IS THE GMC RACIST?
World renowned doctor wins landmark race discrimination claim against the GMC
Jun 17
16th June 2021 - The Reading Employment Tribunal has upheld the complaints made by Consultant Urologist Mr Karim, that he was discriminated against by the GMC on the grounds of his race. Mr Karim is mixed race, Black African/European and is a Muslim.
This is a landmark decision. It is the first time that a race discrimination claim has succeeded in the Employment Tribunal against the GMC, the medical regulatory body for Doctors.
Shazia Khan, Founding Partner at Cole Khan Solicitors LLP, has represented Mr Karim since 2018. Mr Karim was represented at the Employment Tribunal by Karon Monaghan QC of Matrix Chambers.
Facts of the Case
Mr Karim worked as a consultant urological surgeon at Heatherwood and Wexham Park Hospitals NHS Foundation Trust, later the Frimley Health NHS Foundation Trust (“the Trust”). The events that span this case started in 2013, when the GMC received allegations of concern against Mr Karim. The complaints were deemed not to meet the required threshold and were closed, with no further action. In October 2014 the GMC received a copy of an external review commissioned by the Trust into the operation of the Urology Department. The Trust had excluded Mr Karim, among others, in July 2014, while that investigation was being carried out. Mr Karim was reinstated two weeks after its conclusion. But a further investigation was then commissioned after which Mr Karim was again suspended by the Trust in January 2015 and never returned to work at the Trust, having resigned on 22 May 2015. In the meantime, in 2014, the Trust had referred Mr Karim to the GMC. On 3 March 2015, the Interim Orders Panel of the MPTS (Medical Practitioners Tribunal Service) imposed restrictions on Mr Karim’s practice, pending the outcome of the GMC’s investigation.
These restrictions had catastrophic life-changing consequences on Mr Karim’s surgical practice. It was not until August 2015 that the restrictions on Mr Karim’s practice were lifted. His case was then referred to a full hearing before the Medical Practitioners Tribunal but not until some three years later. None of the allegations put against Mr Karim related to his clinical performance or his competence. The FTP (Fitness to Practice) hearing took place in April 2018 at which Mr Karim’s evidence was accepted in full, and Mr Karim was found not to have committed any act of misconduct at all.
Throughout this process Mr Karim alleged that his treatment by the GMC was discriminatory. An adverse outcome could have signaled the end of his career, the loss of the means to earn a livelihood and damage to his international reputation of excellence.
The Tribunal came to the following conclusions:
- Though the GMC argued that Mr Karim lacked credibility, the Employment Tribunal rejected this offensive suggestion. As the Employment Tribunal found, Mr Karim was honest and credible.
- There was less favorable treatment of Dr Karim in the way that he was treated as compared to a white doctor.
- The GMC undertook an investigation into Mr Karim when the same allegation was made against a white doctor whom they decided not to investigate and looked for material to support allegations against Mr Karim, rather than fairly assessing matters presented.
- The GMC continued the investigation against Mr Karim where the investigation into the white doctor was terminated and referred back to the Trust.
- Taking into account all the evidence including the statistical evidence about race which shows a higher proportion of adverse outcomes for BME doctors the Tribunal found that the difference in treatment of Dr Karim in comparison with a white doctor and the significant delay in the investigation of him were on the grounds of his race.
- The Employment Tribunal stated that they were not able to accept the explanations provided by the GMC for the difference in treatment between Mr Karim and the white doctor such as to show that the Claimant’s race did not form part of their considerations.
- The Employment Tribunal also expressed the fact that it was concerned about the level of complacency shown by the GMC about the possibility of the operation of discrimination in the referral made by the Trust to the GMC.
- There was a significant delay of some four years in the GMC’s handling of Mr Karim’s case, which was not necessary for justice to be done.
- The Employment Tribunal expressed the view that there was a level of complacency about the operation of discrimination in the work of the GMC and that there might be discrimination infecting the referral process. The Tribunal formed this view after considering the answers given to the questions around the Respondent’s equal opportunity policy, training around equality and diversity issues and the failure of all the witnesses to express how if at all the awareness of the overrepresentation of BME doctors in complaints to the GMC was considered in the investigation process at any stage, or whether discrimination may have been a factor consciously or unconsciously in the allegations faced by the Claimant.
