Thursday, 29 April 2010

EMPATHY AND RACISM


Empathy is an essential component in medical and legal practice.
Human beings have different capacity for empathy. One social study after another has shown that prejudice can lead to different treatment for different ethnic groups.
It is now established through scientific evidence from research led by Ms Jenifer Gutsell, PhD student and Assistant Professor Dr Michael Inzlicht that people have brain activity that mirrors the activity from the different race members differently.
In their experiments, subjects were watching men of different races take a drink. Brain has motor cells which mirror this activity (sympathetic) ie the brain cells of the observers become active in motor cortex mirror cells when watching a member of the same race take a drink but not so if the person belongs to a different race. Motor cortex mirror cells were less activated when watching a person from different race take a drink. In other words, the brain mirror cells do not go through the same motion of putting oneself in another person's shoes when observing the member of a different race...
This opens possibility of testing judges and doctors for racial bias in a novel way.
We do know that medical regulators in UK such as the General Medical Council have an overabundance of doctors from ethnic minorities facing disciplinary hearings. Should all the complainants take this test so that we can all see how their brains work? What about investigators? Fitness to Practice Panelists? And does the same applies to sexual bias too? Do female judges prefer male barristers to female? Plenty to research in days to come.
The hormonal levels in men and women differ for a number of different hormones. Oxytocin is one of those. Should all of those who need empathy have serum levels of oxytocin measured? Will this identify institutional psychopaths sooner rather than later?
When people arrive to work will they have to pass through the scanners in order to confirm their fitness for work like going through scanners at the airports?
What about a bunch of men judging a female doctor hounded by a bunch of men? On whose side would they be, naturally?
With improvements in science and new applications in social work and politics will some prisons close down one day like many psychiatric hospitals did?

Monday, 26 April 2010

Mr Gary Walker, swearing, and reality

It is terrible to hear that Mr Gary Walker who worked as Chief Executive for United Lincolnshire Hospitals Trust in UK has got into trouble for allegedly using a bit of swearing in some of the meetings.

The truth is that swearing is incredibly common amongs professionals.

For many, many years people have done it without being hounded out of their jobs or dismissed.

In 1999 BMJ published a study where unknown to them, surgeons were observed for use of swear words during operating time.( BMJ Volume 319 18-25 December 1999).

The swear words were classified into three groups, with points assigned to each swear word:

Heaven and Hell Category:

"God", "Bloody Hell", "Bugger" all 1 point

Bodily Products:

"Shi*t", "P*ss" each 2 points

"FOUR" Letter words:

"F***", "C***" , "B***ard" each 3 points

If a string of swear words was used only the highest scoring word was given the points.

Results: 1 point was scored each 51.4 minutes.

On average 16.5 swear words were used by orthopoedic surgeons within 8 hour shift. General surgeons used 10.6, gynaecologists 10, urologists 3.1.

Ear, Nose and Throat surgeons managed five hours without swearing.

Thus, it can be concluded that swearing is common in professional setting. None of those who swore were subject of disciplinary proceedings.

Mr Garry Walker is special, as he saved the trust from 24.5 million debt. He warned about patient safety and considers himself to be the victim as the result of whistleblowing which led to disciplinary hearing.

We wish him good luck in his Employment Tribunal where he is seeking damages. We hope he would not be judged adversely for being normal.
We hope he will not have religiously biased tribunal.

Wednesday, 21 April 2010

GMC for ever


Professor DKK worked for General Medical Council as Health Screener in Fitness to Practice Directorate.
She died in July 2009 while still employed by the General Medical Council. Family informed GMC of her death. Six months after her death GMC issued a Registration Certificate to her. She did not pay the annual fee and months later a reminder letter was sent to Professor DKK reminding her of the fees due.
GMC no longer issues Registration Certificates.

Sunday, 18 April 2010

DYSFUNCTIONAL SERIES: ARTICLE 5: DENIAL

Denial of own feelings is one of the characteristics of victims and abusers/persecutors. Acting responsibly according to feelings is the first step to address individual needs.
When these needs are not met unpleasant feelings surface, but these unpleasant emotions can be changed through addictions which give a temporary high.
Here are some examples of addictions:
drugs/alcohol/smoking
work
dieting
food
exercise
love
sex
gambling
hobbies, etc
Here is one definition of addiction: compulsive behaviours or use of substances to alter feelings leading to chronic neurobiological changes, difficulty stopping and difficulty not seeking to increase the addictive substance use or behaviours.
It is easy to see that for example to remove the feelings of anxiety about something can lead to addictive behaviour or substance misuse.
Eventually, things get worse for the addict, needs are still not met, other people are victimized. Victim turns into a victim persecutor and guilt is used for control of others. Poor self esteem can arise from low achievement as the result of not acting responsibly on own feelings and as the result of persecution and abuse at the hands of others.
Here are some examples:
1. Feelings of anger arise when we encounter injustice. The option open to individual is to change expectations and give up, accept the world as it is and watch TV, do household tasks and what boss and everybody else tells him/her. Another option is to use energy of anger to attack injustice and make a world a better place. Big changes in our society do happen because people had used their anger constructively.
2. Sadness can arise as the result of loss or anticipated loss. Before being able to address sadness many have to address feelings of guilt which may not be justified at all. After sadness has been faced, there is need to acknowledge hurt, after that anger and after that fear needs to be addressed. Feelings change from one to another.
People progress through different stages with different degree of ability to cope. Taking responsibility for own feelings and needs, and subsequent actions is easier than taking responsibility for own beliefs.
Political and religious dogma is one example of the belief system onto which people can hang irrespective of what damage it causes them or other people. State institutions reflect those beliefs, hold onto them or fail to address them through individuals who work there and whose responsibility is to address them. Thus, what may start as individual problem in addressing the needs of the patients or doctors to provide for those needs, becomes a "system problem". In situations where laws already exist to prevent victimization, individual still depends on those institutions to protect the rule of the law and not the rule of the mob BY ABUSING THE POWER OF DECISION MAKER.
After many years of stress some people give up exhausted and unable to defend themselves any longer.
Some people leave early and let others fix the problem that gave rise to the initial feelings of e.g. dissatisfaction.
There are people who never give up. They have positive regard for themselves and believe that eventually other people will be able to help them make the world a better place.

Doctors have a very high risk of being victimized as by nature their job is to take responsibility for the feelings of their patients. In situations where they are obstructed or prevented from doing their job, stress arises and risk of addictions is high.

Expressing one's feelings as in whistleblowing in UK results in persecution and almost all whistleblowers are forced to leave their chosen career. This reflects social dysfunctionality beyond that of an individual.




Monday, 12 April 2010

ORGANISED MOBBING: A BRITISH OPPRESSIVE REGIME



Mobbing

Definition

• Mobbing is a term referring to a type of animal behaviour. A newer use refers to a group behavioural phenomenon in workplaces.

Mobbing as a human bullying behaviour

Mobbing in the context of human beings either means bullying of an individual by a group in any context by (Governmental Department, or Professional Regulatory Bodies, Judiciary, Police etc…), or specifically any workplace bullying.

• Though the English word mob denotes a crowd, often in a destructive or hostile mood, German, Polish, Italian and several other European languages have adopted mobbing as a loanword to describe all forms of bullying including that by single persons. The resultant German verb mobben can also be used for physical attacks, calumny against teachers on the Internet and intimidation by superiors, with an emphasis on the victims' continuous fear rather than the perpetrators' will to exclude them. The word may thus be a false friend in translation back into English, where mobbing in its primary sense denotes a disorderly gathering by a crowd and in workplace psychology narrowly refers to "ganging up" by others to harass and intimidate an individual.

• Research into the phenomenon was pioneered in the 1980s by German-born Swedish scientist Heinz Leymann, who borrowed the term from animal behaviour due to it describing perfectly how a group can attack an individual based only on the negative covert communications from the group".

• In the book MOBBING: Emotional Abuse in the American Workplace, the authors say that mobbing is typically found in work environments that have poorly organized production and/or working methods and incapable or inattentive management and that mobbing victims are usually "exceptional individuals who demonstrated intelligence, competence, creativity, integrity, accomplishment and dedication".

Mobbing in Scots law

• Under the law of Scotland, mobbing, also known as mobbing and rioting, is the formation of a mob engaged in disorderly and criminal behaviour. The crime occurs when a group combines to the alarm of the public "for an illegal purpose, or in order to carry out a legal purpose by illegal means, e.g. violence or intimidation”. This common purpose distinguishes it from a breach of the peace.

THEORY

For any organisation enjoying a certain empowering status over a group of people and wishes to establish a regime to practice Mobbing over them, it has to secure a circle of similar authorities in support of such a regime [e.g. other Government Departments, Professional Regulatory Bodies, Judicial System through Courts, Police etc…]; because if that regime is restricted to one Hierarchical Department it would not be able to survive to apply that Mobbing Regime because it would be exposed and be defeated if challenged for example by the Judiciary.

