CASUAL WORKER, CASUAL JUSTICE

Self-employed doctors who worked as locums had a lot of bad experience and some agencies now realize they lost a lot of the best doctors through casual administration of justice at the government level, GMC, MPS and MDU.

Some are now actively negotiating alternatives ie independent legal advice (insurance) and other measures. At present medical agencies are doing well, but not so well many doctors, and their patients.

The Lauffer case

Hospital Doctor presents largely a one sided view of the Gideon Lauffer case. Nevertheless, it is well written and can be read here. As a brief introduction, this is what Hospital Doctor recently said

"A consultant surgeon dismissed by his trust has won a high court battle to set aside the dismissal and force his employer to hold a full investigation and hearing into its allegations against him.

Barking, Havering and Redbridge University NHS Trust dismissed Mr Gideon Lauffer, on 25 June 2009, after claiming to have lost trust and confidence in him.

Mr Lauffer, with the Medical Protection Society’s representation, took the trust to the high court and on 10 August was granted an interim injunction.

The court decided that the surgeon’s dismissal breached contractual disciplinary procedures and ordered the trust to continue treating him as an employee.

The judge, Mr Justice Holroyde, said that by not following the proper procedures set out in Maintaining High Professional Standards in the Modern NHS (MHPS) the trust had arguably unfairly denied Mr Lauffer the opportunity to respond to criticisms and the chance to clear his name"

The Daily Mail has a different spin on the situation. This is what they say

A surgeon alleged to have botched operations on patients over a 10-year period - resulting in at least four deaths - is under investigation by the General Medical Council.

Last night a lawyer representing relatives of one of the dead expressed fears that many more patients may have died or been harmed after surgery by consultant Gideon Lauffer.

The GMC suspended him last month after the deaths of two patients last year and is understood to be preparing to review operations stretching back many years.

Read more here.

So essentially things aren't looking great for Gideon. Nevertheless, the Medical Protection Society is hell bent on supporting him. It is a shame they failed to show that level of kindness to those who did not end the lives of patients.

Anyhow, the landmark judgment can be downloaded from here. We are one of the only publications to host this judgment. Please feel free to circulate and download. In the interim, we hope innocent doctors make use of this judgment.



"

[2009] EWCA Civ 789 - Kulkarni v. Milton Keynes Hospital NHS Foundation Trust

The judgment for this case can be downloaded here.

The summary of this case according to Old Square Chambers is as follows

The Court of Appeal today handed down judgment in the case of Kunal Kulkarni v. Milton Keynes Hospital NHS Foundation Trust. Kulkarni was successfully represented by Mr Jonathan Davies led by John Hendy QC, both of Old Square Chambers.

The judgment was highly significant for two reasons:

· it establishes that doctors and dentists employed by the National Health Service are entitled to legal representation at internal disciplinary hearings to determine serious disciplinary charges made against them;

· it strongly suggests (albeit obiter) in relation to all employees of public bodies that internal disciplinary proceedings which may result in dismissal in circumstances where, as a direct consequence of that dismissal the dismissed employee is effectively prevented from ever practising his profession again, must comply with Article 6 of the European Convention of Human Rights.

Read the full article here.

VOLUNTEERS TO TAKE PLACE OF PSYCHIATRISTS

There are now many soldiers returning from Afganistan (and Iraq veterans) who are committing suicide at the alarming rate. There are many others who suffer brain damage too. The need for psychiatrists is impossible to meet and US government is recruiting thousands of volunteers to help instead. In UK, there has been little said about these men who suffer terribly and their families too. One of the symptoms of post-traumatic stress disorder is anger and with increased irritability there is increase in marital discord and violence. Without help children become traumatized witnessing what goes on at home when parent is unable to cope.
Losing temper as a result of post-traumatic disorder means poor working ability.
Distressed men are more likely to offend and a startling number are in prisons and on probation. Twice as many as serving on the front! These are UK data. Neglect of these men is quite astonishing.

Meanwhile, there are unemployed psychiatrists in UK who are not allowed to work because regulatory authorities have been too preoccupied defending religion or incompetent NHS management instead of good medical practice. In other words whistleblowers cannot work while soldiers returning from the front are killing themselves.

Graduates Poorly Prepared to be doctors

A new study has criticised the training of junior doctors. The Telegraph presents an interesting summary.

"A study by Catherine and David Matheson of the University of Nottingham's Medical Education Unit said junior doctors were not prepared in eight of 11 topic areas.

Interview with specialist registrars and consultants said new medics were especially unprepared in "clinical and practical skills and the more challenging communication skills".

The research was published in the Postgraduate Medical Journal.

The conclusions are as follows "Overall, F1s in the study were not well prepared either to perform the tasks that await them or in terms of most of the specific background knowledge and skills necessary for the successful execution of those tasks. The level of preparedness raises important issues about medical training and transition from medical graduate to first year doctor. Further research is needed to determine whether this situation exists in other regions of the UK."

This raises further future questions about appraisals, the rate of referrals to the General Medical Council and revalidation. How many doctors are going to have their license revoked in the future. This raises further questions about the effectiveness of Modernising Medical Careers [MMC] Clearly, the microscope should be placed on this training system. Remedy UK has long argued that the MMC has placed patients at risk. They now appear to be right. The architects of the MMC are directly responsible for creating a system that is clearly failing doctors and patients.

Related Links

Medical News Today.

Saha v General Medical Council [2009] EWHC 1907 (Admin)

Source - Penningtons.co.uk

As the purpose of fitness to practise proceedings is to protect the reputation and standing of the profession, rather than to punish the practitioner, factors of personal mitigation carry less weight

This involved an appeal against the decision of the General Medical Council's Fitness to Practise Panel (FTPP) that the doctor's fitness to practise was impaired by reason of misconduct and ordering his erasure from the register.

