite happily be bandied about by non-professionals without serious harm, but I submit that psychiatrists have power and authority in society in relation to diagnosis, and what might lie behind it such as compulsory admission and treatment.

‘Conspiracy theorist’ is a quasi-diagnosis which, from a psychiatrist, carries the implication of psychotic or fantasist, or perhaps personality disorder. I believe it should not be used as a smear in this way.

You can see that one Twitter user has ‘liked’ this smear, and that is Dr Wendy Burn, the current president of the RCPsych. I have expanded her icon below.’

I had previously showed the tribunal this Tweet from Dr Paul Morrison:

181228-Morrison-Bag-of-Sh

I said: ‘‘Young Kinderman’ is Peter Kinderman, a prominent clinical psychologist. In this Tweet Dr Morrison claims that a complaint Mr Kinderman had made in February 2018 about him, relating to Dr Morrison’s alleged ‘bullying, harassment and misogyny’, again on Twitter, had not been upheld. Dr Morrison, as you can perhaps see from his Twitter icon, adopts the persona of Rumpole.

I suggest this Tweet, with the image below and the caption ‘I’ve got a bag of Shh, with your name on it’, is unpleasant and threatening to Mr Kinderman. […] last week I made a complaint to the GMC that Dr Morrison was very likely to have been dishonest in his statements about the bullying and misogyny complaint.

Now looking again at the ‘likes’ below this Tweet you will see an icon on the left, and that is the icon of Dr Samei Huda. Dr Huda is an NHS consultant psychiatrist in Tameside, to the East of Manchester. In the latter part of last year I had an amicable Twitter relationship with Dr Huda, but we fell out in early December because he refused to discuss my concerns about Psychiatry’s relationship with the Pharmaceutical Industry, or Pharma. He blocked me and then in early January […] I criticised him as someone who closed down debate, and pointed out that in the past he had criticised others for the same.’

 

These Tweets are similar to many others that have been complained about to the GMC: they have done very little, while they have claimed that some of my Tweets are deliberately ‘antagonistic’.

I have to be careful on how I report on the tribunal because some allegations concerned non-professionals.

But the MPTS tribunal’s silence on these senior psychiatrists is concerning: a single sentence in the written decision made no acknowledgement of the abusive nature of these Tweets.

My title has ‘one law’ rather than ‘one rule’ because the behavioural standards of medical doctors are supposed to be based on the Medical Act 1983.

More to come. I now have to get the train from Manchester back down to London.

 

Dr Paul Morrison FRCPsych: new complaints to GMC. His false claims about February 2018 ‘misogyny’ complaint, and his libel threats.

[My letter to the GMC, edited here]

The GMC have informed me they will not be investigating Dr Morrison. They are now investigating me!

From: Dr Neil MacFarlane BA MBBS MA MRCPsych GMC 3205688

To: GMC

13th March 2019

Complaints: Dr Paul Morrison FRCPsych (GMC number believed to be 4149224)

  1. His false claims that ‘nothing was upheld’ of a complaint against him to South London and Maudsley NHS Foundation Trust (SLaM).
  2. His threats to sue me for libel.

 

Dear GMC

[Summary of my 6th September complaint and its background omitted here]

 

On 9th September Dr Morrison categorically stated, in a private Twitter Direct Message (DM) to me that ‘Nothing was upheld’.

A few weeks later SLAM confirmed that they had responded to Mr Kinderman’s complaint, but they refused to give details of their response. I updated my blog piece several times to reflect my increasing lack of certainty.

Dr Morrison publicly repeated his claim in late December, in a jokingly threatening and abusive Tweet. You may know that Tweets such as this (if not deleted) can be very quickly found, in this case by searching for ‘from:PaulMor64695904 young kinderman’ in the Twitter search box:

Screenshot_2019-02-22 Paul Morrison on Twitter Young Kinderman claimed the complaint was upheld - factually wrong Then he p[...]

On February 8th Dr Morrison contacted me by DM and asked me to delete my piece as it was ‘distressing’ some of his patients. I pointed out that Mr Kinderman had not retracted any of his statements. He stated: ‘Repeating an allegation of others is…libellous’ and ‘I’m fortunate to have the best legal advice.’

On February 9th he repeated the threat: ‘I’m going to sue you for libel. And I’m being advised to report you to the GMC.’

Again on the 10th: ‘…are you really so foolish to believe that I am bluffing about suing you for libel…It’s not a threat, it’s a promise.’