- BME doctors are 29% of all UK doctors but 42% of complaints by employers are made against BME doctors. UK graduate BME doctors are 50% more likely to get a sanction or warning than white doctors. Other evidence illustrated the adverse position of BME doctors when compared to white doctors. In carrying out its work in respect of the complaints about Dr Karim, the GMC should have been conscious and aware of this background.
Quote: Shazia Khan Founder of Cole Khan Solicitors LLP says:
“This is a landmark victory for my client. The GMC has longstanding documented form on discrimination.
The GMC’s own statistics demonstrate that BME doctors referred to the GMC are more likely to be subject to a full investigation by the GMC. During 2014-17, 41.8% of BME doctors overall referred were subject to a full investigation as compared to 30.3% in the case of White doctors. In the same period, 45.5% of complaints against BME doctors overall were closed immediately as compared to 58% of White doctors. BME doctors are also more likely to experience harsher outcomes.[1]
The GMC’s most recent report State of Medical Practice 2020[2] says:
“This is no longer a question of gathering evidence, but of committing to action. We know that the experiences of doctors from a BME background can be sharply different from those of their white colleagues. It is now a question of what we do about it.”
We are calling for an urgent root and branch reform of the Fitness to Practice processes to address the over-prosecution of black and minority doctors.
Whilst my client is grateful to the Employment Tribunal for its judgment, it has taken a painful 4 years and significant time and resources to get to this place. My concern remains for those black and minority Doctors whose careers and livelihoods have ended due to the discriminatory investigations and prosecutions of them by their Regulator.”
Quote: Mr Omer Karim, the Claimant says:
“I sincerely hope that this judgment helps all doctors and the families of those doctors who are unfairly referred to the regulator. I believe, that, the GMC has a callous disregard for the truth and honesty. The GMC knew that I was a whistleblower yet, the GMC falsely constructed a case to only included evidence that helped their agenda to prosecute me. Right from the outset, the GMC saw me as a guilty black doctor and withheld evidence that could have proven my innocence.
There is an unhealthy relationship between a dishonest NHS Trust and the GMC. We doctors need to work to change the system as, in its present form, it is corrupt and clearly unfit for purpose.
I would like to thank all my colleagues, family and friends who have supported me over the last six years. I would also like to thank my patients who still believed in me as a surgeon despite a sword of Damocles hanging over me and my career. I am incredibly grateful to my excellent legal team led by Shazia Khan of Cole Khan Solicitors LLP and Karon Monaghan QC of Matrix Chambers, who kept me focused throughout this case. They were superb. My thoughts are with those families of doctors who committed suicide while being unfairly prosecuted by the GMC.”
The case has was covered by The Times Newspaper on 18 June 2021:
The Times, 18 June 2021 'The GMC is infected by racism'
Link to full ET Judgement here: Karim v GMC
[1] GMC “The State of Medical Education and Practice in the UK: 2017”.
[2] GMC 'The state of medical education and practice in the UK 2020', p.4.
more on Omer Karim's story
Berkshire surgeon ended up living in Travelodge after £300k four-year race discrimination battle with GMC
Omer Karim won a landmark case but had to live away from his family after selling his home to fund his case
By Julie SpencerReporter 05:00, 24 JUN 2021
https://www.getreading.co.uk/news/reading-berkshire-news/berkshire-surgeon-ended-up-living-20873370
A Berkshire surgeon who won a landmark race discrimination case said "his life fell apart" during years of wrongful investigation.
Omer Karim lost his NHS job, his private practice and the family home during a four year battle with a Berkshire NHS trust and doctors’ regulator, the General Medical Council (GMC).
He spent £300,000 of his own money to take on the GMC which found in his favour last week.
The urologist now wants a public inquiry to address what he says is the "over-prosecution of black and minority doctors".
An employment tribunal held at Reading upheld Mr Karim’s complaint that investigations into his conduct at Slough’s Wexham Park Hospital continued for years while similar complaints against a white colleague were dropped.
