Dodders, late of the Worsted tendency, chugged on to the Today programme this morning. There was a hiss of steam as the old tank engine settled on its axles. The topic of the moment, aptly enough, was whistle blowing. Dodders and his Health Select Committee have been asked to look into the General Medical Council’s pernicious habit of feeding whistle blowers into the firebox, instead of listening to their concerns. Humph did his best to get up a head of steam. There were shunting noises as Humph and Dodders went back and forth over the rails. But they remained stuck in the sidings, puffing platitudes. Delivering professional obligations, puff. Professionals responsible to their regulator, puff. Much good work being done but still too many examples where standards aren’t being delivered, puff puff!
It occurred to Dr No that perhaps Dodders wasn’t so doddery after all. He had deftly switched the points under Humph’s very nose. He had ducked the primary question: how can the GMC ever hope to encourage responsible medical whistle blowing, when it is the very same GMC that relentlessly, and all too often irresponsibly, devotes much of its energy to the malevolent pursuit of medical whistle blowers?
Later, Humph was back on the case, on the long distance telegraph to Oz. Prof Billabong, who long ago uncoupled his wagon from the Great Train of British Medicine following the Bristol baby scandal, could be heard swinging corks in the breeze. He owned up to being a troublemaker, but took the Ned Kelly view when it came to the British authorities. One hoped the GMC weren’t about to do anything rash, like follow him into the bush.
Luckily they weren’t, at least for the time being, because Dickers, the Council’s Chief Pongo, was in the Today studio. Whatever one may feel about Dickers, one can’t fault him for want of a head of steam. Where Dodders had puffed, Dickers billowed. But the general thrust was more of the same, on a grander scale: bigger bolder, more intrusive regulation. There will be closer GMC links with employers – ‘supporting them in their role’ but also ‘making sure that they’re doing their job’ – and ‘regular checks for doctors’. Chillingly, he warned of a Stasification of medical regulation. Henceforth, all doctors will be responsible for The Lives of Others: ‘As a doctor, you are your brother’s and your sister’s keeper’. This is no Old Testament rhetoric: it is the New Order regulation soon to be imposed on a once proud and independent profession.
What neither Dodders nor Dickers grasp is that, not only is bigger, bolder, more intrusive regulation a futile exercise in mistaking the finger pointing at the threatening asteroid for the asteroid itself, not only is it doomed as the apparatchiks drown in a sea of clipboards, as they did at Winterbourne View, it is bound, in the heat of Stasification, to multiply distrust, to corrode confidence, to engender a climate not of openness, but of fear and mistrust. We can expect, in the years head, to see not fewer, but more Ned Kellys.
We need bigger, bolder, more intrusive regulation like Ned Kelly needed a hole in his armour. Far from more regulation, what we need is smarter regulation.
Superb 🙂
Well done Dr No. Of course, the men you affectionately mention have no idea how the GMC should improve. They have failed the public for more than 100 years. From Allinson to Cream – all whistleblowers have been crushed by the GMC’s careless hand.
Rita Pal
wish i was there
It is a dark and murky world out there, with the Men in Black out to follow up on whistleblowing. No-one with any sense blows the whistle lightly. If the powers that be were serious about wanting to encourage a culture of openness they need to show the way by appointing serious medical dissidents to senior roles in the regulatory system. Until then I will bite my tongue.
Even on the closed site of DNUK there are a lot of pseudonyms and closed profiles. After Dr Scot Jr, who can blame them? I had our PG Dean email me following some fairly mild comments that I made over the MTAS debacle of 2007. Lesson learned, I hardly use DNUK any more.
I am not a medical doctor (I have a PhD in philosophy which is in part why I am critical of medical ethicists/bioethicists or whatever they call themselves this year), but since 1969 I have tried to work in the field of mental health care for the NHS and other organisations. Right from the beginning I ran into problems. After reporting a charge nurse for brutally beating up a patient to the “management” I was made to feel very unwelcome. My last blow on the whistle was twenty years ago which resulted in a three year fight with the Richmond Fellowship, West Sussex Social Services and the Local Government Ombudsman (had to go to the wire with a threat of Judicial Review). I have always used the official channels but in most cases have not been fobbed off by the standard official responses. On every occasion I have had to resign my post and return to philosophy (does it get much sadder).
