Why are we so soft on dodgy doctors There are thousands of complaints about them in a single year – yet just ELEVEN are struck off
Doreen Williams had a chest infection — it wasn’t serious but her GP thought it best to admit the 71-year-old to hospital so that she could have stronger, intravenous antibiotics.
Seven days later, Mrs Williams was dead as a result of a pulmonary embolism — a blood clot on the lungs which had developed while she was in hospital.
Her death was entirely needless, says her daughter Karen Rutland.
Karen Rutland's mother Doreen Williams was admitted to hospital for a chest infection. Neither the doctors nor nurses intervened to save her life
‘My mother was a busy retired teacher who had visited Wales and Cornwall in the two months before her death,’ she explains.
‘She had chronic obstructive pulmonary disease, a long-term lung condition, but it never seriously affected her daily life.
'It just meant she had to be careful to get proper treatment for chest infections.’
Mrs Rutland, 56, has no doubt what was to blame for her mother’s untimely death.
‘She was not given the intravenous antibiotics or standard blood tests until five days after she was admitted to hospital.
'And although she was at high risk of a blood clot because of her age and her lung condition, she was never given the blood-thinning medication that would have prevented it.’
The doctor in charge also issued a ‘do not resuscitate’ order — without discussing it with the family.
So, as Mrs Williams lay dying, neither the doctors nor nurses intervened to save her life.
Shocked and distressed by this betrayal of her mother, Mrs Rutland, a former management consultant from Cornwall, did what most people would do. She tried to complain. She got nowhere.
The doctor denied any responsibility for her mother’s death. And Luton and Dunstable Hospital Trust, where Mrs Williams spent her last days, refused to accept any wrongdoing.
There were 7,000 complaints to the General Medical Council (GMC) last year. Only 17 per cent of those by patients were investigated
Perhaps most frustrating, however, was the response of the General Medical Council.
This is the only medical regulatory body in the UK with the power to suspend or strike off doctors in the interests of patient safety.
Initially, the GMC’s senior investigating team recommended the doctor in charge of Mrs Williams’s care should face a Fitness to Practise hearing.
But the hearing was cancelled — twice — because the GMC’s medical advisors said there was ‘an insufficient case to answer’.
However, the coroner who later examined the case said he found it ‘inconceivable that vital steps were not taken to follow up’ particular warning signs that something was seriously wrong.
‘There was every reason to believe that after a short stay in hospital, Mrs Williams should have been well enough to return home,’ he said.
So why didn’t the GMC take action It is a question being asked in an increasing number of cases of alleged medical negligence.
The concern is that the GMC, which is funded by the doctors it regulates, is biased in their favour and shields those it is supposed to discipline.
Furthermore, it is accused of treating whistleblowers who try to expose malpractice as pariahs.
Five years ago Sir Liam Donaldson, who was then the government’s Chief Medical Officer, described the GMC as ‘secretive, tolerant of sub-standard practice and dominated by professional interest rather than that of the patient’.
It’s a criticism that won’t go away.
Last year, the Parliamentary Health Select Committee described the GMC in a highly critical report as ‘overly lenient’ to doctors — while just a few months ago, the chair of the Patients’ Association, Dr Mike Smith, accused the organisation of ‘clearly under-investigating complaints submitted by patients’.
The statistics speak for themselves. There were 7,000 complaints to the GMC last year. Only 17 per cent of those by patients were investigated — with only 11 doctors struck off as a result of these patient complaints. It is worth noting that once the GMC makes a decision, there is no right of appeal from the complainant.
Even when decisions do go against doctors, the criticism is that the disciplinary process takes far too long, allowing incompetent doctors to continue putting the public at risk.
It took 12 years after the first complaints were made about Dr Jane Barton for the GMC to initiate the investigation
In January 2010, Dr Jane Barton was found guilty of serious misconduct after a GMC investigation found she’d given painkillers at six times the recommended dose to 12 elderly patients, causing their death at two wards she ran at the Gosport War Memorial Hospital in Hampshire.
Yet it took 12 years after the first complaints were made for the GMC to initiate the investigation.
