Anna ‘Opposing Views’ Raccoon – who is to blogging as shit is to the fan – has picked up on the General Medical Council’s latest Big Idea. Doctors who admit medical wrongdoing and accept sanctions, and those convicted of serious crimes – helpfully enumerated by the GMC to include murder, rape and child molesting – will no longer have to face Fitness to Practice hearings. Instead, they will be dealt with clandestinely by the GMC, and a note of their wrongdoing and sanction posted discreetly on the GMC’s website. The idea is both to curb the exponential rise in FTP hearings (and save a bob or two in the process), and to reduce unnecessary ‘stress and anxiety’ for doctors and witnesses caught up in the GMC mill.
Racca-Anna is outraged, claiming that the proposals will muzzle the main stream media, and prevent punters from hearing salacious gossip about gung-ho doctors who – to quote from the post – ‘despatch a patient prematurely whilst singing Rule Britannia and smoking a hookah pipe, or stitch the patient’s left arm onto someone else’s right leg, or are simply stark raving bonkers’ only to be allowed, ‘through some technicality’, to continue to practise.
Equally outraged is Central News, an agency which regularly covers FTP hearings in best red-top style (‘Ban For Ripper Pathologist/Doc Invented Fake Patients/Photographed Patient in Underwear’). The concern is not, as one might expect, that the agency fears a nice little gravy train is about to dry up, but lofty notions of loss of press freedom. The Daily Mail has also bagged the story, raising a spectre of medical criminals, not to mention incompetent, drunk and, Heaven forbid, groping doctors escaping the spotlight of publicity, while the London Evening Standard decided to tell it how it is: ‘Killer doctors could escape open hearings at watchdog’. Cripes!
On the face of it, Racca and the rest, including the many commenters, have a point – secret hearings behind closed doors does not sound good. But, if one looks a little closer, one sees that in fact their case rests on a scurrilous hack attack of innuendo and supposition, and that while their conclusion – secret hearings are a bad idea – is correct, they arrive at that conclusion for the wrong reasons.
The first wrong reason, which rests on innuendo, is to equate allegation with fact (‘no smoke without fire, dear boy’). Racca relies heavily on this – killer docs getting off ‘through some technicality’, when it may equally be that the doctor got off because they were innocent – and to ignore that possibility is to ignore the liberal principle of innocent until proved guilty. Indeed, the risk of gratuitous mud sticking to a genuinely innocent doctor could be used, as in a way the GMC do, to argue for closed hearings; while the GMC’s proposals, which provide for named publication of agreed and/or proven in open court wrongdoing along with imposed sanctions more than satisfies Racca’s concern to avoid dodgy doctors – a simple look-up on the GMC website will tell her exactly who to avoid.
The second wrong reason, which rests on supposition, is that the GMC is a medical old boy network with the primary purpose of protecting dodgy doctors (‘professions closing ranks again, don’t you know’). While historically – and that means ancient history – there was some truth in this supposition, and notwithstanding recent bizarre decisions in which it has been suggested that old boy/girl networks have kept dodgy doctors out of the toaster, the stark fact is that today’s GMC is a quango viewed by many rank and file doctors – including Dr No – as nothing short of a medical Stasi that too often recklessly pursues doctors on spurious grounds – and then tries them before FTP panels led by lay chairs, and stuffed with lay members; and given the weight of lay membership on today’s FTP panels, the notion of a ‘profession protecting its own’ simply no longer makes sense.
Indeed, the danger Dr No sees if the GMC moves to secret consensual disposals – a form of out-of-court settlement for doctors allegedly guilty of wrongdoing – is not so much that the public will be deprived of grubby salacious allegations, as that the already over-zealous GMC will be provided with its own secret Star Chamber in which to cajole, bamboozle and ‘persuade’ vulnerable doctors into agreeing guilt and sanctions that would not survive the full scrutiny of open hearing.
And so it is that Dr No agrees that public hearings should remain the norm, as much as a safeguard against abuse of power by the GMC, as to expose medical wrongdoing. If those public hearings should satisfy the salacious cravings of Racca and the red-tops, so be it; but the primary purpose is to ensure that justice is done, and seen to be done, for all, doctor and patient alike, and that requires public hearings.