Therefore, the most dangerous confrontation a Mobbing Regime would have to face is with the Legal Judiciary System; the 2 main reasons for that are:-

That such regime could be defeated by hefty damages and consequently made public. This would act as a deterrent for others.

A precedent legal case would occur and make such regime a vulnerable practice for the organization where mobbing occurred.

Consequently for such a regime to survive it is essential for it to secure a circle of other Authorities which will continue to support it.

If the Legal System has been successfully alienated from justice, this should be the biggest achievement of that regime enabling it to survive; having secured that side the practice of such regime becomes not only unopposed but would enjoy the support by coercing other authorities to practice the same; and if an authority refuses to be coerced into such policies it risks isolation and marginalisation.

GOVERNMENTAL BODIES

E.g. the Department of Health in United Kingdom, Europe

One of the instrumental policies which has been deep rooted in the Department of Health is the Alert Letter System which has been abused on innocent doctors. This system, of Alert Letters which is still in existence is a live example of the Mobbing Regime that the Department of Health is practising. When an employee has been issued with an alert letter system or threatened by it, it would not only means to him the extermination of his career but the system serves as a deterrent to others in the profession that fails to challenge it.

PROFESSIONAL REGULATORY BODIES
E.g. General Medical Council

This organisation is influenced by NHS (National Health Service) Trusts Administrators, Postgraduate Deaneries, and Primary NHS Care Trusts Administrators and government. With the power to discipline, restrict or suspend the practitioner and in particular to label its practitioners with Mental Health Issues is a part of the Mobbing Culture and Practice.

ADMINISTRATION OF JUSTICE

In a biased system, claimants face hefty financial penalties when they lose in courts as all the huge legal fees have to be paid.

The CPR [Civil Proceedings Rule] which has been altered since 1999 reflects the Mobbing Culture successfully reaching the Courts; because they are fundamentally flawed. This has been highlighted in 2 Parts:-

In Part 1: The Overriding Objectives

This overriding objective of these CPR applied only to Judges and to Solicitors and does not apply to the victims.

In Part 2:

That it did turn the table on a fundamental security the Public had if costs were awarded against the victims.

Before the 1999 alterations were made to the CPR (Civil Proceeding Rules) all solicitors bills were subject to a Judiciary Taxation [detailed justification of every penny the winning solicitor claimed]. The Bill of Costs of Solicitors requested that Solicitors do disclose all the evidence regarding their costs which details of has been concealed up to the moment the Judgment was given.

Despite this, the Solicitors Rules are that there is no valid bill of costs until that bill is taxed by the Taxation Judge; under the new CPR, the Judge who attended the trial of the case orders the costs without going through any of the motions of Taxation. This puts victims of claims under serious threats to lose excessive monies if they lost in the courts . It is well known that Perjury is rife in negligence claims.

Another issue that may influence the justice are variable factors eg religious affiliations, freemasonry etc. It is known that religion is politics dressed in drag and yet no religious affiliations are declared by those in judicial positions or sitting at tribunals or fitness to practice hearings. Even when extreme religious views are present and barristers ask for the panellist to recuse himself, they do not do so.


POLICE AND THE CROWN PROSECUTION

It appears that the Police are integrated in that policy of Mobbing . The Mobbing Regime could be used in a criminal act e.g. Committing Perjury in Courts.The fact that Perjury is known to have been committed by the Police for the last 30 years in the British Courts [as stated by the Judge in Cinpress v Melea] proves that the theory is correct.

Because the Police are the first door of call in “Perjury” which is essentially a criminal act it is crucial that the Police should be integrated in that Mobbing Regime.

For civil cases, the Attorney General has refused to intervene in allegations of perjury unless the judiciary reports it.

WHISTELBLOWING

Any attempt to alert an organisation of wrongdoings by its members results in organisational reprisals. We will be fooling ourselves to believe that any system of Whistleblowing could be fair and adequate to protect the person unless organised Mobbing is recognized for what it is and cultural attitudes are changed.

CONCLUSION

If Organised Mobbing has succeeded to coerce the Judiciary and the Police, this would abolish any challenges to its practice and it would prevail. Unless both the Judiciary ( rule with confidence imposing hefty fines to Mobbers); the Police and Crown Prosecution Service ( reprimand with jail sentences perjurers) have been successfully detached from the circle of the Practice of Mobbing, all efforts to address justice for whistleblowers would fail and the Mobbing Culture will continue to spread to all corners of the land with serious repercussions to the Tax Payer and a continuous oppression to the British People.


Written by Dr Mohammad Al Ruby for Doctors4Justice.net

Thursday, 8 April 2010

Psychologists prescribing medication


There are now three states in US where psychologists are allowed to prescribe psychotropic medication. With huge numbers of soldiers returning from the front and shortage of psychiatrists, psychologists have been given powers to do it. There is a requirement to do a two year Masters degree in pharmacology. Pharmacologists' training, from what I have seen in UK, is longer and quite advanced.


Doctors might feel quite aggrieved to hear this knowing just how hard they had to work to understand the relevant sciences from anatomy, biochemistry, physiology, statistics, etc to actually having years of practical experience of prescribing and interactions of many drugs in the context of mental illness and other diseases.


There are also problems of running psychotherapy and in the same time assuming the responsibility of prescribing, when, for example, some patients may, actually, expect the right pill rather than work through defences and the need to change behavioural patterns. It is expected that more US states will pass the legislation to allow psychologists to prescribe. The cost implications may be that it is much cheaper to train psychologists than doctors. The entrance exam requirements to study psychology are not as high as medicine which has been academically competitive for many years.


I would expect that psychologists would now become target of attacks that psychiatrists suffered for many years.


With many people who do not even know the difference between psychologist and psychiatrist and psychotherapist, it does not surprise me that all of this is possible now.


Insurance companies are either asleep or feeling helpless or do not know what is going to hit them.

Tuesday, 6 April 2010

Regulatory Bodies and Equality of Arms

Dear Diana Wallis, Timothy Kirkhope, Andrew Brons, Godfrey Bloom, Linda
McAvan and Edward McMillan-Scott,

Re Regulatory bodies and equality of arms

I wish to raise one very important issue with you.

In the UK there are several regulatory bodies for certain professions e.g. the Nursing and Midwifery council for nurses (www.nmc-uk.org), the General Dental Council for dentists (www.gdc-uk.org) etc.

As you may be aware in 2005 the ECHR ruled in the case of Steel and Morris Application no. 68416/01 15 February 2005 that there must be equality of arms in any legal proceeding and criticised the UK government for lack of legal aid.

This ruling has a profound impact on the regulatory bodies.

These regulatory bodies are funded by their professions. If a practitioner is subject to any form of investigation the prosecution has access to a huge pool of money drawn from the practitioners' annual retention fee. However these monies are not made available to the defence. If the practitioner’s trade union decides not to assist the practitioner then he may be without a defence.

The prosecution in effect has access to an unlimited pool of money. If you are subject to proceedings there is no legal aid to defend yourself. In some cases I have known accused practitioners to have to re-mortgage their homes. In one case I know of one doctor -who had a very strong defence – could not afford a legal team. As such he had to voluntary remove his name from the medical register.

Worse still if you are found innocent there is no means to recover the monies spent. The accused will be left with a huge financial burden for several years.

If you are sanctioned by a regulatory body then you do have the right to an appeal at the High court. Very few cases get legal aid. However the regulatory body will still have access to the huge pool of money drawn from the doctor’s annual retention fee. The sanctioned practitioner may have no means of supporting himself during the period of time between the sanction being imposed and the appeal hearing. Many
end up on income support or benefit. The reason being that if the sanctioned practitioner applies for a non medical job the first thing the employer will ask is why a doctor is applying for such a post. When the accused reveals a GMC finding then all hopes of employment ceases. However at this stage the doctor may well have to repay a mortgage.

At an appeal hearing the regulatory body will still have access to the doctors’ annual retention fund. However the appellant will not.

If the appellant loses then he will have to pay the regulatory body's costs which can worsen the situation.

I am therefore asking you to write to the appropriate commissioner to take action on this. I believe that if the Steel and Morris principle is to stand then the regulatory bodies should have to fund the defence and give a refund to all those practicioners who have had to fund their own defences since the Steel and Morris judgment was handed down.

I look forward to your reply.

Yours sincerely
Sushant Varma

Friday, 2 April 2010

DYSFUNCTIONAL SERIES: ARTICLE 4 HOPELESSNESS AND WORTHLESSNESS



In dysfunctional social units there is victimization. There are certain victim characteristics I want to write about today, in particular, as the General Election in UK approaches.