The appellant surgeon had a contagious medical condition. NHS guidance required healthcare workers with that condition to undergo tests and to refrain from work in certain circumstances.

The GMC became aware that the appellant had undertaken tests other than through formal NHS screening procedures (as required by the NHS guidance). The GMC made a number of requests of the appellant to provide information as to his current and past employers, but he failed to do so That failure was found by the FTPP to have constituted misconduct, leading to a finding of impairment of fitness to practise and his erasure from the register. The appellant appealed on several grounds:

1. Although it would have been 'better' if the FTPP had indicated distinct consideration of the two issues of 'misconduct' and 'impairment', there is no requirement in all cases for there to be a formal 'two stage' process.

The court held that 'the requirement under the Act is that there are two 'steps': the panel must consider whether there has been misconduct and further whether that misconduct is such as to impair fitness to practise. Whilst misconduct is about the past, impairment is an assessment addressed to the future albeit made in the context of past misconduct'. It was held that the FTPP had considered both issues and found, broadly, that one and the same facts gave rise to the misconduct and the impairment. The approach was not erroneous as a matter of law.

2. It was held that 'impairment' is not only an 'elusive concept', but is essentially a matter of overall value-judgement, as well as being a matter of professional judgement. Further, the court noted the concept of impairment in the fifth Shipman report, where one of the four possible bases of impairment cited by Dame Janet Smith is where the practitioner has, 'breached one of the fundamental tenets of the profession'. The FTPP finding of impairment was upheld.

3. It was held that the FTPP is essentially concerned with the reputation and standing of the profession, rather than with punishment of the doctor, and thus factors of personal mitigation carry less weight. The court held further that particular regard should be had to the special expertise of the FTPP, being the body best qualified to judge what measures are required to maintain the standards and reputation of the profession. The court did not accept the appellant's argument that either a short period of suspension or the imposition of conditions would have been an appropriate and sufficient sanction. The court held that the FTPPs 'decision of erasure was proper and should be upheld'.

Download the case here.

Professor Nutt

Ferret Fancier has exceeded himself recently. None of us are very happy about the government's treatment of Professor Nutt. It is a sad fact of life that the Labour government wishes to control everything including scientists. We conclude that either scientists and doctors toe the party line or they are ousted from their jobs. We all think David Nutt is absolutely great.

Ferret writes

"Alan Johnson accused Professor Nutt of becoming political with his statements, in fact what he said prior to his sacking was simply a well rehearsed and well researched scientific argument that was backed up by solid evidence. All of Brown and Johnson's comments on drugs have merely shown an immense lack of understanding of the evidence and a pathetic tendency to appeal to the lowest scaremongering sections of the tabloid press.

Skunk is not 'lethal' as fat Gordo stated, in fact by Johnson's logic Brown should resign as he is clearly straying into the scientific domain with this political statement. Johnson is just as bad as Brown with his illogical statements that he has released in order to justify the unjustifiable.

This is a simple issue and it comes down to the government having no balls. Brown is a weak incompetent leader who will do anything, no matter how wrong or dishonest, to win a few votes. Brown has routinely ignored experts on issues of which he and his fellow morons in power have no clue, he is too stupid to have any insight into his own lack of knowledge, he is a first class buffoon. This affair is not going away, it is about important principles, the resignations continue and I sincerely hope that it has done some good in exposing the rank stupidity and arrogance of those leading our country"

Related Links

Google UK News.

So you want to be a doctor.

Professor Rubin is desperately trying to be a man of the people. The problem is he isn't being very successful. He recently did a interview for the Guardian on encouraging doctors from the lower socioecomic classes. Strangely, the lower socioeconomic class hardly read the Guardian. They have more exciting papers to read. To having targeted the affluent intellectuals in the form of Guardianistas, Rubin expects to encourage poverty stricken teenagers into medicine. Rubin is dubbed The Count for obvious reasons. Having destroyed good doctors through the GMC, he seeks to find more new blood. His fangs are certainly out for the next innocent desperate poverty stricken teenager who is desperate enough to sacrifice themselves to the world of the GMC.

The GMC Register once had 300,000 doctors. It has now dwindled down to 185,000 practicing doctors. So a mere 185,000 doctors now try and help a population of 61.4 million. Doctors are unhappy with the General Medical Council. The option of revalidation otherwise dubbed the "harassment" of doctors isn't going down well. Given this shortage of doctors in general, Rubin is trying to persuade the lower social classes into entering the esteemed medical profession. Is it esteemed anymore? Or is it an imprisonment of genuine people who would otherwise be free? Rubin tells the world that he was from a atypical background. He flaunts his father's personal history to tell us all " if I can do it, you can". The point here is this :- do we really want to be like Prof Rubin? Does any spotty teenager want to be a bald man with large ears who knows nothing about the real world.

"Research by the British Medical Association (BMA), the doctors' trade union, shows that just one in ten medical students comes from the three lowest socio-economic groups, far less than the 30% from such backgrounds in higher education overall. It estimates that by next year the average debt incurred by a graduate of a five or six-year medical degrees will rise to an average of £37,000 by next year, with those in London paying as much as £67,000"

So instead of campaigning for a change in culture ie less judgmental medical school staff, Prof Rubin asks that richer students pay more tuition than poorer students. Rubin assumes this to be "equal opportunities". Rubin makes the assumption that all rich students are funded well by their parents. In reality, not every parent funds their child. This view will create discord and resentment between the two groups. Rubin fails to understand that the entire system of university education should be changed. The whole system is encouraging those from a higher social class into education. We are becoming a generation where education is only given to those who can afford it - a system that was in place in the 18th Century. It isn't just medicine that is in trouble, all students are in dire straits. There is no such thing as equal opportunities. It is time to scrap tuition fees, reinstate the full grants and ensure students from their GCSE years are provided with support and additional funding [ topped up EMAs] in order to work towards their aspirations. Each student should be judged equally - grades should not be lowered for poorer students nor should they be funded by their richer counterparts. The system in the UK used to believe in education for all. It certainly doesn't anymore. Rubin therefore fails to understand the that this issue is a global problem in UK education. The solution isn't to insult poorer students by offering them beggar funds. The solution is to equalise opportunity by ensuring all students are able to study - whether they are rich or poor. If the basic grants were of a decent amount, no one would need extra funds.