A week or so after that, I was emailed (from a parliamentary email account, which end in @parliament.uk) by one of the MPs that I had copied my 6th September complaint into. I was provided with a letter from the SLAM Communications Department (Trust HQ Maudsley Hospital Denmark Hill London SE5 8AZ, Telephone: 020 3228 2830 Fax: 020 3228 2021), which named me and gave an account of my complaint and Mr Kinderman’s. I have not provided you with a copy of this as I have not yet obtained permission to do so, but details in it, of a previous complaint to SLAM that I had made, further prove it is genuine.

SLAM stated that Peter Kinderman’s complaint against Dr Morrison (who was not named) had been ‘partially upheld’, and that he had left the Trust in July. The reason for his leaving was not stated.

I cannot see how Dr Morrison’s false claims that ‘nothing was upheld’ amount to anything other than deliberate dishonesty, and therefore serious professional misconduct.

The threats to sue me for libel, I submit, are also serious breaches of professional conduct.

 

Further comments:

Dr Morrison’s website www.paulmorrison.org (on which he does not state his GMC number) states that he still has NHS patients, but not where they are. If this is incorrect it would be a further false statement.

He retains his academic post at the IoPPN, a role which might involve interactions with SLaM patients enrolled in IoPPN research:

https://kclpure.kcl.ac.uk/portal/en/persons/paul-morrison(07e62444-cb2e-4cd0-92a0-bfc9f4eebc67).html

Dr Morrison has been careless, at least, about misogynistic language in the past. These Tweets are selected from a November 2017 thread:

17114-1-Forgetting-the-girls

171114Anne Cooke-Women, if you don't mind please Paul

171114-Sameer Jauhar-Glasgow vernacular

Dr Morrison’s jaunty, and perhaps not sincere, apology and correction was followed by further provocation:

171114-3-Oops sorry Women I meant

All the Tweets I reproduce here are still public. As psychologist Anne Cooke pointed out earlier, misogyny remains a highly sensitive and important issue in mental health, especially in regard to the inappropriate use of restraint, coercion, and antipsychotic medication, when past trauma is under- or mis-identified:

141126-AnneCooke-women-labelled

I submit that Dr Morrison’s private (and perhaps NHS) patients are at risk from possible misogynistic attitudes and behaviours that have not been properly investigated and dealt with by SLAM.

Yours Sincerely

 

Dr Neil MacFarlane

[See also my piece of 20th March. On that day I was informed that the GMC had received a similar complaint weeks or months ago, but have failed to investigate]

Maudsley ECT debate: two questions for each side

(See also my highly critical piece on John Read posted 10 days later)

‘Electroconvulsive Therapy (ECT) has no Place in Modern Medicine’

I have a ticket and will be voting against, because I know that many people have ECT on a voluntary basis, and it would cause them distress if it were withdrawn overnight.

However, I am quite sceptical about ECT: in ten years as a higher trainee and consultant in Learning Disability (LD) Psychiatry I only ever heard of one person with LD needing it in the UK. I went to national LD conferences regularly and often asked about ‘treatment resistant depression’, partly because as a student in 1984 part of my psychiatry placement was at the Brook Hospital, which was the last major centre for psychosurgery in the UK.

Two Questions for John Read (proposing to abolish ECT):

  1. You have compared ECT to ‘lobotomy and the rotating chair’:  https://twitter.com/ReadReadj/status/1033636959502008325  This seems close to the Scientologists who say that ECT is a deliberate form of torture, and point to early twentieth century history to support that view. As a psychologist, would it not be more honest to acknowledge that your profession has a dark history just as psychiatry does? Intelligence testing was central to eugenics (including deliberate killing in its most extreme form) in the early twentieth century, and more recently American psychologists have designed torture techniques for the US government:  https://twitter.com/peterkinderman/status/542425928773541889
  2. You have recently stated that you want a larger, better quality, randomised controlled trial (RCT) for ECT. You have also stated that you do not accept the concept of diagnosis, and propose an ‘alternative’, but as diagnosis (including a notion of severity) are necessary for an RCT of a treatment for severe depression how is this possible? https://twitter.com/NMacFa/status/1034063327847239680

Two Questions for Sameer Jauhar (against abolishing ECT):

  1. As a Maudsley Hospital consultant psychiatrist, and a researcher at the ‘world-leading’ Institute of Psychiatry, Psychology & Neuroscience, is not your professional and academic credibility undermined by an apparent culture of minimising ‘bullying, harassment and misogyny’ in those organisations?
  2. Given that the previous RCTs of ECT showed a significant placebo effect, do patients deserve more honesty about this to be able to give proper ‘informed consent? And is there a case for offering randomised sham or real ECT in clinical practice?