The GMC announced on Wednesday, June 23, that it would appeal the tribunal’s judgement.
Mr Karim, one of the top robotic surgeons for prostate cancer in the UK, is of European/black African heritage. His friend and colleague Marc Laniado who was also investigated is white.
The tribunal ruled Mr Karim’s complaint of race discrimination against the GMC "was well-founded".
The employment court stated: “We have come to the conclusion that there is a difference in the treatment of the claimant (Mr Karim) in contrast to Mr L (Mr Laniado), a white doctor."
The ruling said the GMC was “looking for material to support allegations against the claimant rather than fairly assessing matters presented”.
The panel concluded the GMC’s referral procedure may be “infected with discrimination”.
Mr Karim, 62, said allegations against him arose from the Care Quality Commission (CQC) report in 2014 which ruled Heatherwood and Wexham Park Hospitals NHS Foundation Trust was inadequate.
Mr Karim went on local radio to discuss the Trust’s failings and blew the whistle on what he described as a poor surgical practice by inadequately-trained surgeons.
He was suspended from the Trust in 2014 but reinstated. He was suspended again in 2015 after which he resigned.
Restrictions he said were "catastophic" and "life-changing" were placed on his medical practice during the GMC investigation.
The case against Mr Laniado was dropped but the GMC inquiry into Mr Karim continued for another three-and-a-half years.
A Fitness to Practice hearing took place in April 2018 when he was found not to have committed any misconduct at all.
Mr Karim said he had struggled to find work because of the allegations.
'I had to sell my family home and live in a Travelodge'
He said: “My life has been pretty devastated since 2014. My life fell apart. I had to sell the family home to take on the GMC which has cost me £300,000.
“I could only get locum work so lived apart from my family in a Travelodge for five years after I got part-time job in Portsmouth.
“As a consultant of 20 years standing I should be teaching abroad and at retirement I should be able to sell on my practice but there is nothing to sell now.
“I funded my case by selling our family home where my children grew up.
“The minute you are referred to the GMC you cannot work abroad, you cannot change jobs.”
Mr Karim, who lives in Henley-on-Thames, described the complaints against him at Wexham Park as “woolly, HR types of allegations which are very easy to make in the NHS”.
He said: “The allegations were not clinical.
“I was too vocal, I stood up for patients’ rights but I was guilty until I was proven innocent.”
He said his patients had never given up on him with one “very wealthy patient” offering to pay all his legal costs, an offer he refused.
He is now working at London’s Charing Cross and Royal Marsden hospitals.
LATEST DEVELOPMENTS OMER KARMIM CASE
GMC UNABLE TO DEFEND ITSELF AGAINST CHARGE OF RACISM?
GMC INFECTED BY RACISM
www.thetimes.co.uk/article/gmc-is-infected-by-racism-says-tribunal-n7lss8nk9
GMC is infected by racism, judges fear
Catherine Baksi | Jonathan Ames, Legal Editor Friday June 18 2021, 12.01am, The Times
Racial discrimination could be “infecting” the General Medical Council, a tribunal said as it backed the first claim brought against the body.
Judges upheld complaints made by Omar Karim, 62, a consultant urologist who is a Muslim of African and European heritage.
A ruling from Reading employment tribunal found that the GMC had discriminated against Karim by continuing an investigation into him when it did not investigate the same allegation against a white doctor.
“We do not consider there has been a credible explanation for the difference,” the judges said, adding that the GMC “was looking for material to support allegations . . . rather than fairly assessing matters”.
The tribunal was told that Karim, an internationally renowned specialist in prostate cancer and robotic surgery, blew the whistle over concerns about poor practice, bullying and discrimination at Heatherwood and Wexham Park Hospitals NHS Foundation Trust and claimed that allegations against him were malicious. The trust, now the Frimley Health NHS Foundation Trust, accused him of bullying and threatening behaviour towards a colleague.