One of the GMC blessed programmes encouraging those from a so called "lower social class" is the Extended Medical Degree Programme. This extended medical degree programme has recently been criticised by its students. The programme has been accused of being insulting to minority students by implying they are in some way a special needs section of medical school. Students were given psychometric tests to show if the experiments in social mobility were working.

Medical Students were subjected to the draconian processes as implemented by the General Medical Council. Again, Prof Rubin believes that any person in their right mind would opt to choose a profession where every segment of you is scrutinised.

What to expect from the GMC.

This is what he says about Revalidation

"Rubin will certainly leave a major footprint in the sand of UK healthcare. His top priority is implementing the revalidation of all those 185,000 doctors. Although he describes it as "the biggest change to medical regulation since the GMC was established in 1858", revalidation has so far generated little controversy outside specialist medical publications – despite significant suspicion towards it among doctors. It will involve every doctor undergoing an annual 360-degree appraisal – with input from colleagues and patients – to prove their skills are up to scratch, and having to acquire, every five years, a fresh licence proving that they are fit to practice"

This is what the Telegraph said about GMC Style hearings for medical students.

The issue was highlighted at the British Medical Association's annual representatives meeting after student Drew Kinmond said the numbers graduating with black marks against their name has increased from three per cent in 2006/7 to one in ten last year.

He told the conference in Liverpool: "Students are not doctors, we are still in training. There has to be a period of time where students can be students and learn what it takes to be a doctor. There has to be a period of time where we can make some mistakes.

"That is why students are not in charge of patient safety."

He said he supported disciplinary action in serious cases such as assaulting a patient or dealing drugs, but urged the rules to remain in proportion.

The General Medical Council has issued guidance on disciplinary matters at medical school in an attempt to standardise rules that apply to behaviour before graduation.

The guidance states: "Students must be aware that unprofessional behaviour during their medical course, or serious health issues that affect their fitness to practise, may result in the GMC refusing provisional registration.This is the case even if the circumstance in question occurred before or early on in medical school."

The medical schools can set their own rules and hold hearings when they are breached.

Students have been warned they face action for skipping bus fares, setting off fire alarms, damaging carpets and floors, playing loud music, being impolite, not filling out forms on teacher feedback, parking violations, and attendance.

Of course, Rubin fails to inform the general public about the oppression that exists in medicine.You could successfully get into medicine and one night out may end your career. There are very few good things to say about medicine. Rubin implies that doctors earn a great deal. For the hours they do, they earn practically nothing. By the time you pay your student loans off and living expenses, MPS fees, GMC fees etc you will probably have as much in your pocket per week as someone working at the checkout in ASDA.

Professor Rubin also misses out the fact that hundreds of doctors are prevented from working due to the GMC's draconian Interim Order Panel. Having got rid of the usual good doctors in the NHS, Rubin wants to get in new blood. Well, one cannot expect any less from the man referred to as Count Rubin.

WHISTLEBLOWER TRAP

Chief Medical Officer Update Autumn 2009 newsletter issue 49 just informed me that NHS has independent NHS Whistleblowers Helpline (Public Concern at Work-PCaW). How could I resist calling: 020 7404 6609? Chief Medical Officer said they were independent yet authorised by the Department of Health to provide whistleblowing support to the NHS in England until 2011. Wow, a man who likes to be in control. There must be a long line of people waiting to kiss him. So dependable he is.

When I telephoned Public Concern at Work I found they are not really independent in the sense that they have contracts with NHS Trusts.

They protested that I did not understand that they really do provide independent advice.

It seemed reasonable to test them.

On the famous telephone help line for whistleblowers I said I was a consultant psychiatrist who raised the issue of the inappropriate wearing of religious uniforms in mental health setting and took one example of mentally ill patients who were raped. Specific example would be of men raped by clergy when they were children. I said they would not be able to trust Mother Superior working as a Social Worker with their history of abuse. Giving history to a health professional / social worker is the first step in that setting (NHS, Social Services). PCaW wanted to know if it was against the policy to wear religious uniforms. I said there was no policy but there is professional ethics: doctors do not wear white coats in psychiatry and nurses do not wear nursing uniforms in psychiatry. Social workers do not wear uniforms. I explained I did speak with the managers who said they would do something about it, but did nothing. Eventually, I went to the press.

PCaW told me I was asking for trouble by going to the press. They added; "You have to go with them (managers) even if you do not agree with them". Helpfully, the spokesman added: "They probably dismissed you with a good reason". Also he told me that at that time "PIDA was not in place in 1999". I pointed that it was. PIDA is Public Interest Disclosure Act.

Naturally, PCaW are confident that they have been able to help other people raise their concerns.

They tried absolutely everything they could to fob me off. They told me my concerns happened too long ago. When I pointed this was still my concern as religious uniforms were still worn whenworking with mentally ill I was told I held strong views.

I explained that I lost everything, Health Ministers changed (resigned), Prime Ministers changed, but that Department of Health still would not issue a policy about not wearing religious uniforms in mental health.

Eventually, I was told to contact Humanist Society. Well, at least there was a recognition that my concerns had something to do with human beings. When I called them they told me:"Well, I am not sure this is something that we would"...