Victims learn through repeated failures that there is no hope for a better world and that they are worthless. It is not difficult at all to understand why this thinking arises: past performance is taken to indicate the future performance. Well, if you were an investor, nobody could guarantee to you future performance based on the past profits. Similarly, all business would strive to do better.

Learned behaviour resulting in feelings of worthlessness and hopelessness is not necessarily how things are or could be for the victims.

Hopelessness and worthlessness result in refusal of help, lack of effort and trust in others amongst other serious consequences. Victim who feels worthless is saying: "Why should anyone care about me? I am not able to test others to find out if they are worthy of me as I am worthless myself" This is how voters who are apathetic stay at home and do not vote true to their value system of worthlessness and hopelessness. President Obama was so right to run his campaign with a slogan: "Yes, we can".

There are extremes of worthlessness and hopelessness which can lead to suicide and damage to other people.

To overcome feelings of hopelessness and worthlessness one has to put things in perspective and realize the origin of such thinking. There are choices that one can make as an adult that one could not do as a child, for example. The choices are there for us all the time, as it reflects our inner world as well in how it develops.

Inspirational readings about great historical figures and how they overcame their difficulties is very helpful and not just to those who are aware of their feelings of hopelessness and worthlessness.

Doing new things everyday is strengthening even if it is a minor change such as driving the car using a slightly different route. Gradually, one builds confidence in doing things differently, being open to change and the ability to protect oneself.

Having dreams is important as in dreams we are capable of everything. To liberate one's brain to dream well, one starts while awake allowing imagination to leave imprints in memory. Human brain remembers reality and fantasy and whilst asleep it has a choice what to work with, as it is always doing something. Positive visualisation exercises can get rid of the nightmares and much more.

Thursday, 1 April 2010

DUPLICITY


Commission for Health Regulatory Excellence has decided that the case of Dr Jane Anne Barton does not need the referral to the High Court to overrule the General Medical Council decision to allow her to practice under only 6 conditions, initially, and which mushroomed magically to more sanctions on her practice over several days and after the hearing, as seen by us on GMC website. I note that there was no declaration of conflict of interests by anyone at CHRE panel deciding if GMC made the correct determination in the case of Dr Jane Anne Barton. I note that, for example only, 39 Essex St. barristers chambers specialize in professional regulatory body cases and approve of more lay people policy at Fitness to Practice hearings (the majority of Fitness to Practice Committee that judged Dr Barton were lay people). It is nice for the government to choose people they know will approve of its policy even when things go horribly wrong. As if class politics has not moved on in our times.
Thus, in my opinion, none of the barristers could expect any rejection from the GMC for future work referrals, government would not suffer the scandal of another doctor eliminating patients and everything stays the same for the poor English working people who are not part of the regulatory establishments.
England can say that a doctor should have been struck off medical register (CHRE did that in case of Dr Jane Anne Barton) and in the same time claim that it was all according to law and even in the public interest not to ask the High Court to uphold their opinion that she should have been struck off!) Oh, please.
Surely, what matters is competence of Fitness to Practice panellists, but their selection is grossly incompetent and negligent. Doctor, GMC FTP panellist can believe in demons causing epilepsy and be the judge of other doctors, a lay member can be impressionable and also into any sort of supernatural beliefs, with sexist, racist attitudes which are allowed for ever. Hundreds of doctors are referred for psychiatric examinations each year by GMC including political dissidents who are subjected to sham peer review and the list of failures goes on. So where are all those regulators when it comes to Human Rights Abuses? Disapproving and approving of themselves in the same time? Looking at the mirror but transfixed by the image to such a degree that they are unable to attend for corrective surgery?
Dr Jane Anne Barton, did not undergo any psychological evaluation to determine her attitude to patients or people in general, as far as I know, but CHRE approved of her. But as GMC has a busload of medical experts to make any reports they would like any time, who cares anyway if she had an independent psychological assessment?
There are thousands of pages of allegations regarding GMC expert witnesses sent to Fitness to Practice, but GMC takes no action if it suits their prejudices and vanity. Surely, the investigators are not going to investigate themselves at the GMC?

Wednesday, 31 March 2010

WHISTLEBLOWING IN UK: PROBLEMS AND SOLUTIONS
























I presented this paper to Shadow Health Secretary Mr Norman Lamb (Liberal Democrats) and Chief of Staff Ms Jenny Parsons (Conservatives). Mr Burnham, Health Secretary was unable to make any commitment for any date of his choice to meet with us. The presentation went well and without any opposition to the recommended solutions. We also had the opportunity to meet with Sir Jarman who just came back from his meeting with Department of Health with an offer to write a paper with us on Whistleblowing in BMJ with him acting as our advisor! We are aware that British Medical Association did not help whistleblowers when asked to help but they did take our money. Here is our paper in full:

MEDICAL WHISTLEBLOWING IN UK: PROBLEMS AND PROPOSED SOLUTIONS

Dr Helen Bright, Dr Mohamad Al Ruby

Paper first presented by

Dr Helen Bright

(Founder of Doctors4Justice)

to

Mr Norman Lamb

(MP, Shadow Health Secretary, Liberal Democrats Party)


Houses of Parliament


30 March 2010

Abstract:

Raising Concerns during training and employment has invariably resulted in the persecution of the person who raised these concerns.

Consequences for whistleblowers have been identified: harassment, loss of employment and career, loss of reputation consequent to a campaign of malicious allegations, mobbing in the form of sham peer review by regulatory bodies such as the General Medical Council, financial losses leading to bankruptcy, poverty, loss of credit rating, loss of other business, proliferation of court cases, social difficulties (loss of status and friends), physical and emotional changes related to stress such as various symptoms of Post-traumatic Stress Disorder [PTSD], sometimes suicide, exposure to corrupt state institutions, emigration and exile. Consequences of Post-traumatic stress disorder include: difficulties maintaining relationships with the opposite/same sex; marital difficulties; divorce; the breakdown of the family unit; children suffering; inability to find the financial means to supplement their education and other activities; repercussion of the low self esteem on the spouse and dependants with consequent high rate of depression in the spouse as well as other members of the family and friends.

The positive effects of whistleblowing are development of new skills, awareness of court procedures/failings and legal rights, more awareness of employment rights ; the creation of new circle of friends, increased political awareness, serving as advisers for peers in the same situation; the creation of political groups motivated to defeat corruption; expansion of horizon, creativity and increased determination. There is impetus to replace current legislations and procedures with awareness of responsibilities to safeguard public as well as whistleblowers.

Problems faced by whistleblowers include: secrecy and closed shop practices, the gang culture created by NHS Administrators and Medical Directors which serves as a deterrent to any person who dares to challenge, the Medical self-regulation hands being used as an extension of the arm of the defendant to reprimand any such concerns being raised, or any challenges facing Hospital Administrators; disrespect and misapplication of the laws by authorities, ignoring crucial evidence; the marginalisation of the concerns and the complainant; adversarial legal system unsuitable for the health regulation and various conflicts of interests at national level; and reversing the concerns on the complainant.

Proposed solutions: A European Whistleblowers Centre, public rehabilitation of whistleblowers, public education and increasing media awareness of the impact of whistleblowing, state pension for whistleblowers, psychological intervention for bullies, punitive measures shared by offenders and state/private institutions, reward system for whistleblowers and organization/individuals that handled whistleblowing well (The Gold Whistle Award).


Definition:

A Medical Whistleblower is a person who has come forward to report

Medical Fraud, Abuse or Neglect to State, Federal or international governmental authorities according to Dr Janet Parker, founder of Medical Whistleblower Advocacy Network.

Medical Whistleblowers are from many professional disciplines, patients and their families. Medical Whistleblowers are human rights defenders of others.

The United Nations has recognized the defence of human rights as a right in itself. The resolution 53/144 was adopted in order to protect both human rights defenders and their activities: "Declaration on human rights defenders".

Method:

Doctors4Justice is a political campaigning organization formed by Medical Whistleblowers in the UK. Research and experience of individual members in Medical Whistleblowing is considerable spanning over thirty years.

Doctors4Justice.net has a website which is visited by people on all continents in the world and we receive and give information/ support to those who approach us and to those we approach ourselves.

Findings:

Medical Whistleblowers Characteristics

Personal characteristics of whistleblowers include intelligence, increased social awareness and empathy, integrity, openness, consciousness, competence and sometimes greater popularity. This may predispose them to increased chances of being attacked through bullying, mobbing and other forms of persecution. This may result in low self esteem, isolation, and inability cope with the en masse organisational retaliation involved in medical mobbing [ Huntoon et al].


