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Better Read than Dead

Posted by Dr No on 02 May 2014

john_donne.jpgIt emerged last year that doctors facing General Medical Council Fitness to Practice hearings have a remarkably high death rate. Over the last decade, these doctors have been dying at between fifteen and thirty times the expected rate, depending on the comparator group used to do the calculations. Some of these deaths are known to be suicides, with others suspected but not so recorded. A groundswell of grassroots objection grew to a chorus of high profile outrage, culminating last September in the discreet – it was all but buried in Council papers - announcement by Stilton, the GMC’s Chief Pongo, of an enquiry into some of the deaths. In a faux pas on a par with appointing an Anti-Terror chief to enquire into the Muslim school plot, Stilton appointed a National Patient Safety Agency chief, one Ms Horsfall, to enquire into the suicides.

Sarndrah (sic) Horsfall brings a wealth of experience to the table, including ‘a background in strategic management, transformational change, service improvement, team development, financial and performance management and partnership working’ combined with – as if the foregoing was not full hand enough – ‘extensive health sector experience with a background in commercial and business management’. Dr No who lacks a background in strategic management (what is management if not strategic) transformational change (what is change if not transformational) etc., has nonetheless attempted to do some partnership working with (what is working with if not partnership etc) this impressive list of credentials, only to emerge art a larss to comprehend quite how this wealth could bring the right experience to lead the enquiry. Instead, Sarndrah appears to bring a bad case of adjectivitis (def: inflammation of the adjectives) to the table. But no matter. As Stilton always reminds us, the GMC is all about patients’ safety, not doctors’ safety, so that’s all right then. Even if doctors are sometimes also patients.

Stilton’s announcement of Sarndrah’s (sic) enquiry makes it plain that only deaths by confirmed suicide will be examined. There remains public uncertainty over how many of the FTP doctors’ deaths were suicides. Writing in July 2012, Mark Ellen of the GMC’s Information Access Team wasn’t giving much access to information at all: ‘There are currently 3 such [doctor suicide] investigations in place’ so establishing at least three of the deaths were by suicide. But what about prior and later suicide investigations that weren’t ‘currently…in place’ in July 2012? And then, what about deaths strongly suspected of being, but not recorded as, suicides?

Almost four hundred years ago, John Donne published his Devotions, which include in Meditation XVII the well known passage: “No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend's or of thine own were: any man's death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.”

Stilton may have sent for Horsfall, may even have sent to know for whom the bells tolled and why, but we have yet to hear the results of her investigations. However dark the findings, however long the shadow – and Dr No suspects the findings are very dark, the shadow very long – we need to hear not the sounding brass and tinkling cymbals of Stilton’s goons, but the tolling substance of the report. Horsfall’s findings need to be released, and released soon, so they can be read. The longer the delay, the greater the conjecture that the report is already dead, perhaps even buried.


Apparently the report is taking longer than expected to publish, I've been told to expect publication in the summer.
(I'm not holding my breath)

Is it known whether Dr Debra Shepherd's one of the cases being investigated in this report (was 2008, so, maybe not)

The short answer is we don't know. Possibly not, since it appears from this post (see last comment) that the GMC "did not have any communication with Debra Shepherd in the month prior to her death". It may be that Dr Shepherd had not got to the FTP stage (ie was at an earlier stage in the GMC 'process') and so strictly speaking was not an FTP death.

Dr No has previously suggested FTP deaths should include 'year and a day' deaths to pick up those dying after FTP proceedings. Perhaps we should also be enquiring about pre-FTP deaths ie deaths occurring after a complaint has been accepted by the GMC and notified to the doctor but before the 'process' has reached (if it was ever going to) the FTP stage.

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