Department of Health has been informed numerous times they are in breach of Human Rights e.g.

Article 9 Freedom of thought, conscience and religion

1 Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief and freedom, either alone or in community with others and in public or private, to manifest his religion or belief, in worship, teaching, practice and observance.
2 Freedom to manifest one’s religion or beliefs shall be subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedoms of others.

Department of Health told me that they will not respond to me but that they will log my letters.

It is the response that is required. The policy on the wearing of uniforms in mental health is faulty, but it can be corrected.

What is responsibility? One way to define it is the ability to respond. According to that definition there are some people in the Department of Health who appear to lack that ability.

Meanwhile, of those raped men who suffer with post-traumatic stress disorder, some would kill themselves and some would kill others.

Post-traumatic stress can cause violence in extreme form.

I am a doctor who raised my concerns appropriately, at the right time to the right people in the authority and discovered an awful lot of irresponsible people. When I read about the recent shooting at the largest military base in USA I wondered if the faults were made because of "political correctness".

My impression of military psychiatrists is that one has to be the darling of establishment to do the job. In UK, the rate of PTSD is about ten times less than in USA in military personnel. Do we really, think that British man is the strongest in the world? Or do we think some of the British psychiatrists are the weakest in the world? Diagnostic criteria are international. Human Rights are international too but it is the application that matters.

The Royal College of Psychiatrists has refused to issue the guidance on the wearing of religious uniforms in psychiatry and they have Spiritual Section contrary to their own regulations. Psychiatrists are very well aware on how they can limit the power of the patients and also how to keep status quo in their own interests. Traumatised people guarantee good business for many generations of psychiatrists to come, assuming public continued to maintain them. But the public will not do so. It already has cheaper options to use.

Laws are of no importance, I conclude, in the case of the wearing of religious uniforms because British judges are not willing to protect the whistleblowers and are not acting independently of religion or government.

Meanwhile, the government funded PCaW help line will be just another window dressing exercise. PCaW supports the government, not whistleblowers or the patients or the public.

Justice in Health Network (JIHN)

Of late, we have all been puzzled as to why Justice In Health Network had failed to invite a number of people to their meeting in the Houses of Parliament. Another meeting dated 23/11/09 is due to be held. Anyone wishing to attend, should make contact with the individuals below. Justice in Health Network kindly issued an invite to a member of Doctors4Justice. Doctors4Justice is taking this opportunity to extend this invitation to the wide public and members of the health profession.

An outline of Justice in Health Network (JIHN)

The Justice in Health Network is an independent, non-party political, grouping bringing together patients, service users, family carers, voluntary sector organisations, and others with knowledge and experience in health matters, social care, and other relevant fields.

We desire an efficient, sedulous, and well run, NHS that is both democratic and accountable, and to bring about beneficial change in medical services, and social care.

We endeavour to facilitate an independent, informed, and coordinated, voice on health policy issues.

From time to time, we hold conferences to promote debate on issues relevant to a wide cross section of health service users, and to encourage and inform public involvement.

We wish to support positive action to improve health services, but will be critical where that is appropriate. We endeavour to do this from an informed viewpoint, to propose possible solutions in a spirit of engagement and co-operation, and to do no harm.

In addition to general networking and other activities, we are currently :-

a) Opening and developing a lines of communication and dialogue between the Network, members and participants, and the health unions, regulators, and other influential bodies.

b) Exploring opportunities to bring about a co-ordinated approach on health issues.

Adrian Delemore,
Project Organiser
Justice in Health Network, March 2009
Justice in Health Network
Park Cottage, Portsmouth Road, Esher, Surrey KT10 9JF
Tel: 07973 834 012 Email: justice_in_health@yahoo.co.uk

Biological clock stops

Biological clock has stopped! Revolutionary research by American Scientists published in Nature described how sperm and ova were made out of skin cells! I am very happy with this research and wish I can show it to some people. Yes, those girlfriends who ignored me for months while desperately manipulating their men to marry them.

This discovery means patients undergoing treatment for cancer can have children in the future.

It means those previously rejected by Reproductive Clinics will have new treatments.

Trans gender people can celebrate if they wish.

Many ethical problems are solved and some new questions will be raised.

The ramification of this discovery are formidable.

It means more justice for women who suffered a lot of discrimination based on their age.

Sheffield Medical School. The CRE Investigation

I raised issues about the failure rate of ethnic minority students at Sheffield University medical school in October 1997. This article has been extracted from the material listed on http://www.examfraud.co.uk/. Refer to the website for detailed evidence. Further material can be accessed in this Times Higher article. A second article in Times Higher can be accessed here.

In fairness, it must be emphasized that it is always, without exception, in the interest of the university that students should pass exams. People who engage in discriminatory practices are contravening the interests of the university and add to the workload of their colleagues.

That said I do have a taped conversation with the GMC president Professor Sir Graeme Catto where I discussed the issue of falsifying medical students exam results with him and he accepted that this can happen.

If you read the NUS Mark My words briefing it says

“When colleges and universities do not have anonymous marking in place, research shows that black students can receive up to 12% lower marks. This anomaly has been vigorously tested by independent bodies with the results consistently demonstrating bias in the scoring process as a root cause.”

Report after report shows that the NHS is riddled with institutionalized racism. As such a student being assessed in such an environment will be most vulnerable. That is one reason why university courses allied to medicine have a disproportionate failure rate among non white students.

Sheffield University has an anonymous marking policy. It says that in 1994 the Senate of the University decided that students names would not be visible to examiners, only their registration numbers. That is far from the truth.

I went to see Mr. Richard Allan, then MP for Sheffield Hallam. He made representations about this. He wrote to Mr. Page, the Undergraduate Dean of Sheffield medical school on 23/10/97. The letter was faxed through to Mr. Page.