Complaint to Maudsley Hospital Governors: Chief Executive Dr Matthew Patrick MRCPsych’s failure to fully deal with upheld complaints, of misogynistic abuse, against consultant psychiatrist Dr Paul Morrison FRCPsych

Added 13th March: the February 2018 complaint is now confirmed as ‘partially upheld’, although details are not known, and I have today made further complaints to the GMC.

Added 8th February 2019: I have left the title of this piece unchanged to avoid airbrushing history, but there is significant doubt as to whether the original complaints were upheld (see below).

If anyone is concerned about the unresolved nature of the issues described here, I recommend they write to the Maudsley Governors and/or the politicians listed below. On 27th September I received an acknowledgement from an official at the Department of Health, which stated ‘I note your comments and appreciate your concerns about this matter’, but made clear it was a matter for the hospital trust to resolve.

The original (19th February 2018) complainants have not withdrawn (or, I believe, qualified) their statement:

Screenshot_2019-02-08 Peter Kinderman on Twitter Indeed Nobody is complaining about disagreement conducted in a civil manne[...]

Added 12th (& 24th) December: I have now had a partial response which casts considerable doubt on whether the original complaints were ‘upheld’ . See end of this piece.

Added 13th September:

Anyone concerned about this issue who lives in the Camberwell and Peckham parlimentary constituency (which includes the Maudsley Hospital/IoPPN) may want to consider writing to the local MP Harriet Harman. Your letter will remain confidential (including your address). If you live elsewhere, a letter to the Minister for Mental Health Jackie Doyle-Price, plus a copy to your local MP (even a third to Harriet Harman), will also help. You can check who your local MP is here: https://www.parliament.uk/mps-lords-and-offices/mps/.

Expressing such a concern would not make you a co-complainant: on the other hand I would be happy for anyone with more knowledge and experience of misogyny and related gender issues than myself to take this up publicly. The blog pieces on my website (especially those under the ‘Pharma’ category) provide background for why I believe the Maudsley Governors (and the Pharma-dominated IoPPN hierarchy) may not act without outside pressure.

 

Update 11th September:

My understanding is that the original (19th February) complainants will not be retracting or modifying their statements of 5th-6th August, which include: ‘Nobody is complaining about disagreement conducted in a civil manner. What we objected to was the breach of professional ethics and the descent into bullying, harassment and misogyny. And, while the complaint was ours, the independent investigation agreed.’ (my emphasis)

 

My 6th September complaint:

To: Mr Roger Paffard, Chair of Board of Governors, South London and Maudsley Hospital Trust (SLAM)

Dear Mr Paffard

On 6th August it was announced on Twitter that multiple complaints against Dr Morrison had been upheld by SLAM. The complainant provided a link to a redacted version of the 19th February letter, but declined to provide a copy of SLAM’s response, or any details within it.

The 19th February complaint letter contained dozens of examples of Dr Morrison’s tweets. The most serious are clearly examples of misogynistic abuse, referring to female professionals as ‘girls’, and mocking the ‘lips’ and sex drive (‘libido’) of a named female mental health professional, in the context of the critical comments Dr Morrison had been making:

https://drive.google.com/file/d/1efdBCzCNSLY3KB9dycEFE2rZwzLplBqw/view

I submit that Dr Patrick should have responded to these complaints within, at most, two weeks, and made that response public. The abuse was public, and is likely to have been viewed by hundreds, perhaps thousands, of service users, other members of the public, professionals and academics.

It appears that Dr Morrison himself was only informed of the outcome of the complaints process in early August. These misogynistic tweets were then deleted. You will know that it is common practice for images to be made of questionable social media posts, so that deletion rarely means the end of them. I myself have made images of Dr Morrison’s later posts that I quote from below.

I submit that the abusive Tweets were serious enough to suspend Dr Morrison from clinical practice at the Maudsley Hospital (which claims national and even international excellence) until a full investigation into his gender-related attitudes and behaviour was completed.