The tribunal highlighted the disproportionate number of complaints made about doctors from ethnic minority backgrounds compared with their white colleagues. It quoted figures showing that ethnic minority doctors formed 29 per cent of UK doctors, “however, employers make 42 per cent of their complaints about [ethnic minority] doctors. UK graduate [ethnic minority] doctors are 50 per cent more likely to get a sanction or warning than white doctors”.
The judges said the GMC should have been conscious of the “adverse position” of ethnic minority doctors in considering the complaint: “The tribunal was concerned that there was . . . a level of complacency about the operation of discrimination in the work of GMC or that there might be discrimination infecting the referral process.”
The trust suspended Karim after several investigations in his department and referred him to the GMC at the end of 2014. The following year, the interim orders panel of the Medical Practitioners Tribunal Service imposed restrictions on his practice, pending the outcome of the GMC’s investigation. The restrictions were lifted later in 2015 but Karim’s case was not heard until three years later. At a fitness-to-practice hearing in 2018, he was found not to have committed any act of misconduct.
After the ruling Karim accused the GMC of having “a callous disregard for the truth and honesty”. The GMC said it was “giving full consideration” to the findings. The trust did not comment.
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GMC REFUSES TO ACKNOWLEDGE OWN GUILT
GMC DEMONSTRATES NO 'INSIGHT' THOUGH IT INSISTS THAT DOCTORS MUST DEMONSTRATE INSIGHT TO AVOID BEING 'STRUCK OFF'
GMC to appeal tribunal decision that found case against urologist was racist
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1619 (Published 23 June 2021) Cite this as: BMJ 2021;373:n1619
The General Medical Council is to appeal against a “flawed” employment tribunal decision that the regulator discriminated against a consultant urologist on the ground of his race.
Reading employment tribunal made the finding this month in the case of Omer Karim, the first doctor to succeed in a race discrimination claim against the GMC.1
Karim, who is of Sudanese and Irish heritage, was referred to the GMC by his employers in 2014. Interim conditions were placed on his registration in 2015, then lifted later that year. When his case was finally heard in 2018, he was cleared of misconduct.
The employment tribunal held that he was treated differently from a white doctor who was also under investigation, and that there was no credible explanation for the difference in treatment. The tribunal considered that the way the GMC dealt with some of the allegations suggested that the regulator was “looking for material to support allegations rather than fairly assessing matters presented.”
The GMC said the facts of the white doctor’s case differed in key respects from those of Karim’s case and the tribunal had wrongly concluded that disproportionate referrals of ethnic minority doctors to the regulator by employers constituted evidence of direct discrimination.
GMC chair Clare Marx said, “We know that many doctors feel discriminated against by the way in which referrals to the GMC are handled, and there remains much for us and others to do to change that. But accepting a flawed tribunal judgment will not help achieve the aims we and others share to tackle inequalities where they exist in disciplinary proceedings for healthcare professionals.” She added, “We know and are sorry that this will prolong uncertainty and anxiety for all involved, and we will seek to resolve this as swiftly as possible.”
Karim’s solicitor Shazia Khan said he was “very disappointed” by the GMC’s decision to appeal. “It is particularly regrettable that the GMC have decided to appeal in the face of the strong and clear findings made by the tribunal,” she said. “Any appeal will serve as yet another distraction, when full focus and commitment should now be given to a reform of the fitness to practise process to tackle the over-prosecution and other discriminatory treatment of doctors from ethnic minorities.”
Responding to the GMC’s decision to appeal the ruling, BMA council chair Chaand Nagpaul said, “The outcome of this landmark case has caused much anger and distress among the medical profession around the discriminatory treatment of ethnic minority doctors. A GMC referral can wreck the lives and mental health of doctors, with some tragically taking their own lives as a result. It’s unacceptable for ethnic minority doctors to be working in a system in which they feel that the dice is loaded against them.
“It is vital that the GMC openly acknowledges these concerns and demonstrates how it will provide the profession with the confidence that it treats all doctors in an even handed manner. This must include urgently commissioning a comprehensive independent evaluation of its fitness to practise decision making procedures, and a commitment to act quickly on its findings.