I was concerned about the anonymous marking system adopted by the University in 1994. Mr. Allan said in his letter that it was alleged that the names of the students were in fact easily identifiable to those doing the marking. We suggest that there was a list of names against the numbers used on exam papers which was known to be available to course tutors. It was further alleged that this had led to a racial bias creeping into the marking whereby a higher proportion of ethnic minority students was failing than would be statistically normal.

I gave the official fail lists to the MP. In the 5th year of the 1996/97 session group of medical student's 27/181 students were of home ethnic origin. Almost exactly 15% at Sheffield medical school at the time there were three subjects taught in rotation. They are Obstetrics and Gynaecology, paediatrics and psychiatry.

Among all those who failed Obstetrics and Gynaecology in that year 7/18 that failed were of ethnic minority. The exam consisted of 25% attachment marks, 12.5% coursework 25% essays and 37.5% Objective structured clinical exam (OSCE) In the OSCE candidates were given a two-digit candidate number to put on their papers. The list of names and numbers was put on a notice board for all to see. On essay papers at Sheffield University there is a confidentiality flap which is very difficult to seal down. Candidates have to write their names underneath the flap. Although there is nothing to stop a student sealing down the flap with cello-tape or stapling it down.

In Paediatrics 5/7 that failed were of ethnic minority. Paediatrics was, under that system 50% continuous assessment, 25% OSCE and 25% clinical exam. If the candidate failed the clinical exam it resulted in an outright fail. In a clinical exam there is no protection of anonymous marking. In fact anonymous marking doesn’t give you any protection at all.

In psychiatry 5/12 that failed were of ethnic origin. This exam consisted of a clinical exam, a written paper and an attachment. Dr. Peters the then undergraduate course tutor in sychiatry and now Undergraduate Dean would openly admit to having the list of names and numbers before the papers were marked. He would insist that the students wrote their names on the papers. Of the students who had to drop down a year into this group of students due to exam failure seven were of ethnic minority. Six were in Obstetrics and Gynaecology.

I saw Mr. Page on 23 October 1997. He admitted to me, Dr Varma (snr) and Mrs. Varma that he knew that Dr Peters was openly flouting the rules on anonymous marking.

In Mr. Page's reply of 30 October 1997 he said

"The Medical School adheres to this policy. However the system cannot guarantee complete anonymity as the identifier of an individual student is the student registration number, access to which is available to nearly every department in the University, via the Management and Administrative computer. Internal examiners do not receive the list of names corresponding to student registration number."

Clearly Mr. Page was economical with the truth. He should have said that the medical school is meant to adhere to the system but they flout it.

In theory, he could face a misconduct charge by the GMC. However he won’t. Firstly he is white, secondly he is a consultant but most importantly he is on very good terms with Professor Weetman the Dean of Sheffield University Medical School. Given that Weetman is a GMC member himself nothing will happen. You only have to read Dame Janet Smith’s 5th report to the Shipman inquiry to see that the GMC is an old boys club.

Mr. Page went on to say

"any academic member of staff with a will to identify the name of an individual form their registration number could do so but when faced with having to mark nearly 200 or so scripts to a tight deadline would waste time doing so."

He did not mention the confidentiality flap nor the fact that not every examiner would mark 200 scripts. They don’t mark anywhere near that. Besides if you see my website http://www.examfraud.co.uk you will see the ways around anonymous marking that they don’t want people to know of.

The question is what about students on courses where there are not so many students? On top of that what about resits where there are very few students?

"Project work submitted for assessment in the first two years of the course uses student registration number as an identifier." In theory, it has been known that such work is done by name, but the work is handed back to the student once marked. "In the latter stages of the course, assessment includes clinical and oral examinations, which are obviously conducted face to face and cannot be anonymous. Individual examiner biasing the whole assessment is minimal.

These safeguards are threefold:

1) A range of assessment at each level of the course ensures that a number of examiners would be responsible for assessing each candidate, with each component of the examination often having a different set of examiners.

If you believe that you will believe that the moon is made of cream cheese.

2) Clinical and oral examinations are conducted by examining pairs, with each examiner marking independently of the other before arriving at an agreed mark.

That is not true they usually confer.

3) The External Examiner is present to moderate marks and to ensure standards are comparable with other medical schools."

What you mean like external examiners like Professor Ann Mortimer who falsely accused me of being a drug taker on the basis of my exam papers? Or even Professor Mindham who failed one of my projects which was published?

As far as the failure rate of ethnic minority students was concerned he said:

"I am unable to comment on the failure rate of any particular group of students. The school does not routinely monitor failure rates based on race, nationality, ethnic origin or gender but believes the above procedures should ensure that racial bias does not occur."

Mr. Allan was not satisfied and wrote back to Mr. Page on 21/11/97 . He said

"I feel that the introduction of a secure system of student identification for closed book examinations and routine monitoring of failure rates would help the University in responding to allegations of bias."

Catherine Davison a senior member of staff of the Medical School replied on 26/11/97 . In her letter she stated that she had passed on the letter to the University Teaching Committee, There was never a reply. This made the press in one of the local papers on 26/11/97.

On 28/11/97 the then academic and welfare secretary of the Student Union – Miss Nicole Meardon- wrote to Professor Woods, the Dean of the Faculty of Medicine about this article. She expressed concern that

"It was alleged in this article that the University's policy on anonymous marking was not being fully implemented by your faculty. I am also aware that discrepancies following the procedure were acknowledged by the faculty during a student review hearing at which a member of the Unions Student Advice Centre was present representing a student."