System Characteristics

Medical Whistleblowing occurs in system which is not performing well, when normal working is not possible or where a healthy response to concerns raised is not possible. On one level, one can assume that it is part of the normal working life to encounter problems which need resolving. Firstly, when problems are resolved smoothly some people might not even think of it as Medical Whistleblowing. On a second and more dysfunctional level, the organisational retaliation may be a response to their failure to accept fault or fear of repercussions e.g. subsequent litigation. The usual response is to shoot the messenger.




Problems:

General Problems

1.Medical professionals are self regulated and thus incapable of being objective in all the stages of investigation, defence and persecution in an adversarial legal system.

2.There is no independent organisation where concerns can be reported to anonymously or otherwise. There is no guarantee of protection for the whistleblower.

3.The Public Interest Disclosure Act (PIDA ) has been shown to be ineffective [ Lewis et al 10 Years of PIDA].

4.There have been a number of high profile cases elucidating the complete lack of support for whistleblowers. This is now resulting in financial cost and significant loss of life. Examples include Mid Staffordshire NHS Trust, Gosport Memorial Hospital etc. Patient safety is currently being placed in jeopardy. Without adequate protection of whistleblowers, there will continue to be a loss of life and significant resources meant for patient care deviated towards litigation. This is not in the economic interests of the current government.

Problems with Medical Regulation

5.Medical regulatory bodies have no intention to comprehend the problems surrounding whistleblowing. Every regulatory body will dismiss legitimate concerns raised by the whistleblower (Marginalisation and Gang Culture).

6.The White Coat of Silence is the term used to denote non reporting of mistakes by co-workers and White Coat Barricade - the silence of the regulatory bodies which actively protects the offenders and serves as a deterrent to anyone who dares to challenge.

The General Medical Council protects dishonest Expert Medical Witnesses and other doctors involved in Sham Peer Review. Other regulatory bodies appear to have the same response [ NMC v Margaret Haywood]. This shows the prosecution of the whistleblower and the protection of those who were negligent. This characteristic is also highlighted by Wilmshurst et al [ A Personal View of the GMC]

7.Defence Unions [ Medical Protection Society, Medical Defence Union and MDDUS] provides poor service. Characteristically, they do not defend the whistleblower robustly and fail to obtain vital documents via disclosures when Medical Whistleblowers are mobbed by their own profession. Unfortunately the BMA, Medical Defence Organisations, from our personal experience, work with intent as part of the Gang Culture to obstruct any legal rights or any attempt to raise concerns to the Courts.

8.Bias [ Religious, Political Affiliations, Scientology etc] is not well detected due to failure of the regulatory bodies to vet their panellists. Fitness to Practice hearings may be populated with panellists who are religious fanatics e.g. hold belief in exorcism, demons causing epilepsy etc.,

9. they may have affiliations and friendships with the accused superiors, they may have political agendas e.g. governments may not approve of those who raise concerns on suboptimal care.

There is failure to adequately screen Fitness to Practise panellists and this leads to faulty decisions making where negligent doctors are not admonished and innocent doctors persecuted for a number of years until they are ruined professionally and financially..

10.That there is no Criminal Records Bureau checks of staff or panellists at the General Medical Council (GMC) is only one of the failings which have not been addressed despite our demands.

11.There are no Occupational Health screenings of staff and panellists at the GMC. Chronic alcoholics sit as panellists or as Legal Assessors [ Esther Cunningham SRA prosecution 10068-2008]

12.GMC has on occasions failed to disclose complaints against doctors often termed as the “Discreet Inquiry”. Pal v GMC 2004, the GMC was described as acting like a totalitarian regime following an inquiry on a typographical error and a collection of material written on the internet, none of which affected patient care. The reversal of a complaint against a whistleblowing doctor has been shown in the following in GMC v Vaidya, GMC v Phipps, GMC v Wilmshurst, GMC v Bright, GMC v Pal, GMC v Al Ruby, GMC v Varma and others. No complaints against doctors accused of malpractice [ raised by the whistleblowers] were taken up or investigated adequately by the GMC.

Character Assasination

13.Whistleblowing doctors can be subjected to character assassinations. One method used by regulatory bodies is to question their mental health. Psychiatric examinations of hundreds of doctors each year are performed by GMC selected Medical Experts.

These experts are not held accountable for the most extraordinary professional negligence and incompetence. International Classification of Diseases is not followed and neither is Diagnostic and Statistical Manual of Mental Disorders. Political dissidents are declared insane with discredited diagnosis such as querulous paranoia. As Dr Lawrence Huntoon said (20): “ Absolute immunity, like absolute power, corrupts absolutely and invites abuse”

Anything can be regarded as a sign of mental illness. For example: starting a sentence with word "But", or a typographical error, having an opinion different from the Department of Health, writing a six page letter, and having a number of complaints made against the doctor (not what the complaints are about and how truthful these are).
Criticism of medical colleagues and institutions is not tolerated by GMC ( the Creation of a Police State-Like-Organisation). The GMC fails to practise what it preaches in its terms of what constitutes Good Medical Practice.

When doctors manage to defend allegations of mental illness, pseudo psychiatric monitoring is ordered instead, in the form of sanctions on medical practise such as supervision by psychiatrists, anger management, communications training, team working even when there are no findings of fact by the GMC itself that any patients have been harmed. The whistleblower is essentially labelled the trouble maker. This then has the ripple effect acting to prejudice employment prospects completely. There is always the prejudicial impact of the post Shipman recommendations – to disclose open and closed complaints on job application forms. Naturally, a hospital will opt to employer someone who is not tainted by any hospital allegations or a regulatory body investigations. Effectively, whistleblowers who have been character assassinated are deemed damaged goods and even when they managed to get a couple of days work they do not get paid.

14.Challenges to the General Medical Council decisions prove impossible on occasions. Doctors with conditions or sanctions often do not have defence union cover as they are dropped by their defence bodies as unworthy lepers.

Pro Bono support is scarce and refused in complex cases. Without employment and lack of money, the doctor cannot fund their defence. Free legal aid is refused in view that similar cases are judged by the Legal Aid Panel as complex, long winded and difficult to win knowing the climate created by the Judges from previous cases.

This is the common result of the assassination of character as experienced by whistleblowers. The stigma suffered by an investigation is immense and the pariah effect commences. Social isolation results and whistleblower is left without peer support.

15.Alternative career development and structures are absent. Non medical careers are dependent on previous references too. Over qualification is an impediment to obtaining any job in the outside world. The only other option left for a whistleblower is Self Employment.

16.Employment Tribunals have failed to protect Medical Whistleblowers under Public Interest Disclosure Act (PIDA ) and the tribunals have been structured to include a member who worked with defendants (ie in the same hospital as administrator). Again, there is poor recognition of the problems faced by whistleblowers [ Perkin v St Georges Hospital NHS Trust – where the whistleblower's character was criticised].

17.Although there is a Code of Conduct for NHS Managers this is disregarded by GMC in case of medically qualified managers. Most whistleblowing episodes regarding suboptimal care have been due to medical mismanagement. There is no accountability for managers who mismanage their departments causing substantial cost and loss of life.

18.Investigators at GMC/CQC (Commission for Quality Care) have refused to obtain patients' records and have protected those doctors who actually made medical errors. The Medical Whistleblower is branded as being aggressive, incapable of good team working, with poor communication skills and alleged to be guilty of professional misconduct.[ e.g. Perkins v St Georges Hospital NHS Trust]

19.There is abuse of power/process in many forms. There is a reluctance to vindicate the whistleblower. Instead, numerous unworkable conditions may be placed on their practise. This not only prohibits them from finding work in other countries but effectively stigmatises them permanently and prevents them from developing any private practise either.

20.The post Shipman disclosure policies of a doctors' employment and fitness to practise history is detrimental to doctors who have been subjected to organisational retaliation (mobbing).

20. The alert letter system has been repeatedly open to abuse. Unofficial alert letters have been sent [ Al Ruby v Norfolk NHS Trust] with the persistent refusal to investigate the allegations at all levels.
21. Following the Soham Inquiry and the guidance on Data Retention, any defamatory, inaccurate or prejudicial allegation regarding a whistleblower is likely to remain on their records forever [ Pal v North Staffordshire NHS Trust – false allegation of a needlestick injury in 1998 continues to remain on record 12 years later, Al Ruby v Queen Elizabeth NHS Trust – false allegations continue to remain]. There appears to be a lack of concern regarding the prejudicial repercussions to a medical career and inability of the High Court to protect whistleblowers. This therefore denies the whistleblower their civil rights to medical employment. The High Court is in contravention with the Human Rights Convention Article 6 (Albert and Le Compte v Belgium (1983) 5 EHRR 533.