“Throughout the UK’s health and care system, too many doctors from ethnic minorities continue to experience discrimination and disadvantage, ranging from differential attainment of postgraduate examination, poorer career progression, increased levels of bullying and harassment, to an ethnicity pay gap. All parts of the NHS have a responsibility to ensure that doctors from all backgrounds are treated equally and fairly.”
References
- ↵
- Dyer C
- . GMC is accused of complacency about discrimination in its work. BMJ2021;373:n1595. doi:10.1136/bmj.n1595 pmid:34154995FREE Full TextGoogle Scholar
WHAT THE BMA THINKS
https://www.bma.org.uk/news-and-opinion/a-fight-for-fairness-beating-racial-discrimination
A fight for fairness: beating racial discrimination
by Peter Blackburn
Surgeon Omer Karim suffered years of turmoil when the GMC racially discriminated against him. The BMA, supporting Mr Karim, says it is time for the GMC to accept independent scrutiny
Location: UK Published: Friday 17 September 2021
‘Life-changing. Devastating. Catastrophic.’ Omer Karim is doing his damnedest to hold back his emotions as he tries to explain the brutal effects a lengthy – and, ultimately, discriminatory – GMC FTP (fitness-to-practise) investigation has had on his existence.
Doctors sometimes speak of the instant, nauseating terror felt when they receive a letter or email with that dreaded three-character heading: GMC. They tell of that stomach-tightening anxiety and panic accompanying a career flashing before their eyes and premonitions of their life crashing down around them.
These are concerns felt even more gravely for doctors from minority ethnic backgrounds – who are more likely to be referred to the GMC by their employer. For Mr Karim, those premonitions were not blown out of proportion. He ‘lost everything’.
Having the investigations hanging over me meant I felt like a prisonerDr Karim
Mr Karim was a consultant urological surgeon at Heatherwood and Wexham Park Hospitals NHS Foundation Trust, (now the Frimley Health NHS Foundation Trust).
During his time there the trust made several investigations into his conduct, eventually referring him to the GMC. After almost four years of investigations, the GMC subjected him to an FTP tribunal. That tribunal was to determine that Mr Karim had done nothing wrong.
But the process was lengthy and painful. The GMC had first received allegations of concern against him in 2013 and he was officially referred in 2014 but the final FTP hearing – he had been subject to an interim orders process in the meantime – did not take place until April 2018.
In the meantime, Mr Karim lost his private practice and felt forced to leave his trust through a settlement agreement to be able to work elsewhere in the NHS. On top of that Mr Karim sold his family home of 20 years and his daughter left her private school which helped with costs.
Life on hold
Mr Karim, an acknowledged authority in robotic surgery for prostate and kidney cancer, also had to give up teaching roles across the world and was unemployed for five months before taking locum shifts at a south-coast hospital trust miles away from his home, living in a Travelodge when on call.
‘Every family holiday we went on we were constantly wondering whether we would be able to do something like this next year,’ Mr Karim says.
‘We were constantly answering emails from my lawyers and my daughter has lived with this as a huge part of our lives from the age of 15 onwards. Having the investigations hanging over me meant I felt like a prisoner.’
Mr Karim argued that, while the investigations into his conduct continued for years, similar complaints against a white colleague were quickly dropped. In August 2018, he brought claims against the GMC, including a claim of direct race discrimination, and an employment tribunal found in his favour.
In June of this year the tribunal judgment said it was concerned there was ‘a level of complacency about the operation of discrimination in the work of GMC or that there might be discrimination infecting the referral process’.
The judgment also said the GMC was ‘looking for material to support allegations against Mr Karim, rather than fairly assessing matters presented’.
I was mistreated by the very organisation supposed to be looking after meDr Karim
At the FTP hearing in 2018, the GMC failed to disclose evidence which it considered not relevant to the allegations against Mr Karim. Facing prejudice is not a new experience for Mr Karim, who was one of the only minority ethnic boys in a grammar school in the North West.
‘In the NHS it is subtle,’ he says. ‘You applied for jobs and didn’t get shortlisted. If you have a foreign-sounding name you perhaps miss out.’
He adds: ‘In this country, to achieve the same as your white colleagues you have to be better than them. You have to be above everyone just to get the same treatment.’