That such a suspension should now occur is even more clear, given that Dr Morrison continued to Tweet defiantly after 6th August, implying that he had been unjustly treated. On 14th August he Tweeted that the complainant and the female professionals were ‘radical political activists’, and claimed that many of their opponents ‘have thanked me personally for debunking this radical faction and their pamphlets’. After I tweeted (25th August) that he should apologise, he closed his account, but I am not aware that he has publicly or privately changed his position that he is a martyr to his cause.

On 7th August, another Maudsley male consultant psychiatrist (and close academic colleague of Dr Morrison), Dr Sameer Jauhar MRCPsych, tweeted in support of Dr Morrison, and proposed a ‘moratorium on MHPs [mental health professionals] reporting other MHPs to regulatory bodies’. This suggests that a wider investigation into a possible culture of abuse/bullying minimisation and complaint suppression within the Maudsley and IoPPN may be necessary.

I also submit that service users, the public, professionals, and staff at King’s College London’s (KCL’s) Institute of Psychiatry, Psychology & Neuroscience (IoPPN, where Dr Morrison is a full Senior Lecturer) deserve answers to these questions:

  1. Has the Executive Dean of the IoPPN, Professor Ian Everall FRCPsych been informed of the complaint? If so, when, and what has he done in relation to academic staff (and perhaps non-patient volunteers in research) at the IoPPN? I note that Professor Everall, a psychiatrist, also sits on SLAM’s Trust Board.
  2. There are close links between the Maudsley/IoPPN and clinical/academic psychiatry in Oxford. Concern has recently been expressed about misogynistic language used by the Oxford psychiatrist Dr Michael Sharpe FRCPsych in an email to Carol Monaghan MP, who has been investigating the so-called PACE trial of ME/CFS: Dr Sharpe wrote that her ‘behaviour’ was ‘unbecoming’, in his opinion. The IoPPN was a major participant in the PACE trial and KCL’s Dr Simon Wessely FRCPsych (a consultant psychiatrist who worked for a long time at the Maudsley and appears to retain close clinical links) has been repeatedly involved in its promotion and defence. Has Dr Wessely been informed about this complaint; if so, when?

 

Yours sincerely

 

Dr Neil MacFarlane MRCPsych

cc (email):

Rt Hon Harriet Harman QC MP (Camberwell and Peckham) (& letter)
Helen Hayes MP (Dulwich and West Norwood)

Victoria Atkins MP, Minister for Women
Naz Shah MP, Shadow Minister for Women
Jackie Doyle-Price MP, Minister for Mental Health
Barbara Keeley MP, Shadow Minister for Mental Health (letter)
Luciana Berger MP, Health and Social Care Committee & Labour Mental Health
Dr Lisa Cameron MP, Health and Social Care Committee

Women and Equalities Committee:
Rt Hon Maria Miller MP (Chair)
Tonia Antoniazzi MP
Sarah Champion MP
Angela Crawley MP
Vicky Ford MP
Kirstene Hair MP
Eddie Hughes MP
Jess Phillips MP
Mr Gavin Shuker MP
Tulip Siddiq MP

ME/CFS:
Carol Monaghan MP (& letter)
Steve Brine MP (Minister for Primary Care)

Stella Creasy MP

 

Added 12 (& 24th) December: I have now had a brief response which indicated that the original complainants (Peter Kinderman and others) were free to make the response from the Trust public. I received this email on 16th October, but then made several further attempts to obtain more information. (Bold highlighting by me).

Dear Dr MacFarlane

I write further to your below email and previous correspondence in relation the your concerns about the actions of a doctor on social media. […]

I am sorry that you are disappointed that the complainants in this instance have declined to share our response with you. […] The matters concerned were reviewed by senior member of the Trust with oversight by the medical director.

Yours sincerely

Edith Adejobi

South London and Maudsley NHS Foundation Trust
Complaints and Serious Incidents Department | Maudsley Hospital |111 Denmark Hill|London| SE5 8AZ

 

Dr Morrison returned to Twitter and continued to make critical comments, mostly legitimate in my view, about anti-diagnosis purism and excessive claims for CBT as a treatment for psychosis. He continues to avoid and deflect questions about Pharma bias, but appears to take more care about being seen to be ‘abusive’.

Therefore Kinderman et al’s claim that the Trust had agreed Dr Morrison’s Tweets amounted to ‘bullying, harassment and misogyny’ seems very dubious. For me, this is not an isolated example but is in keeping with false statements that Peter Kinderman and John Read have made about other issues. I suggest that if they want to be credible in this case then they will release what screenshots they have of the claimed ‘bullying’ etc, and also the response to their complaint from the Maudsley Hospital.

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