‘If Dr Barton had been suspended by the GMC in 1998 when her actions were first questioned, then many of these patients would have been saved, including my mother,’ says Ann Reeves, 57, whose mother Elsie Devine died aged 88 of a ‘substantial overdose’ of opiates administered by Dr Barton in 1999.
Incredibly, despite finally finding Dr Barton guilty of serious misconduct, a Fitness to Practise panel — who are appointed by the GMC — still allowed her to continue working as a GP (she has since retired).
Indeed, in 2010, 39 other doctors were permitted by panels to remain on the medical register even though the GMC’s own investigators recommended they be struck off.
One of these was general surgeon Gideon Lauffer, who was found guilty of serious misconduct after a series of botched operations that caused the death of two patients and injured 18 more.
Yet a Fitness to Practise panel ignored the advice and imposed a six-month suspension allowing him to return to work ‘under supervision’. /02/06/article-2097389-0E8FD6D400000578-506_468x410.jpg” width=”468″ height=”410″ alt=”Dr Kim Holt was suspended by Great Ormond Street Hospital after blowing the whistle on staff shortages and a 'chaotic' appointment system at the clinic” class=”blkBorder” />
Dr Kim Holt was suspended by Great Ormond Street Hospital after blowing the whistle on staff shortages and a 'chaotic' appointment system at the clinic
Yet in 2008, the Fitness to Practise panel, a group of medical and non-medical volunteers, appointed to investigate Dr Rehman’s behaviour, was cancelled — because an independent medical expert claimed ‘none of the points in respect of medical management reflect either incompetence or malpractice’.
Astonishingly, the same thing happened a year later when a second hearing was set up following a complaint from the Rutlands.
Despite the coroner’s unusually critical verdict last January, the GMC insists its own rules prevent it from ‘reviewing a decision to cancel a hearing’.
Chief executive Niall Dickson recently defended the organisation’s record, claiming problems often lie with flawed perceptions of the GMC’s responsibilities.
‘Our job is not to punish doctors but to protect patients by taking action against a failing doctor,’ he said.
‘We look closely at every complaint to see if the doctor’s fitness to practise could be impaired but will only take a case forward if the complaint indicates serious concerns about the doctor. In the majority of cases where a doctor has made a single mistake, this is not indicative of a bad doctor, however catastrophic the consequences.’
So what exactly does a doctor have to do in order to provoke ‘serious concerns’ by the GMC The worrying answer may be to tell the truth — there is growing concern that doctors who try to blow the whistle on unsafe practice could can end up facing disciplinary action themselves.
Two weeks ago, the GMC issued new guidance reminding doctors they have a duty to raise concerns about poor patient care.
Yet it’s an empty warning for Dr Kim Holt, a consultant community paediatrician at Haringey Primary Care Trust.
In 2006, Dr Holt was suspended by Great Ormond Street Hospital, the trust that then employed her, after blowing the whistle on staff shortages and a ‘chaotic’ appointment system at the clinic where, months later, Baby P (Peter Connelly) was treated days before his death.
‘It didn’t ever get to the stage of a complaint to the GMC. But there was an attempt to discredit me, to force me out of medicine as a damage limitation exercise,’ she recalls.
‘I was lucky in that I’ve now been reinstated in my job. But I’ve met several doctors who have been reported to the GMC by their trusts after they became whistleblowers, and a handful who have even been struck off the medical register.
‘Hospitals use threats of referral and actual referral to the GMC as a means of ensuring silence from medical staff.’
Brian Jarman, professor of primary health care at Imperial College, London, agrees changes are needed.
‘There is precious little evidence the GMC supports doctors who speak out when they see failing practice. Why doesn’t the GMC have a confidential helpline for people who see problems at their hospitals That would be a start.’
Later this year, the GMC will supervise the launch of a revalidation scheme under which doctors’ performances will be evaluated every five years.
Katherine Murphy, of The Patients’ Association, is not impressed.
‘Unfortunately the GMC’s record on managing complaints makes you wonder how revalidation will work — and whether it’s going to be friends revalidating friends,’ she says.
‘We have many experiences of good care and unsung heroes in the NHS,’ adds Mrs Rutland.
‘But there has to be a way of taking action against the bad ones — otherwise standards slipping and people dying unnecessarily becomes acceptable.’
Luton and Dunstable Hospital Trust was unable to provide a comment.