But experiencing discrimination from his regulator – a body which is supposed to support patients and doctors – was even more galling.
‘I was mistreated by the very organisation supposed to be looking after me, and it was vexing that, the GMC questioned the credibility of their own witnesses,’ he says.
Amazing support
It is not the first time the GMC’s actions have come into question of late.
The BMA is supporting a legal case by the family of Sridharan Suresh, a consultant anaesthetist who took his life within hours of receiving a GMC letter. Dr Suresh’s widow, Viji Suresh, says he was left feeling alone and unsupported.
Mr Karim tells The Doctor he doesn’t think he would have survived his ordeal had he not had such ‘amazing support’ from family, colleagues and friends. Mr Karim’s case has been hailed as a ‘landmark’ moment.
Doctors from minority ethnic backgrounds are already disadvantaged by being referred by their employers to the GMC more than twice as often as their white counterparts – as revealed in the GMC’s own Fair to Refer report, published in 2019.
However, BMA council chair Chaand Nagpaul says the tribunal ruling raises a further ‘significant concern’ that ‘not only do minority ethnic doctors find themselves referred to the GMC more often, but that they can then face further discrimination from [the GMC itself]’.
The judgment said the GMC was “looking for material to support allegations against Mr Karim, rather than fairly assessing matters presented”Dr Nagpaul
Dr Nagpaul says: ‘The profession already feel they are working in exceptionally challenging environments – environments that are unfair for them to work in with too few colleagues, a lack of beds and facilities and capacity nowhere near to meeting demand.
'Our own studies have shown that nine in 10 doctors go into work every day worrying they will make a mistake because of these pressures.
‘These pressures are compounded for ethnic minority doctors who suffer twice the level of bullying in the workplace, they feel less confident to speak out about safety concerns due to fear of recrimination or it affecting their careers, on the back of already being disadvantaged with poorer career progression. Many feel isolated and without support from their employer and managers.
'When you add all of that together they are less likely to feel able to challenge or to defend themselves and can become soft targets for blame. The GMC referral is one manifestation of this unequal, unfair existence, and it pervades every area of the system.’
He adds: ‘The GMC has always maintained their [investigations] once the referral has been made are fair but Mr Karim’s case challenges that claim directly. This example will resonate with the views and experiences of so many other ethnic minority doctors who have felt similarly unfairly treated.’
‘Serious misjudgement’
The GMC is appealing the outcome of Mr Karim’s case, arguing that ‘the tribunal wrongly concludes that disproportionate referrals to the GMC by employers constitutes evidence of direct discrimination in Mr Karim’s case’, and also that the case of the doctor with whom Mr Karim was compared differed in key respects.
But doctors from minority ethnic backgrounds told The Doctor they felt the GMC’s refusal to accept the ruling – and to take the opportunity to look at their own processes – ‘crystallised’ worries that the GMC treats doctors from minority ethnic backgrounds differently.
Dr Nagpaul says: ‘The GMC should acknowledge there is a desperate need to ensure their own processes are fair and be open about the fact that they may not be. While the GMC also suggests that this is a problem of workplace referrals, we know that GMC employment liaison officers often provide advice on referrals for disciplinary action.
'The right thing – the moral thing – to do is to allow proper, independent, scrutiny of their processes and for the GMC act on any recommendations for change. Given the devastating impact a GMC referral can have on doctors it is imperative that its investigations treat all doctors equally and fairly.’
The BMA is calling for a full, independent, review of the GMC’s FTP processes.
MORE EXAMPLES
The Case of Surgeon Dr Annamalaikani Jeyapragash
https://www.bmj.com/content/359/bmj.j5002
GMC is criticised for failing to properly investigate case against cosmetic surgeon
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5002 (Published 27 October 2017) Cite this as: BMJ 2017;359:j5002
- Clare Dyer
A cosmetic surgeon accused of improperly anaesthetising a patient and lying to cover it up has been exonerated on all charges by a medical practitioners tribunal, which also strongly criticised the conduct of the General Medical Council in bringing the case.