Ms. Meardon was also concerned by the allegations of racial bias against students from ethnic minorities. She said

"Could you please send me any statistics on failure rates, compared to the intake of ethnic minority students and could you let me know what monitoring is carried out by your faculty? I would also be grateful if you could send me a written assurance that the Medical Faculty is abiding by the University's anonymous marking policy."

Professor Woods replied on 17/12/97 . He said

"I know of ONE instance where an ambiguous statement made by a lecturer led to confusion in the minds of the students sitting an examination. It is wrong to extrapolate from this single episode to a general statement that the Faculty as a whole has not implemented the University policy on anonymous marking. At the Faculty Student Review Committee, to which you refer, the Committee did acknowledge that a discrepancy had occurred on one occasion but this was not done with any intention to identify individuals and it was understood that the marking of the examination was conducted fairly and without bias, in accordance with the Departments usual practice."

If they have been caught once how many times have they done it? Woods lied- he knew that it came out at this hearing that Peters had flouted the anonymous marking system repeatedly.

I am amazed that Woods had the arrogance and audacity to say what he did. At that hearing John McSweeney of Howells solicitors exposed some 20 acts of alleged misconduct on the part of Dr Peters. Indeed the most serious was the fact that the external examiner Professor Ann Mortimer from the University of Hull falsely accused me of being a drug taker on the basis of my exam papers.

According to one of her websites she has taught at all levels doctors and professions allied to medicine for many years. She is the Chief External Examiner to the University of Birmingham and is the Deputy Chief Examiner for the Royal College of Psychiatrists. So you can see how unfair medical assessments are.

Despite the false accusation of being a drug taker the University made me resit the exam. That’s Sheffield university for you. That hearing was a huge cover up, they reinstated me and I believe that it was to protect Dr Peters and stop the events of the hearing of 6 November 1997 coming to the public domain.

Professor Woods did not send Ms.Meardon any failure lists nor a written assurance that the medical faculty was abiding by the anonymous marking policy. As far as monitoring was concerned he said

"I am unable to answer your general allegation about racial bias in examination within the Faculty of Medicine. As you should know, and in accordance with the University Equal opportunities Policy, the Faculty does not record, nor have access to, details of ethnic origin of individual students. We are therefore unable to monitor failure rates based on ethnic origin."

However he obviously took Ms. Meardon’s letter seriously. He sent courtesy copies of his reply to The Registrar of the University, Mr. Page, Professor Sharp (Dean of the medical school) and Hilary Shenton. (The Senior administrative member of staff at the medical school.) It is also interesting to note that the course handbook also makes a statement on equal opportunities.

In the same month the Steel Press – Sheffield university’s student union’s newspaper ran a story on the matter.

All this material was passed onto the Commission for Racial Equality. In their letter of 2 February 1998 to me they stated that

"in the case of Obstetrics and Gynaecology exams and the Paediatrics results the disproportionate impact of the failure rate on ethnic minority students seems to be a real cause for concern."

They commented on the response of the Mr. Page's reply to the MP.

"He states that the medical school does not monitor failure rates but seems to have a belief, (possibly divine) that their procedures are free and fair from racial bias. Given that the University must be aware of the concerns in their exams and their apparent commitment to a programme of action to make their comprehensive equal opportunities policy effective"

It seems strange that they have not decided neither to monitor the situation or take any action as a result.

"It would seem useful for the Commission to raise its concerns about these issues with the University and possibly investigate the medical schools examination system in particular."

The CRE agreed with me that three things were clear:

1) The University was clearly not following its own rules.

2) The University procedures were clearly inadequate.

3) The University was bound by it's own equal opportunities policy to do something about the problem. The CRE said that they had heard the same thing from other students before, which is no such discrimination, has EVER been alleged in the pre-clinical part of the medical course. It is in the clinical part of the course that such acts occur. In July 1998 after much liasing between the CRE and the University, the CRE confirmed that the University agreed to monitor failure rates by ethnic origin as of the 1998/99 academic year in all courses.

However who is doing the monitoring? Dr. Peters, the Department of Paediatrics or Obstetrics and Gynaecology? However the University has made another step to make sure this cannot happen again. The results are now put up in a lockable glass cabinet where nobody can take them down again. They put that lockable cabinet up very quickly after the press started making noises about the lack of compliance with the anonymous marking policy.

I was asked to write an article saying why students should have their papers back once marked for student BMJ . They then asked Weetman to write an opposing article. Weetman demanded to see my article before he wrote his response.

He argued why students should NOT have their papers back once marked. I couldn’t believe his comment where he says that most students won’t want to see their exam papers back. I just wondered how out of touch with reality he was when he made that comment. Then again when I interviewed him on student debt matters he said “It probably hasn’t changed that much since I was a student.” He qualified in 1977 the interview was in December 1998.

Why did he demand to see my article before he wrote his? Well if you want to know why then go to www.examfraud.co.uk

The Steel Press was going to run a story on my case but were prevented from doing so.

By Dr Sushant Varma

BRAIN PAINTING

It has been disturbing to see yet again an eminent psychiatrist labeling a man of above average intelligence as cognitively impaired (suffering brain damage) when there is political motivation to do so.

Psychiatrists can make extra income through private work and authorities would be only too relieved to have a person that taxes their brains too much decanted to a psychiatric institution in order to discredit him. This symbiotic relationship is something that may not be obvious to a layperson, but is a classic social problem of Human Rights Abuses.

Doctors4Justice members successfully intervened and the man is out of the psychiatric hospital now.
http://www.youtube.com/watch?v=xFJSzngrjTg

Medical Mobbing

Hospital Doctor presents an interesting piece related to Medical Mobbing. Many in the medical profession have experienced mobbing of this kind.