In defining the autonomous meaning, for Convention purposes, of "civil rights and obligations" in article 6(1), the Court has chosen to give the expression a broad meaning, so as to embrace some administrative and disciplinary decisions. This has the consequence that decisions in fields such as this are routinely made in the first instance by bodies that do not have and are not intended to have the independence and impartiality to be expected of a judicial tribunal as required by article 6(1). This was, it would seem, true of the Provincial Councils considered in Le Compte, Van Leuven and De Meyere v Belgium (1981) 4 EHRR 1 and Albert and Le Compte v Belgium (1983) 5 EHRR 533, of the Social Insurance Office which featured in Döry v Sweden (Application No 28394/95) (unreported) 12 February 2003, of the planning authorities whose decisions were challenged in R (Alconbury Developments Ltd) v Secretary of State for the Environment, Transport and the Regions [2001] UKHL 23, [2003] 2 AC 295 and of the rehousing manager who featured in Runa Begum v Tower Hamlets London Borough Council (First Secretary of State intervening) [2003] UKHL 5,[2003] 2 AC 430. The Court has not, however, held that the making of an initial decision by a body which does not meet Convention standards of independence and impartiality necessarily taints or invalidates the further stages of decision-making consequent on that initial decision: Le Compte, Van Leuven and De Meyere v Belgium 4 EHRR 1, para 51(a). But, as it was put in Albert and Le Compte v Belgium 5 EHRR 533, 542, para 29:
"in such circumstances the Convention calls at least for one of the two following systems: either the jurisdictional organs themselves comply with the requirements of article 6(1), or they do not so comply but are subject to subsequent control by a judicial body that has full jurisdiction and does provide the guarantees of article 6(1)."
Thus, in cases such as Le Compte and Albert much of the argument turned on whether the Belgian Court of Cassation had the competence and provided the guarantees necessary to remedy deficiencies at lower levels.


22. Media Attitude. The media continue to misunderstand some of the aspects of whistleblowing. Initial whistleblowing to the press is followed by silence once regulatory bodies find doctors guilty.

23.The positive aspects of doctors coping after whistleblowing have not yet been publicised.

24.At present there is no understanding of multidimensional effects of whistleblowing. The media understands – whistleblowing equals suspension and erasure from medical register and the matter ends there. The role of the GMC, mobbers retaliation, supportive stories to investigate the nature of the whistleblowers concerns rarely exist.

25. Moreover, junior whistleblowers are neither supported nor featured by the medical media or national media. Consultants are given preferential treatment in many cases up to the point they are successfully destroyed by medical regulators and inadequacies of domestic courts where the appeals are lodged.

26. Evidence of breach of Article 6 of Human Rights is withheld (absence of court recordings, judgement passed but not issued for months thus obstructing the right to appeal within the time limit).


Proposed Solutions:

1.European Medical Whistleblower Centre. This Centre would provide Advocacy and Communication of whistleblowing concerns to other authorities.
2.Psychological therapy for bullies/medical mobbers. Further studies on Medical Mobbing and Sham Peer Review in UK. US Research has been far more advanced in this area.
3.Gold Whistle Award for whistleblowers and those able to protect and support whistleblowers.
4.Independent investigation of complaints against doctors, separate from the medical Registration Body.
5.Education for Regulatory Bodies and the Media regarding the serious problems involved in whistleblowing.
6.Investigation into Regulatory Bodies response to whistleblowers in the last 10-20 years with a view to implementing improvements.
7.Health Select Committee Review of Whistleblowing with a view to obtaining recommendations for the NHS (National Health Service).
8.Enforcement of Data Protection Act 1998 and Freedom of Information Act 2000 where the Whistleblower has the right to all the information concerning them and the matter they raised.
9.United Nations protection for Medical Whistleblowers to be enforced. UK has breached it.
10.Personal Accountability and financial liability for the offenders along with health authorities accountability rather than leaving the tax payer to pay all the damages.
11.A Managers Regulatory Body in the United Kingdom.
12.Rehabilitation of Medical Whistleblowers by multidisciplinary team at the European Medical Whistleblower Centre – BioPsychoSocial Support.
13.Political Rehabilitation and Public recognition of all whistleblowers.
14.Pension for Medical Whistleblowers to include state compensating for all the lost years of not being able to contribute


Acknowledgement:
We thank Dr Michael Thompson for his contribution.

References:

1.Medical Whistleblower Network by Dr Janet Parker
2.What is intimidation by Dr Janet Parker, Medical Whistleblower
3.The White Coat Barricade by Janet Parker in Medical Whistleblower's Canary Notes Volume 3 Issue 11
4.Mental Health Advance Directives in Medical Whistleblower's Directive Volume 1 issue 11
5.UN Declaration-Rights of Disabled People in Medical Whistleblower's Canary Notes November 2006, Volume 1 Issue 11
6.Twenty steps towards a closed society on health by Richard Smith in British Medical Journal Volume 295, 1633 19-26 December 1987
7.In remembrance of Martin Luther King Jr in Medical Whistleblower's canary Notes April 207 Volume 2 Issue 4
8.Witness Intimidation in Medical Whistleblower November 2008, Volume 3, Issue 11
9.UN Declaration of Human Rights 3/8/99 A/RES/53/144 in Medical Whistleblower Canary Notes Volume 3 Issue 10
10.The Role of Human Rights Defenders in Medical Whistleblower Canary Notes Volume 3 Issue 10
11.Rights and Protections for Human Rights Defenders in Medical Whistleblower Canary Notes Volume 3 Issue 10
12.
Ten Years of Public Interest Disclosure Legislation in the UK: Are Whistleblowers Adequately Protected? By David Lewis in Journal of Business Ethics 82 (2).
13.Tactics Characteristic of Sham Peer Review by Lawrence R. Huntoon in Journal of American Physicians ans Surgeons Volume 14 Number 3 Fall 2009
14.Sham Peer Review and the Courts By Lawrence R. Huntoon in Journal of American Physicians and Surgeons Volume 11 Number 1 Spring 2006
15.Abuse of “Disruptive Physician” Clause by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 9 Number 3 Fall 2004
16.Sham Peer Review: Poliner Verdict by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 11 Number 2 Summer 2006
17.The Psychology of Sham Peer Review by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 12 Number 1 Spring 2007
18.The Insulting Physician “Code of Conduct” by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 13 Number 1 Spring 2008
19.Sham Peer Review: the Unjust “Objective Test” by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 12 Number 4 Summer 2007
20.Sham Peer Review: the Fifth Circuit Poliner Decision by Lawrence R. Huntoon in American Journal of Physicians and Surgeons Volume 13 Number 4 Winter 2008


Sunday, 28 March 2010

THE POPE MUST RESIGN




Today I went to the demonstration PROTEST THE POPE in front of Westminster Cathedral in London. There was a huge amount of media interest.



The Pope described our demands for his resignation as "petty gossip of dominant opinion" and the Irish bookmakers changed the odds of his resignation from 12:1 to now 3:1.




As the huge doors of the Westminster Cathedral swung open to let the congregation out, the priests stood at the door anxiously looking at the demonstrators ahead and heard the loudspeaker announce our demands for the Pope to resign.


Parents walked by with their children and I heard one boy ask his dad: "What are they doing? Why Doctors4Justice". Father said: "I'll tell you later. They are protesting", but I could see they were reading all the placards.

One woman walked by muttering to us: "Shut up! Shut Up!"

A man came straight from Westminster Cathedral to say to us: "And what about all abortions? Is that not killing?" A loud chorus protested; "Don't change the subject! Don't change the subject!Don't change the subject!" Like a crab, he run backwards towards the Cathedral with a smirk on his face. But I could see the demonstrators were well prepared for this question when they responded en masse.

Police stood thirty yards away from us and not in front of us as is the usual custom at the demonstrations. After all, we demanded the right for the police to investigate child abuse cases and not the Vatican mafia which hushed their crimes for centuries.

One of the protesters was dressed as a Pope and he demanded resignation over the loudspeaker and the right for children to be safe. Again and again as congregation stepped out and passed by us. Some took photographs.

There were no violent incidents.

This was the first public protest demanding resignation of the Pope and it has been widely reported in the world media very quickly. Doctors4Justice was right in the front row standing up for the rights of all the children in the world to be free from abuse from Catholic clergy.

Read more here. See more photographs here.




Friday, 26 March 2010

PROTEST THE POPE

The first demonstration against Papal visit is this Sunday in front of Westminster Cathedral, 11am -2pm . Nearest Underground Station is Victoria


German Chancellor Angela Merkel has condemned the latest series of scandals in Germany where Pope was born. Is he the last Pope as some have predicted long time ago?Pope's brother has been accused of physical abuse. Read here.

What is terrible is also that tax payers have paid huge damages for Catholic Church. In Ireland hundreds of millions have been paid in compensation to victims of sexual abuse by the tax payer (90%) and only ten percent came from the Church.

Surely, Doctors4Justice is not the only organization aware of the huge assets of the Catholic Church.