I would never advice whistle blowers to use the official channels unless they wanted to spend years communicating with duplicitous half-witted bureaucrats and had decided to leave their job. I agree with you that regulation is not the solution. I do not believe large bureaucratic institutions can “regulate” for whistle blowers until they show signs of understanding why some people do it and others not. You may be surprised to learn that medical students in this country can spend a year attaining a MSc in medial ethics and law that barely mentions whistle blowing and complaints (this is a bit of a gripe with me). The problem is that most people in this country just don’t get it. Whistle blowers are snitches and are ‘letting the side down’. They are also, as I know from my own experience, subject to Catch 22 – If you know that whistle blowing is going to cost you your career you must be mad to be a whistle blower, ipso facto all whistle blowers must be mad and are therefore untrustworthy and not fit to do their job.
Dr Phil – but at least you are here, reminding us of the pernicious effects of self censorship, and the subtle and sometimes not so subtle imposed censorship from the likes of PG deans who would silence any dissent, however bona fide that dissent.
KT – I think you hit on two very important points, amongst others: firstly, that whistle blowers are seen as disloyal snitches/grasses (as it happens the title and part of this comment (the bit below) was in my mind before I read your comment, so we were thinking on similar lines) and I would go one bit further (and this is begins to tie in with your Catch 22 point) – in a way they are being disloyal to the institution – but of course are (usually – but not always – there is vexatious whistle blowing too) loyal to a wider common good.
Had Dr No been in a more red-top/Mail frame of mind, he might have titled this post as he has the title of this comment, and continued in the same vein:
“Senior MPs and medical watchdog the GMC joined forces today to warn lazy medics who ignore wrongdoing: speak up, or we’ll ship you out.
Regulators fear cowardly medics are staying zipped in a bid to protect their careers, despite official warnings that medics must grass on mates who pose a threat to patients.
Chief watchdog Niall Dickson said today: “As doctors, you are your brother’s and sister’s keeper”.
He warned medics that the watchdog had plans to become ‘more proactive’ in a bid to stamp out smug doctors who look the other way. ‘We’ve got their numbers,’ he added. ‘They can run, but they can’t hide.’
etcetera etcetera…”
but plenty of other bloggers (notably Dr Z, who appears to have got within a rapiers breadth of stabbing himself in indignation) have picked up on this stuff and nonsense, which is little more than a crass damned if you do/damned if you don’t policy. Whistle blowing reality, on the other hand, is a lot more nuanced and far far more complicated.
Dr No will continue to plug the same basic idea: we don’t need more regulation, we need smarter regulation: and that, amongst other things, means making proper intelligent use of whistle blower intelligence, most likely through a protected truly independent channel.
The most interesting aspect of Dr Phil is that he believes everyone is a whistleblower just because they say so. He has already made one spectacular error in judgment, had to pull his pet story out. One wonders how many errors of judgment he makes because he never stops to think but is blinded by those who will pull the wool over his eyes. He cannot even bring himself to see the difference between those who play the whistleblowing card and those who are real whistleblowers.
Some of the whistleblowers he features don’t even have vindicated reports to their name. They say ” I am a whistleblower, therefore the world must think so”. Of course, this doesn’t work in the real world.
Anyhow Dr No, you have always written to a far higher standard than Dr Phil. Private Eye should move him over and take you on instead. No doubt, Dr Phil will copy some of your ideas and make them his. This is what he does in his spare time…..
His colleague emailed me only the other day admitting that he had extracted my so called home address from the GMC. The GMC finds it interesting of course.
Rita Pal
So, the GMC claim they intend to be tougher on doctors who fail to whistleblow. Meanwhile the GMC has been refusing to investigate a doctor who they commissioned to write an expert report about another doctor. The report is an obvious whitewash, but the Court of Appeal has recently rejected my challenge to the GMC. The whole thing stinks of corruption.
The GMC is stuffed with self-serving hypocrites who really don’t care if a few patients here or there are harmed as a result of their arrogance. And most of the time the GMC gets away with its petty corruption – petty corruption which nonetheless can and does have a profound impact on patients.
If you have ten minutes to spare and feel like reading some of the court papers go here:
http://www.gmcabuse.com