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THE BIG INTERVIEW Professor Louis Appleby


‘It may add to the risk that doctors face’


Fitness-to-practise procedures may be worsening doctors’ mental health, the GMC’s new independent expert tells Joe Davis


Appointing the respected mental health expert Professor Louis Appleby is a big statement of intent by the GMC. Following intense criticism over the stress caused to doctors undergoing its fitness-to-practise (FTP) procedures, the regulator has asked Professor Appleby to ensure its treatment of vulnerable doctors is more ‘compassionate and sensitive’.


The GMC says he will look at ‘every


stage’ of the FTP investigation process and suggest changes the regulator could make within its current legal powers, as well as ones that may require fresh legislation.


Professor Appleby brings a wealth of


experience to the table; he leads a group of more than 30 researchers at the Centre for Mental Health and Safety at the University of Manchester, where he is a professor of psychiatry. He speaks to Pulse as he begins his


work, and despite the size of the task in hand, appears confident that he will find ways to ensure the distress the GMC’s processes currently cause doctors can be ‘avoided as much as possible’.


What will the independent review look at?


The remit is to evaluate every aspect of how the GMC approaches its fitness-to- practise process. This will link into a wider review, including how people get into difficulties with the GMC in the first place, what happens to them after they have gone through fitness to practise and what sort of support the system as a whole provides for doctors who have mental health problems.


46 February 2016 Pulse


It’s my intention to examine this broader context and how the fitness-to- practise element fits into it. A lot of people have told me about their experience with the GMC and delays in the system is one aspect that people find difficult. That’s one of several. People feel that they are treated as guilty from quite an early stage. They also feel the system is harsh in tone, that it’s quite protracted and that the long-term consequences are sometimes disproportionate and go beyond the immediate issue.


Would you agree with those views? I’m very sympathetic to the points people have made to me and it’s my intention to try to understand them better. My starting point is that we have to try to do the right thing by doctors even when their practice has been problematic, and my starting sympathies are always with a doctor who is in difficulty.


A total of 28 doctors died by suicide while undergoing FTP investigations between 2005 and 2013. The GMC has said some of them had very serious mental health problems when they entered the process. How do you approach this situation? My work as chair of England’s National Suicide Prevention Strategy Advisory Group has helped me understand that people die by suicide for complex reasons. There is not a single cause of suicide in most cases. It is usually that people face a number of problems, which include issues with their mental health. This is why I said there was a broader context to this; it is about how doctors ►


CV


Age 60


Education University of Edinburgh


Career • 1996-present Professor of psychiatry, Centre for Mental Health and Safety, University of Manchester • 1996-present Director, National Confidential Inquiry into Suicide and Homicide by People with Mental Illness • 2002–present Chair, National Suicide Prevention Strategy Advisory Group • 2000-2010 National director for Mental Health • 2010-2014 National clinical director for offender health • 2013-present Non- executive director and board member, CQC


Other interests Cleaning his clarinet and making lists


NEIL O’CONNOR


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