In 1999 I objected to the wearing of religious uniform by Catholic nun employed by Harrow Social Services to work as a Social Worker with mentally ill , some of whom suffered abuse at the hands of local Catholic priest.Following my whistleblowing about the wearing of religious uniforms, the system did everything to protect the church and not patients.

Religious uniform acts as a reminder of trauma of abuse and why should men have to suffer panic attacks (one of the consequences of Post-traumatic Disorder) when talking to their Social Worker?

It is a shame that The Royal College of Psychiatrists in London put religion first and not patients with respect to this particular issue. They supported Catholic nun wearing her religious uniform when working with mentally and do so to this day. Their reason is that the matters are : "Complex".

When everybody knows that uniform has symbolic meanings as well as denoting power and status of the wearer, what can we say of the institution that is committed to conformity of religious privileges, status quo and ultimately the security of their own jobs in state hospitals.

I note with interest that English Health Secretary went to a Catholic school. Is that the reason why The Royal College of Psychiatrists is so unassertive or is it simply that some men fancy the idea that God's male image is identical to what they see in the mirror.




Monday, 22 March 2010

DYSFUNCTIONAL SERIES: ARTICLE 3 ADDICTION TO CHAOS






Chaos is a Greek Goddess of emptiness and confusion from which everything originates.

Addiction can be defined as habitual behavioural pattern to change emotional state, and it has characteristics such as increasing tolerance (to chaos) and the need to increase the dose (of chaos). Addiction to chaos is seen in dysfunctional social units (families and organisations).

The most common reason for this addiction is inability to tolerate uncertainty when things are going well. For those who have experienced abuse and violence, for example, peace and security are not credible as long lasting possibilities. Rather than wait for somebody to break it, the most anxious individual(s) does something to provoke dysfunctional outburst from others.


Living (working) in dysfunctional environments is like walking on egg shells, it is anxiety ridden atmosphere and the individual may feel ready to explode with tension from uncertainty and they do it by doing something that causes chaos.

There are numerous examples of addiction to chaos one can find in health and other organizations. For example, there are established ethical principles of how staff should dress for work in psychiatry (no uniforms), but politicians introduce religious dress and cause chaos and death.

When it is known who causes problems in the functioning of an organization e.g. medical regulators, people who cause chaos are employed for many years until their retirement.

Doctors and lay people sitting at Fitness to Practice hearings should be mentally fit to do so, but no checks are made health wise, no criminal records checks and one can believe in anything e.g. demons causing epilepsy, that lies are good, spacemen being our fathers, humans with wings waiting in the sky to help us and guide us and so on. This is the case in UK today.

Regulatory body such as General Medical Council has refused to place health checks, and criminal records bureau checks on Fitness to Practice Panellists although panellists are well paid and can afford to pay for those checks out of their pocket.


Checks on religious extremism are absent in medical regulatory institutions in UK. There is no compatibility checks for those doctors and lay people sitting as panellists at Fitness to Practice hearings to see if they can perform their role without religious/supernatural bias. This is the case despite the fact that there is both a hilarious and tragic element to what has been happening for decades up to present day. A doctor who is into exorcism, demons and prayer may not be practising what is known as evidence based medicine. Why bother with regulation when anything is actually OK? In my opinion, addiction to chaos is one of the elements of dysfunctionality that maintains such silly regulatory practice.

I admit, it is exciting to have demons around even if it is only imaginary. Maybe, GMC Fitness to Practice Panelists are delayed in their journey to work not by London traffic jams but demons possessing them. Yes, all the way from Charring Cross to Euston Road one was seized by hellish wonder which continued throughout the Fitness to Practice Proceedings and beyond. Maybe, coffee breaks at GMC provide the means for panellists to exchange useful information on the latest updates on demonic possession and exorcism.

What happens to doctors who may have a mole on their face or in a certain shape, would that be the sign for a bit of exorcism in the form of punishment such as warnings, sanctions on their practice, suspensions or erasure? In middle ages witch hunts one could use unusual or usual appearance of a mole to declare a person guilty of witchcraft. And some doctors are even foreign. More than GMC can cope with.

In sixteenth century England it was believed that healing was connected to witchcraft and that witches made pact with the devil. At that time, Christians thought that witches could not act alone but in groups. Thus catching one was not enough. A bit like today in UK, many whistleblowers are punished by the regulator. Healing ability is really suspect. Death is good, it frees hospital beds and decreases tax expenditure.

Bible has various parts to it including different versions and some include so called Apocrypha's (hidden) elements which allow believers to lie. So why swear on Bible that one would be telling the truth? I really do not understand that.

Another aspect of addiction to chaos is that GMC protects a whole bus load of lying expert witnesses for the simple reason that it is too embarrassing to admit that they believed them for years.

High adrenaline is said to be addictive and pleasurable to some people. This is one explanation for the resistance to order and healthy procedures.

A major attraction of chaos is that weak individual(s) gains control for a moment or two when issues are muddied/confused and before others organize themselves. Thus misinformation, lying and sheer fantasy can cause enormous problems for centuries to come. Butterfly effect in chaos theory. See illustration above.

According to chaos theory butterfly effect is that a small event can have large consequences i.e. butterfly flapping its wings can be a crucial event in a sequence of events precipitating a tornado or stopping it from occurring. A small change having a crucial effect.

Working or living in dysfunctional settings can be very dangerous to those who try to correct it. Whistle blowers are people who suffer severe punishment and expulsion for trying to right a chaotic situation, for example. There could be allegations of madness, incompetence, fraud and even criminality made against whistle blowers. The chaotic system acts to preserve itself and laws are just words on paper. If it is not what was said than false allegations are made that it is very wrong how it was said. A sparrow dressed as a wolf syndrome, I call it.

Injustice can cause social unrest and yet repeatedly human rights are abused as if there is no law to protect them. For some people, it is like sado-masochism and chaos is planned. Human beings can prepare elaborate rituals when it comes to abuse of others. Chaos is not something that is necessarily impulsive or difficult to understand. Huge amount of investment in time, money and effort is made into creation of sheer chaos.

Confusion is an interesting element of chaos. It can be a potentially useful phase in the mind of person not otherwise impaired when changing from one dysfunctional pattern to a new way of relating to oneself or others. This represents a link from chaos to creativity as expressed in the myth of Chaos Goddess from which everything is born. For example, GMC is certain that what it does to whisleblowers is correct. If they had experienced confusion in their mind about it, this would be the first step to correcting so many mistakes.

Sunday, 14 March 2010

WHY POSTGRADUATE TRAINING PROGRAMMES IN THE UK ARE SO INCOMPETENT, By Dr M Al Ruby

Not Paiced

It is about time that the training programmes for Medical Post Graduates are changed to become comparable to the USA/Canadian Training programmes.

Why should the trainee in the UK apply, after every few months or few years, for more posts? This uproots the doctors family and himself necessarily.

Now, it is more sensible that the system should be changed to simulate the USA and Canadian Programmes. These adopt the graduates from year 1 until he/she has finished his/her training programme year 3-4 5-or 6 and to whatever specialty the programmes leads to.

At the end of the training the trainee would have been expected to have passed his specialty exam and subsequently identifies himself as a competent specialist in that field.

The Specialist would then choose either to practice from his private rooms or in conjunction with a hospital appointment.

All European countries graduates should be given similar programmes in the whole of Europe.All Royal Colleges examinations should to be canceled and substituted by clinical feedback from hospital programmes and the direct clinical supervisors during the training. Specialty papers should be in multiple choice or a variety of different tests.

The Royal College Exams ( which are an Honorary degree) should not to continue to become the criteria for specialisation in Medicine and Surgery. This should be replaced by a proper academic degree like Masters and Doctorate Degrees.

It is about time that clinical research is substantiated by the Gov provide opportunity to graduates of Medicine to involve themselves in preparing academic degrees such as Masters and Phd's. Once this happens medicine would solve many more ailments and there would be a real upturn in curing many diseases. This lacks in the system today in areas like treating depression some killers like diabetes, cancer, strokes and heart disease. One of the most common causes of acquired blindness is Diabetic Retinopathy; it is a shame that the only treatment available to date is the laser destruction of as much possible of the retina in order to preserve the central vision. It is clear that progress in clinical science has not been made and this may be due to the type and nature of postgraduate training doctors receive.



Dr M A Ruby.

Related Links

Medical Training in the USA

PMETB.

Thursday, 11 March 2010

DYSFUNCTIONAL SERIES: ARTICLE 2A HARMONIA'S NECKLACE, FEAR OF CONFLICT


Harmonia in Greek mythology was the Goddess of Harmony. There is controversy who her parents were but one of the myths is that she was the product of a love affair between Ares, God of War and Aphrodite, Goddess of Beauty. Aphrodite was married at the time.