"In medicine, mobbing has been recognised as ‘sham peer review’. US neurologist Lawrence Huntoon defines it as “an official corrective action done in bad faith, disguised to look like legitimate peer review. Hospitals use it to rid themselves of physicians who advocate too often or too vociferously for quality patient care and patient safety, and economic competitors frequently use it to eliminate unwanted competition”.

Kenneth Westhues, University of Waterloo, said that: “sham peer review is defined by a particular technique of punishing, discrediting, and humiliating the target: the quasi-judicial procedure of peer review, whereby in response to one or more complaints, a hospital committee formally deems the target deficient or incompetent in some way, and decides on a penalty (like retraining, suspension, or dismissal)”.

In his editorial, The Psychology of Sham Peer Review, Huntoon goes onto say: “The psychology of the attackers is a combination of the psychology of bullies and that of the lynch mob. The attacks are typically led by one or a few bullies who have gained positions of power over others and who enjoy exercising and abusing that power to attack and harm the vulnerable. Although there is always some improper motive that precipitates the attack, the attack itself often serves to distract attention from the bully’s own underlying shortcomings, deficiencies, insecurities, and cowardice.”

Here are some related links that may be of use to everyone.

1. In their own Words Academic Mobbing

2. Psychology of Mobbing

3. Bullying in Medical Schools

4. Bullying in Medical Schools

5.Uncovering the face of racism

6. Mobbing in the Workplace

7.Wikipaedia on Mobbing

8. Bullying online on Mobbing

9.Workplace Mobbing Australia

10. Mobbing USA

11. Mob Bullying in the NHS

12. How to Beat NHS Workplace bullying

13. NHS Employers Guidance on Bullying and Harassment

14.Targets Triggering bullying Culture

15. Costs of Bullying to the NHS

16. NHS Bosses "bully 1 in 12"

17.Business Strategy of Equality and Human Rights

18. Mobbing Portal

DOUBLE ERASURE

Consultant Psychiatrist working part-time asked for voluntary erasure from the General Medical Council register (UK).

He was doing a Section 12(2) Mental Health Act 1983 emergency assessment on a suicidal patient when he received a telephone call on his mobile from the General Medical Council stating that as there was a postal strike it was decided to inform him by telephone that his erasure has been immediate!

He had the presence of mind to complete his assessment and save yet another life despite being informed he was no longer registered.

Fortunately, it was possible to persuade the General Medical Council to allow voluntary erasure to take place at a planned date at the beginning of November 2009 and for loose ends to be tied.

If one can be erased twice like that anything is possible.

Mental Health issues and the Practitioner Health Programme [PHP]

This Department of Health document provides an insight into doctors who suffer from mental health issues. "Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years."[ See abstract]

Latest research suggested that doctors were in denial about their mental health problems.

"Research by the Royal College of Physicians, published in the journal Clinical Medicine, found that nearly three quarters of respondents said they would rather discuss mental health problems with family or friends, than seek formal or informal advice, citing reasons such as career implications, professional integrity, and perceived stigma of mental health problems.

The survey of over 3,500 doctors in Birmingham is the first of its kind of this scale looking at (non-psychiatric) doctors' preferences for disclosure and treatment in the event of becoming mentally ill.

Almost three quarters (73%) of respondents to the study would be most likely to disclose mental health problems to family or friends, rather than seek formal or informal advice. The most important reasons affecting that decision were issues such as career implications (33%), professional integrity (30%), and stigma (20%). Forty one per cent of respondents would seek informal advice for outpatient treatment, but 8% would either self-medicate or opt for no treatment at all.

The Royal College of Psychiatrist document on Doctors and Mental illness can be downloaded here.

A Doctors4Justice member kindly informed us of the Practitioner Health Programme. The website tells us as follows :-

The Practitioner Health Programme is a free, confidential service for doctors and dentists who have mental or physical health concerns and/or addiction problems and who live or work in the London area.

Any medical or dental practitioner can use the service, where they have

* A mental health or addiction concern (at any level of severity) and/or
* A physical health concern (where that concern may impact on the practitioner’s performance).

The BBC Report can be downloaded here.

Their contact details are as follows Our Help line is 020 3049 4505 or email us at php.help@nhs.uk

Khan v General Medical Council. GMC Beaten in Court

Members of Doctors4Justice assisted on Khan v General Medical Council. The case involved a surgeon who sadly infuriated David Graham of Liverpool Deanery following a threat to sue under the Race Relations Act. This caused a domino effect where the Deanery referred Mr Khan to the General Medical Council for minor CV errors. Despite the fact there was no case to answer, it was taken to hearing where he was given a draconian three months suspension.

We were in close contact with his wife, advised her of the case law, the relevant manner of arguing their case. To Ms Rifat Malik a ex national TV newsreader, the injustices meted out by the GMC came as a real shock. It was her hard work with all our assistance that finally achieved a victory in court. Dr Sushant Varma's tireless work on this case led this family to achieve a successful outcome. The suspension was lifted and Dr Khan was given a clean record.

On the day of the victory, we received this email.

The landmark victory can be downloaded here.

The chocolate did it!!

We just wanted you to be among the first to know that we have been totally vindicated and amir has been cleared of dishonesty and the impairment and sanctions have been set aside.

The judge said that he would be ordering 'no action' to be taken.

We also want to say that you both have been the ones who gave us hope and support for all these years and without you both we would never have made it so far. You are tireless and resourceful and we know there are so many drs and their families that you have helped through your work - your compassion, humanity and fight for justice has been inspirational. There is no doubt that our success after 5 years of struggle is almost wholly down to your help - we are indebted to you both forever.

Thank you from the bottom of our hearts.

