Niall Dickson, chief executive and registrar of the General Medical Council (The UK authority with responsibility for regulating doctors) recently gave advice in the light of junior doctors’ industrial action which has been widely reported in the press as counseling doctors against strike action given risks to patients.
The GMC statement boasts several headings including: “Advice for doctors contemplating industrial action,” “Advice for doctors in leadership roles,” ‘”Advice for senior doctors and those not in training,” and “Advice for employers.”
Niall Dickson’s proclamation did not appear to have a heading on advice for doctors under enormous stress from the NHS and who are now at a loss to know how to cope.
Such a heading might have been expected from the GMC following the publication of an investigation entitled, “Suicide whilst under GMC’s fitness to practise investigation: Were those deaths preventable?” – a review article published in the Journal of Forensic and Legal Medicine in January 2016.
In their paper, David Casey and Kartina Choong point out that 28 doctors committed suicide between 2005 and 2013 whilst under GMC fitness-to-practise (FTP) investigations. These shocking figures were revealed following a Freedom of Information (FOI) request made independently to the General Medical Council in 2012 by psychiatrist, Dr. Helen Bright.
Casey and Choong emphasize that of all 28 doctors who committed suicide, at no point did the coroner’s system consider that their prevailing circumstances might be contributing to the future deaths of doctors. This is despite the coroner, in one case, asking the GMC to comment on a suicide note, which clearly implicated the GMC in the doctor’s death.
Yet coroners have a duty, the authors of this study explain, where appropriate, to report on a death with a view to preventing future deaths. Reviewing the chief coroner’s recommendations on when to issue such a report, it can clearly be seen from this investigation, that there were future risks of death.
Casey and Choong point out should there have been a cluster of mental health deaths a coroner would have issued a report.
These authors also point out that should there have been a series of preventable hospital inpatient deaths a coroner would have issued a report. The concern must be that 28 doctors committed suicide, beyond all reasonable doubt, whilst under GMC investigation, yet there is no evidence that the coroner issued a report.
Casey and Choong argue that although the responsibility of regulators towards those they regulate remains unclear, the case of Watson v. British Boxing Board of Control (BBBC) Ltd55 demonstrates that a regulatory body does owe an affirmative duty to exercise care towards those it licensed as professional boxers.
Therefore, the authors conclude, the relationship between a regulator and those it licensed falls within an established category of liability for which a duty of care arises.
The GMC and the NHS appear ever more concerned about doctor’s duty of care towards patients, as UK doctors’ protests against their hours and working conditions continue to escalate, culminating in ever more extensive industrial action.
But what about the NHS’s and GMC’s duty of care towards doctors?