The Unraveling of the GMC

The New Year Honours for Julie Bailey and Helene Donnelly for repeatedly raising concerns about horrendous care failings at Mid Staffordshire hospital are welcome,  although it remains to be seen whether this represents a genuine change in NHS culture where whistleblowers are praised, encouraged and listened to, or a political gimmick to give the appearance of change.

Most NHS whistleblowers championed in the Eye, such as Ed Jesudason, Raj Mattu and Gary Walker, are still facing a horrendous struggle to clear their names, get their jobs back and get their concerns  properly investigated (Eyes passim ad nauseum). Evidence submitted to the Health Select Committee by Private Eye for its annual accountability review of the General Medical Council on December 10 was accepted and circulated, and helped demonstrate just how unsupportive the GMC is for whistleblowers, how slow, secretive and unaccountable it can be and how it doesn’t follow its own basic rules for investigation.  At the hearing, Charlotte Leslie, the MP for Bristol North exposed the hypocrisy and incompetence of the GMC in the Barbara Hakin case (Eyes   ) with devastating simplicity.

Leslie (to Niall Dickson, chief executive of the GMC): If one person has one set of evidence and that is presented to somebody else who has another set of evidence, will you share the counter-evidence with the person who provides the first set of evidence so that they can come back on it and challenge it? Do you share conflicting evidence? Is that part of the procedure?

Dickson: Yes, it is.

Leslie: You always share conflicting evidence.

Dickson: Yes.

Leslie: And then discuss it through.

Dickson: Yes.

Leslie: I am being a bit slow. The first person says that x, y and z has happened; the second person says, no, no, no, a, b and c has happened. Do you then give the first person the conflicting evidence and say, “What do you say to that?”, and they say, “They’re wrong, because I can prove the claims they make are false because of this evidence”? Is that what you do?

Dickson: Yes

When Dickson was subsequently asked by Leslie why the GMC had not shared disputed evidence in the Barbara Hakin case (Eyes ), he had no credible answer and was told to go away and think about it.  Hakin – now deputy chief executive of the NHS – was referred to the GMC by MD and fellow Eye journalist Andrew Bousfield. The heart of the complaint is about who is telling the truth and whether deliberate deception has occurred in an attempt to protect reputations, cover up problems in Lincolnshire and not heed the warnings of a hospital’s chief executive and chair about a dire lack of capacity and the potential danger to patients of an order from Hakin – then chief exec of the SHA – that ‘100% of targets must be met.’

All our evidence, and the evidence of whistleblowers Gary Walker and David Bowles, was shared with Dr Hakin and her lawyers, but none of Hakin’s evidence was shared with us. On reading the GMC’s reasoning for not holding a public hearing, we strongly challenge Hakin’s evidence but were not given the opportunity to do so. How can the GMC make such a fundamental error in proper process when it has spent 15 months ‘investigating’?  Is it incompetent, can it not cope with its workload or is it protecting the most senior and powerful doctor in the NHS?

Niall Dickson was asked by the HSC acting chair David Tredinnick to write a letter to the committee explaining why it failed to follow its most basic rule of fair and proper investigation in the Hakin case. MD has already written to the Registrar of the GMC demanding a review of the decision. The case is being handled by John Barnard, Rule 12 Investigation Manager, who warns that ‘the process takes some time.’ If the GMC refuses to reconsider, a judicial review may follow.

The GMC has allowed itself to be sidetracked into arguing that bullying is subjective and proving a direct link between a politically enforced directive on targets and actual patient harm is hard. What the GMC must focus in it who is telling the truth about what happened, based on an open cross examination of the evidence. Anyone – manager or  doctor – who can be shown to have lied to or in other ways deceived the GMC cannot, in MD’s view, be trusted and is an ongoing threat to patients. If Niall Dickson cannot grasp this, he is not fit for office either.