When Harmony grew up she got married and all the Gods came to her wedding including Aphrodite's husband who was spiteful and gave Harmonia a gift: a cursed necklace. This meant that everyone who possessed the necklace would suffer misfortune without knowing what was the cause of it. Harmonia certainly suffered a lot of misfortune and had to go into exile with her husband. While in exile they helped Enchelean people in their conflict with Illyrians (around lake Ohrid ). The mythical people they helped were Eel people (Encheleans), I presume, given such name because they lived around the lake where they could fish for eels.

However, I know that eels are also symbol of temptation and passion. It is interesting here as Harmonia and Cadmus (her husband, a Phoenician Prince, who introduced the first Phoenician alphabet about four thousand years ago) led Encheleans who won over their enemies Illyrians. Thus symbolically they aligned themselves with passion but rose above temptation. They became leaders first and won the war for Encheleans.
Encheleans also went to famous Delphi and plundered the temple, presumably, not overwhelmed by the superstitions of the time,according to the historical records.
The necklace changed hands several times and eventually it was given to a Temple. However, a tyrant stole it to give it his mistress. She gave birth to a son who was said to be mad and he burnt the palace with all the possessions including all the treasures. That was the end of that necklace.
Harmonia myth is a fascinating myth about resistance to harmony, envious destruction of Harmony's quality which is concord and the only way she could elevate herself was eventually through war.
Madness is an interesting concept in Harmonia's myth and it comes across as the only liberation from the cursed necklace that brought misfortune to princess and deity. Is it not just as possible that tyrant's son was not mad but angry enough to put an end to dysfunctional abuse of power? He may have looked mad to some because when person stands up to overwhelming power he does seem to be taking a risk only a madman would. Standing up against the abuse from tyrannical power is often misinterpreted as madness when in fact, it is the only way forward.

I find it fascinating how dictatorial regimes declare dissidents mad and dangerous throughout human history and myths live on.

Tuesday, 9 March 2010

Beware: The Drunken GMC Legal Assessor


Today, I noted the above sign and it reminded me of beleaguered Esther Cunningham. Esther once sat on Helen Bright's GMC Hearing. Helen complained that Esther was intoxicated. The GMC paid no attention. Anyhow, the Solicitors Regulatory Body issued this judgment [ see below]. This was sent to the General Medical Council who did not bat an eyelid. We asked them whether the GMC would review all hearings where Esther Cunningham was present. The GMC did not respond.


No. 10068-2008
IN THE MATTER OF ESTHER LYNN CUNNINGHAM, solicitor
- AND -
IN THE MATTER OF THE SOLICITORS ACT 1974
______________________________________________
Mr A H B Holmes (in the chair)
Mr J P Davies
Mr S Howe
Date of Hearing: 13th January 2009
______________________________________________
FINDINGS
of the Solicitors Disciplinary Tribunal
Constituted under the Solicitors Act 1974
______________________________________________


An application was duly made on behalf of the Solicitors Regulation Authority by George Marriott, solicitor and partner in the firm of Gorvins Solicitors, 4 Davy Avenue, Knowlhill, Milton Keynes, MK5 8NL on 31st July 2008 that Esther Lynn Cunningham, solicitor, might be required to answer the allegations contained in the statement which accompanied the application and that such Order might be made as the Tribunal should think right.

The allegations against the Respondent were that she:-

1. Impaired her integrity and compromised the good repute of the profession and her duty to the Court when appearing before the Grantham Magistrates Court on 8th November 2006 in breach of Rules 1(a), 1(d) and 1(f) Solicitors Practice Rules 1990 (“SPR”) and in breach of Rule 16A SPR by virtue of breaching Part II 2.1(a) of The Law Society code for Advocacy.
2. Failed to act in the best interests of her client when appearing before the Grantham Magistrates Court on 8th November 2006 in breach of Rule 1(c) SPR.
2
3. Brought the profession into disrepute whilst delivering legal training to members of the profession on 17th and 18th May 2007 in breach of Rules 1(c), 1(d) and 1(f) SPR.
4. Failed to provide a prompt response to the Solicitors Regulation Authority (“SRA”) in breach of her duty to cooperate with the SRA under Rule 20.03(1) of The Code.

The application was heard at The Court Room, 3rd Floor, Gate House, 1 Farringdon Street, London, EC4M 7NS on 13th January 2009 when George Marriott appeared as the Applicant, and the Respondent appeared and was represented by Richard Nelson, solicitor in the firm of Business Defence Solicitors, 30-31 Furnival Street, London EC4 1JQ.

The evidence before the Tribunal included the admissions of the Respondent, an email message dated 15th October 2008 from Mrs Justice Macur to the Respondent and a number of references relating to the Respondent’s character.

At the conclusion of the hearing the Tribunal made the following Order:-

The Tribunal Orders that the Respondent, Esther Lynn Cunningham solicitor, be suspended from practice as a solicitor for the period of six months to commence on the 13th day of January 2009 and it further Orders that she do pay the costs of and incidental to this application and enquiry fixed in the sum of £5,750.00.

The facts are set out in paragraphs 1 – 22 hereunder:-

1. The Respondent, born in 1956, was admitted as a solicitor on 16th June 1980 and her name remained on the Roll. The Respondent did not currently have a practising certificate.
2. The Respondent appeared before Grantham Magistrates Court on 8th November 2006 where her cousin, Mr B, faced a charge of being in charge of a dog which was dangerously out of control. The dog in question belonged to the Respondent’s son and was being looked after by Mr B while the Respondent and her son were on holiday.
3. The Clerk to the Justices at Grantham Magistrates Court, Mr P, raised matters relating to the Respondent’s conduct in court with the SRA by a letter dated 10th November 2006, to which he attached the handwritten record of the court usher Ms C.
4. The court usher’s contemporaneous record of the hearing, interpreted in light of Mr P’s letter of complaint and substantiated by accounts of Mr C (a solicitor) and Ms D both of the Crown Prosecution Service, noted that the Respondent:-
�� forcibly kissed another solicitor;
�� aggressively demanded to know the identity of other people within the courtroom;
�� behaved as if drunk;
�� refused to sit down until encouraged to do so by her assistant;
�� interrupted the Magistrates whilst they gave their ruling;
�� was escorted out of the courtroom by a security guard; and


3 after removal from the court demanded to know the identities of the Magistrates, stating that she was a District Judge, before telling the Usher to “fuck off” when she (the Usher) refused to divulge this information.

5. The Respondent also referred to the CPS Prosecutor, Mr C, as a “fuckwit”. This, the Respondent subsequently claimed was not meant to be offensive but was intended to be derogatory. The Respondent has since told the SRA that she used the term as an insult to Mr C’s professional competence. The Respondent stated that Mr C, in his role as a Prosecutor for the CPS, “has been called far worse things in his time”.

6. When asked to explain her conduct by the SRA, the Respondent wrote in a letter dated 5th February 2007 that she “should not have gone” to Court, was “thrown” because she was “too close to the problem” and had accordingly upset the Magistrates by being “forceful” in her objection to the Prosecution’s amendment to Mr B’s charge.

7. Despite it having been recorded in the court usher’s contemporaneous record, the Respondent in her letter of 18th November 2007 denied using abusive language before the Usher although she said she “realise[d] that [she] should not have attended Court as [her] behaviour was likely to be somewhat robust.”

8. The Respondent also denied being drunk, in her letter of 5th February 2007, and told the SRA that she had a migraine, which explained her swaying and the need to hold on to the bench to steady herself. The Respondent further told the SRA that she suffers from a medical condition, the medication for which can make it smell as if she has been drinking.

9. In her letters dated 5th February 2007, 16th July 2007 and 18th November 2007, the Respondent told the SRA that she did not appear before the Court in a legal representative capacity and therefore did not appear as a solicitor. However:-

- prior to the hearing, the Respondent wrote to the CPS on headed paper which noted that she was a Solicitor Advocate;
- the Respondent wrote to the CPS in terms that she represented Mr B;
- the Respondent spoke with the CPS about the charge against Mr B on the morning of the hearing;
- once at Court, the Respondent acted as Mr B’s Advocate by booking in with the Court Usher;
- the Respondent made representations to the Court on behalf of Mr B;
- the Respondent forcefully objected to the amendment of the charge against Mr B;
- all members of the Court considered that the Respondent was there to represent Mr B (the defendant);
4
- the Respondent again telephoned the CPS on behalf of Mr B after the hearing; and
- the Respondent told the SRA that it was “unfortunate on the day an application to up-grade [sic] the charge was made without reference to [her]”.

10. In her letter of 16th July 2007 the Respondent said that she “went into the Magistrate’s [sic] Court to see what was going on” and “decided to call in at the Magistrate’s [sic] to see how proceedings went” with her research assistant “as moral support to see what was happening”.