Rifat and Amir

GMC Backed Down on Ethnicity Data Collection

The material below was written by Dr Sushant Varma. He details the evidence on Race Discrimination at the General Medical Council. Dr Varma's work directly led up to the change in the data collection procedures at the General Medical Council. The GMC commenced ethnicity data collection in 2007. Previously, no one could sue the GMC successfully or establish racial discrimination due to the lack of statistics. Discrimination law is dependent on statistics.

This was the main downfall in those who sued the GMC. Dr Sushant Varma noted this and made a formal complaint to the then Commission of Race Equality. Both Dr Pal and Dr Varma formally requested an investigation into the GMC citing that the GMC was in breach of the Race Relations Act. We pointed out that for 100 years plus, the GMC purposely failed to collect ethnicity data so that there was no finding of racial discrimination against them. An absence of statistics meant it was impossible to make a evidential finding of race discrimination.

In 2007, the response from the CRE was as follows

"As stated in my previous e'mail , the Enforcement and Public Duty team is currently in communication with the GMC , regarding allegations of a disproportionate representation of overseas doctors on their Fitness to Practice Panel investigations . This is a specific issue that we have become increasingly aware of and are therefore making enquiries on it in order that we can establish the best cause of action. We are also considering a similar approach with regards to the treatment of BME doctors"

As a direct result of this complaint supported by a number of members of Doctors4Justice, the CRE recommendations to the GMC effectively forced them to collect ethnicity data. Congratulations to Dr Varma who made history by this excellent research and work.

Dr Varma and Dr Pal's arguments to the CRE were cut and pasted for the GMC's document on ethnicity data here. The document trail between the GMC, CRE and ourselves detail the processes that led up to this landmark change. The GMC have marketed this issue as if it was miraculously their idea. The fact is that they refused to collect data until they were forced into a corner by the CRE.

GMC and Racial Discrimination - by Dr Sushant Varma -2006/2007

The evidence suggests that the GMC are tougher on foreign doctors if you read this article GMC tougher on foreign doctors (1) written in 2003 you will see evidence of this.

Concern was raised on this issue in Dame Janet Smith�s 5^th report to the Shipman inquiry (2). Here the high court judge commented on the work of the policy studies institute in 1996, 2000 and 2003 finding the same

In February 2005 (3) Dr Surendra Kumar wrote an article in BIDA news (British International Doctors Association) expressing concern about the disproportionate number of overseas doctors facing hearings at the GMC. In response the president of the GMC said this is due to the fact that overseas doctors are more likely to be referred to the GMC. Whilst that may be partly true I have no doubt that there is discrimination.

Indeed if you go to www.bapio.co.uk you will see a recent story entitled BAPIO raises the issue of disproportionate disciplinary actions against ethnic minority doctors with the GMC. President Professor Sir Graeme Catto assures action. It seems that three years on nothing has changed.

Although the president- Professor Sir Graeme Catto has partially explained the problem by saying that a disproportionate number of overseas doctors are referred to the GMC (4) I have no doubt that there is discrimination.

For example Dr Peter Wilmshurst wrote a beautiful article (5) showing all sorts of issues. He has found gross inconsistencies as have I. For each time a foreign doctor gets disciplined by the GMC I can give you details of how a white doctor does worse and gets away with it.

For example if you look at (6) you will see an article showing how a final year medical student was caught cheating in her medical finals. I now have official confirmation that she faced no penalty.

If you look at my website www.examfraud.co.uk you will see that I was cheated of my medical degree due to wilful manipulation of evidence and procedures to ensure I failed exams. It reached such an extent that I was forced to have to take my exams externally. However after qualifying in medicine externally my medical school dean wrote to the GMC president alleging fraud. The president said that there were no grounds to take any action. 5 years in September 2006 on the GMC erased me from the medical register for precisely that. The GMC did nothing about those responsible for manipulating my exam results. (7).However on 21 December 2006 the GMC wrote to me after I made representations to the Information Commissioner saying that they had found memos showing that in August 2001 they knew that they could not take action against me on this matter.

In my case several facts are clear.

In 1998 a lecturer was caught manipulating evidence and procedures to ensure a non white student failed exams- an exam decision was overturned from fail to pass. The GMC did nothing. (7)

In 2000 a student at University College London was caught cheating in her finals- the GMC did nothing (6)

In 2001 a professor of medicine is caught manipulating evidence and procedures to ensure a non white student failed exams (www.examfraud.co.uk)

Instead of taking action against the professor and lecturer the GMC takes action against the student.

I would again ask that all FTC members sign my online petition.

(1) GMC tougher on foreign doctors 14 February 2003 http://news.bbc.co.uk/1/hi/health/2757243.stm

(2) Chapter 17 The Shipman Inquiry http://www.the-shipman-inquiry.org.uk/5r_page.asp?id=4715

(3) President�s Report BIDA news February 2005

(4) President looks back on a year of changes (page 4) GMC news June 2004 http://www.gmc-uk.org/publications/gmc_news_archive/gmcnewsjune04.pdf

(5) The General Medical Council a personal view Cardiology news October/November 2006 http://www.pinpointmedical.com/cardiology/article_archive/2006/ON06_gmc.pdf

(6) Cheating at medical school British Medical Journal 12 August 2000 http://www.bmj.com/cgi/content/full/321/7258/398

(7) Sushant Varma vs. Dr Steve Peters GMC reference FPD/1998/1234

Update on petitions

Since the preceding article was written the 10 Downing Street website has made itself available for petitions. Members of Freedom to Care are recommended additionally to sign the following petitions.

'We the undersigned petition the Prime Minister to Abolish the General Medical Council of the United Kingdom.'

http://petitions.pm.gov.uk/AbolishGMC/

'We the undersigned petition the Prime Minister to Investigate Allegations of Institutional Racism at the General Medical Council.'

http://petitions.pm.gov.uk/GMCRacism/


Related Links

GMC to Collect Ethnicity data.