The tribunal also had harsh words for the “fundamentally flawed” original investigation of surgeon Annamalaikani Jeyapragash by Aspen Healthcare, owner of Highgate Private Hospital in north London, where he performed a bilateral breast implant change on “Patient A.” She later complained that she had awoken during the procedure despite requesting general anaesthetic.
Numerous witnesses called by the GMC against Jeyapragash were deemed “unreliable,” “evasive,” or not credible, including Patient A herself, the anaesthetist booked for the operation, the scrub nurse, the theatre manager, and an operating department practitioner, said the tribunal’s chair, Nigel Westwood.
The case dated back to 2012, when Patient A sought a change of breast implants. The operation went without any incident noticed by theatre staff. But more than a year later the hospital received a letter of complaint alleging that she had woken during the operation, despite expecting general anaesthesia.
The documentary evidence showed that Patient A had consented to sedation and local anaesthetic, the tribunal found. Summing up her evidence, Westwood said that Patient A “was unwilling to listen properly when questions were put to her.”
Patient A “stated that she did not read documentation, especially documents that included ‘long words,’ including her own letter of complaint,” said Westwood. “When asked about the consent form she had signed, Patient A stated: ‘It was the normal hospital thing, that you give your permission to blah-blah-blah, what-have-you.’”
Patient A also “distanced herself from the complaint letter that had been sent to Aspen in her name,” said Westwood, “claiming to have no knowledge of it, and she declined permission for her lawyers to provide information as to how that letter came to be written.”
Patient A’s “considerable reluctance to attend” was one reason the case dragged on for more than four years. One hearing, set for early this year, was cancelled when she failed to board the train because the GMC had not provided advance payment to kennel her dogs.
A theatre manager, who alleged that Jeyapragash had written a false statement during the investigation and asked her to sign it, also proved unwilling to attend and was “obviously reluctant to be examined on her evidence,” said Westwood, dropping the charge.
The anaesthetist who Jeyapragash said had administered the sedative initially claimed not to have been present during the operation, but later her signature was found in the controlled drugs book, signing for the midazolam that Patient A was given. She denied that it was her writing, but a forensic expert concluded that it was.
The GMC, Westwood concluded, had not identified flaws in the evidence, “which may have been apparent had it more assiduously discharged its responsibility.”
Jeyapragash had been forced to investigate and obtain evidence himself because the GMC had not done so, said Westwood.
The GMC’s expert witnesses had also “missed opportunities to bring matters to the attention of the GMC which may have made the GMC’s case preparation more thorough and more balanced.”
“In all the circumstances,” said Westwood, “the tribunal considers that it was incumbent on the GMC to ensure that such serious matters as have been alleged here were thoroughly investigated and reviewed.”
A GMC spokesperson said. “This has been a very complex case. The tribunal has made a number of comments in its determination, which we will reflect on.”
Solicitor Sian Davies, representing Jeyapragash, said that because the surgeon was pursuing ongoing matters her ability to comment was limited. But the long wait for exoneration “reflects very poorly on the entire process,” she said. At no time had the GMC suggested that his ability to practise should be restricted in any way, she added, and he had continued to see and treat patients throughout the process.
IT'S BEEN GOING ON FOR A LONG TIME
Letters No doctor should be untouchable
The GMC can learn from its institutional racism
BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3226 (Published 22 May 2013) Cite this as: BMJ 2013;346:f3226
- Nadeem Moghal, consultant paediatrician1
As outlined in by Wilmshurst,1 black or Asian doctors who have misrepresented their qualifications will be treated differently from their white counterparts. The GMC may well be institutionally racist, but it probably can’t see this and seems unable to be self critical. Perhaps it might read the Macpherson report and reflect on the definition again: “The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.”
The advantage the GMC has is data. If seven Asian and black doctors can be erased for falsifying qualifications and one white doctor is simply reprimanded, the GMC should go back and explore the processes, attitudes, and behaviours that generated that data. How else will it learn?
Notes
Cite this as: BMJ 2013;346:f3226
Footnotes
- Competing interests: None declared.
References
- ↵Wilmshurst P. No doctor should be untouchable. BMJ2013;346:f2338. (18 April.)FREE Full TextGoogle Scholar