11. The Respondent delivers legal training to the profession through her company, Cunningham Training Limited (“CTL”), and through other training providers. The Respondent was the tutor on a two day course for solicitors seeking to obtain their Higher Rights of Audience arranged through A, a large legal training provider, on 17th and 18th May 2007.

12. A delegate from the SRA attended the course and noted that the Respondent behaved as if drunk on both days.

13. Other delegates attending the course on the first day were similarly concerned that the Respondent behaved as if drunk and expressed as much to the chief executive of A, Mr L, who attended the second day of the course as an observer.

14. The Respondent appeared annoyed that Mr L was observing her tutoring and twice suggested to the SRA delegate that she should restrain Mr L so that the Respondent could punch him.

15. Mr L, having observed and believing the Respondent to have been under the influence of alcohol to the detriment of her behaviour and performance as a trainer and also noting reports that she had been rude, threatening and abusive to the staff of the hotel at which the course was held, terminated A’s arrangement with the Respondent.

16. In a letter to the SRA dated 26th June 2007 Mr L confirmed that he had previously been alerted to problems caused by the Respondent’s drinking.

17. The SRA wrote to the Respondent on 18th September 2007 to formally raise the matters relating to her conduct at the Higher Rights training course and a response was required by 2nd October 2007.

18. The Respondent replied on 25th September 2007 in terms that she denied all of the matters within the SRA’s letter, did not understand the need for a prompt response to the regulator and would reply to the matters raised in due course, after taking legal advice.

19. Nothing further was heard from the Respondent until 31st October 2007, six weeks after the SRA first raised the matter and following a repeat request for an urgent explanation in a letter of 23rd October 2007, when the Respondent wrote to request a further extension of time in which to respond. The SRA replied on the same day in

5 terms that she had been provided with ample opportunity to consider her response and that it would now proceed to prepare a report for formal adjudication.

20. The Respondent replied to the SRA’s fax on 5th November 2007. She denied avoiding a response to the SRA’s enquiries and stated that she worked away from home and would often not see letters until two or three weeks had passed. She stated that:-

�� she did not act in an inappropriate manner towards a male delegate;
�� the observations which the SRA’s delegate on the course deemed to be inappropriate could be explained by her “outgoing” personality and her “bold” teaching style based on “the American method of NITA”;
�� when she suggested to the SRA delegate that she should pin down Mr L so that the Respondent could punch him, she had done so in jest;
�� she had “[had] to have words” with hotel staff which had prompted the hotel’s complaint to A about the manner in which she had spoken;
�� she did not follow the course agenda or cover all of the required topics because she tailored the course to cover the issues which were assessed;
�� her “general condition of oesophagitis was raised”.

21. The Respondent also told the SRA that she was “particularly stressed for personal reasons at the time”.

22. The SRA prepared a report for formal adjudication which was sent to the Respondent with an invitation to make further comments should she wish to do so. The Respondent replied by a letter dated 18th November 2007 denying that any of the matters alleged arose in the course of her acting as a solicitor and that Practice Rule 1 was therefore not engaged. She denied she was under the influence of alcohol and stated that the impression gained by the SRA delegate and by Mr L was due to the combination of her medical condition and her “extremely informal method [of teaching]”.

The Submissions of the Applicant

23. The Respondent had admitted all the allegations. The Applicant submitted that the Respondent, as a solicitor, is an officer of the Supreme Court and must conduct herself in legal practice (whether for clients or when acting on her own behalf), in her business activities outside legal practice and also in her private life so as not to bring the profession into disrepute.

24. The Applicant indicated that whilst the Respondent had referred to taking medication, the Tribunal was asked to give little credit to the Respondent for this as she had not provided any evidence of it.
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25. The Applicant submitted that the Respondent had behaved in such a way so as to impair her integrity, to compromise the good repute of the profession and in breach of her duty to the Court.

26. The Applicant indicated he wished to claim his costs and these had been agreed with the Respondent in the sum of £5,750.00.

The Submissions of the Respondent

27. The Respondent confirmed all the allegations were admitted. The Respondent also accepted that there had been no admission previously of her abuse of alcohol and today was the first day that such an admission had been made. The Respondent submitted that it was widely accepted alcohol dependency is an illness and often, a person suffering from alcohol dependency is misguided, in denial and lacks judgement.

28. The Respondent submitted that 2006 and 2007 were a low point for her and this had caused her to act in the way that she had done. She was extremely embarrassed, ashamed and apologetic about her behaviour and hoped that this was the final stage of her humiliation.

29. The Respondent had had a distinguished career, having worked her way up, not only working in teams but offering assistance to other solicitors and she was now recognised as a good Deputy District Judge. There had been a number of events which had caused particular stress to the Respondent and two of these were very significant. The first was the diagnosis of her son’s illness which was very difficult for her to come to terms with and the other significant stress was an abusive relationship. This had now ended but there was still recent contact which was causing the Respondent continuing distress. The person involved had indeed contacted the Respondent this morning to try and make her more nervous about today’s hearing. The alcohol dependency was the Respondent’s attempt to try and escape from all these problems.

30. In relation to the incidents at Grantham Magistrates Court, the matter had related to an order for the destruction of the Respondent’s son’s dog and the Respondent was very emotional. In order to deal with the hearing, she had had some alcohol to allay her distress. The incident relating to the forcible kissing of another solicitor was also distressing for the Respondent as the solicitor involved was a colleague she had known for thirty years.

31. The Respondent submitted that her actions had taken place when she was not in control and since that time she had sought counselling and was receiving treatment for her alcohol dependency. She had been reinstated to her judicial position such was her recovery. The Tribunal was referred to an email message from Mrs Justice Macur dated 15th October 2008 which confirmed the Respondent could recommence sitting. It was submitted the Respondent had come to terms with events and had now dealt with them.

32. This was a tragic case and the Tribunal was asked to show understanding and sympathy whilst acknowledging the Respondent’s behaviour was not acceptable.
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33. Concerning the training course, the Respondent had not undertaken any training since the incidents referred to. It was submitted that when the Respondent had said to the delegate on the course that she should hold Mr L whilst the Respondent hit him, this was a humorous comment with no intention of violence being delivered whatsoever.

34. The Tribunal was referred to the number of references produced in support of the Respondent’s character. These showed that she was highly regarded in her judicial capacity and had a reputation for being polite but firm. The Respondent was a caring individual who would normally deal with matters with dignity and confidence and not in the manner referred to by the Applicant today.

35. The events relating to the allegations had taken place when the Respondent was not in control; 2007 had been a very bad year for her, she had suffered a stroke as well as dealing with her other problems. It was submitted that tremendous willpower and control is required in order to overcome alcoholism and the Respondent had shown that she had this. She was now performing her judicial functions again, and indeed that was her sole source of income as she had not undertaken any training since the incidents complained of.

36. The Tribunal was asked to deal with the Respondent with leniency bearing in mind the Respondent had acknowledged her problems, dealt with them and now got them under control. The Respondent also confirmed that the Applicant’s costs had been agreed at £5,750.00.

The Findings of the Tribunal

37. The Tribunal found the allegations to have been substantiated. They were not contested.

38. This had not been an easy case for the Tribunal to determine the correct sanction to impose. Mr Nelson, on behalf of the Respondent, had understandably urged the Tribunal to exercise leniency. However, the Tribunal had to look carefully at the circumstances in which the Respondent found herself here today, especially her admitted misconduct whilst acting as a solicitor and advocate in the Magistrates Court. That conduct was simply not acceptable and could not go unpunished.

39. It was only today that the Respondent had given an indication that she admitted the allegations and previously she had denied the allegations although it was appreciated that this could have been due to her alcohol dependency.

40. The Tribunal acknowledged the considerable difficulties the Respondent had had and was pleased to note she had begun treatment and wished the Respondent well with her recovery. The Tribunal also took into account the references provided. However, notwithstanding this, the Tribunal felt that the Respondent’s behaviour had affected the reputation of the profession, so much so that a number of complaints had been made about it. It was vital that solicitors acted professionally and with integrity at all times in order to maintain the confidence and trust placed by the public on members of the profession. The Respondent’s behaviour had brought the profession into disrepute and could not go unpunished. In the unanimous view of the Tribunal, the
8 correct sanction in this case was to impose a suspension from practice for a period of six months starting today.

41. The Tribunal Ordered that the Respondent, Esther Lynn Cunningham of xxx solicitor, be suspended from practice as a solicitor for the period of six months to commence on the 13th day of January 2009 and it further Ordered that she do pay the costs of and incidental to this application and enquiry fixed in the sum of £5,750.00.

Dated this 17th day of April 2009

On behalf of the Tribunal
A H B Holmes
Chairman