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THE BIG INTERVIEW VIEWS


with mental health problems are supported in general and how doctors work with employers, because many referrals come from employers. And it is about working out where the limits of public accountability lie. My concern is about all the difficulties that a doctor might face, including their mental health, and then how those difficulties might be affected when the GMC gets involved. The FTP process itself might add to the distress and the risk that doctors face – that seems to be something that should be avoided as much as possible.


What can the GMC do to minimise this potential effect? It is bound to be stressful for doctors to face investigation, but there are about 2,500 investigations every year, which seems to me to be a lot given that there are 150,000 doctors in the country. So one question is bound to be whether all those investigations are necessary because each one carries a degree of stress for the person being investigated. It is a relatively small proportion – in 2014 it was 18% – that will face some kind of sanction including a warning. That’s


a lot of people facing investigation who in the end have nothing done to them; the rest have no outcome or the outcome is consensual. My interest is looking at whether the GMC process can be more consensual in the future. The issue of doctors already having mental health issues when they come in is an important one. It is bound to be true, but the question is what does the GMC do in those situations? The people who die by suicide don’t necessarily have mental health problems that are already known. So there are some people who come in


who have mental health difficulties that are already explicit – they will need careful and sympathetic handling because they are already in difficulty and people can see that. But there are some people whose mental health difficulties haven’t been known and who might well deny they have such problems, but who nevertheless might be in distress and at risk. There has to be a similarly sympathetic way of handling those people.


Are there too many fi tness-to- practise investigations? I haven’t identified a number of


‘We want doctors to feel protected’


Watch clips of GMC chief executive Niall Dickson telling Pulse of plans to boost support for vulnerable doctors pulsetoday.co.uk/biginterview


48 February 2016 Pulse


To me, 2,500 investigations a year seems to be a lot


investigations that shouldn’t have taken place – I am looking at the pure numbers. Of the 2,500 investigations concluded in 2014, 82% didn’t lead to a sanction. That to me sounds like people are going through investigations, increasing their risk and distress with no outcome imposed on them. It makes me think there are too many and that a consensual process and outcome should be the aim for as many processes as possible. I do think that the lack of a consensual


process adds to the risk in people who are distressed and vulnerable – that’s the whole basis of my involvement.


ONLINE


Do you think the GMC failed in its duty of care to those doctors who died by suicide while under investigation? I understand why you might ask that, but I’m starting from now to see what the role of the GMC might be going forward. There is an emotive language there, which I don’t want to get caught up in. It’s about improving the investigative process rather than levelling accusations at the GMC.


A more compassionate regulator? GMC reveals plans to overhaul its FTP process pulsetoday.co.uk/ GMC


The GMC has said that it wants to be more compassionate to the needs of vulnerable doctors: it’s my job to consider the ways in which this can be achieved. There have been some serious criticisms of the tone of communication with the GMC as well as the number of investigations that are carried out, and therefore the number of people who get caught up in a distressing situation. The protracted nature of these investigations and their long-term impact on a doctor’s career all need to be looked at.


NEIL O’CONNOR


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