Suspended Doctors Group; victory in 2004
It is nearly twenty years since Dr. Harry Jacobs, the late President of the Society, proposed establishing a study group to look at the problems relating to suspensions of doctors within the NHS. Initial examination of a series of cases soon identified that there was widespread abuse of the disciplinary system, and extensive maladministration, and that unwarranted suspensions were multiplying alarmingly.
Only recently has it been confirmed by the Public Accounts Committee that the huge increase of the number of suspensions, and their astronomic cost, was largely a result of NHS maladministration. The escalation of suspensions has now been brought dramatically to a halt, as a direct consequence of the Society’s unremitting campaign on behalf of wrongly suspended doctors, in association with Hospital Doctor and with the assistance of Baroness Jill Knight in both Houses of Parliament.
Work of the Suspended Doctors Group
It emerged that some suspended doctors suffered severe depression (as, of course, do victims of abuse of power in other walks of life). There were cases of stress-induced myocardial infarcts, some of them fatal, and overt racism and sex discrimination were revealed (see reports 1990 and 1999).
After its early fact-finding meetings, the group decided to continue in being, with several distinct but complementary aims:
1. To provide a mutual support group in order to exchange experiences and advice, based on what past sufferers had experienced. This included commenting on any attempt to negotiate a deal for any individual in order to avoid a sell-out by a body more anxious to strike a deal than equitable treatment of the suspended doctor .
2. To ensure that psychiatric support was always available – and available at short notice – to assist suspended doctors and try to ensure that their mental health was maintained. To this end, the entire membership of the Society was put at the disposal of the Group, to be called upon to offer assistance wherever and whenever needed. Fortunately this proved not to be a heavy demand on the membership, as often the suspended doctor , working with his general practitioner, could find a local consultant whom the GP and the suspended doctor could both trust.
3. To try to change the system of disciplining doctors.
A campaign was organised with three strands:
(a) to maximise publicity about suspensions, both as a group and also about individuals, so that frivolous suspensions could be brought to public attention. In this connection Hospital Doctor has campaigned about wrongly suspended doctors, and this greatly helped the Group to get its message across (search their archive under “suspended doctors”).
In addition, talks were given to local societies and published in the more conventional medical press, where the injustice was exposed and the most vulnerable groups identified.
Gradually our statistics were accepted. Hitherto there had been no statistics, and at first considerable doubt was expressed about our figures. But detailed surreptitious investigation indicated that, if anything, our figures were somewhat conservative as to the scale of the problem.
(b) the second strand was political, and in this we were greatly helped by the intervention of Baroness Jill Knight, who organised questions in Parliament, both in the House of Commons (when she was a member of that House), and later in the House of Lords. She organised a number of debates and meetings in the Palace of Westminster and she even persuaded a Minister of Health to meet with us and discuss the issues. That happened, and we were promised reform, but unfortunately a general election was called and that Minister lost his seat as the Government changed hands.
(c) the third strand was to bring financial pressure to bear on the Government. It was quickly apparent that the Government had no statistics, and had no idea of the scale of the problem. It was therefore deemed apposite to involve the National Audit Office as to the waste of money caused by suspensions. This lead to that Office investigating the case of the 11yr suspension of Dr Bridget O’Connell. Their investigations were then reported to the Public Accounts Committee, which investigated it further and produced a scathing report on the waste.
This investigation at least secured the settlement in that long running case. The most critical member of that Committee eventually became Secretary of State for Health, but alas proved remarkably ineffective as far as improving the disciplinary system was concerned. There had been some minor changes in the regulations governing suspensions, but these were honoured more in the breach that in the observance.
Meanwhile Baroness Knight introduced a Bill in the House of Lords to improve the situation. That Bill was the outcome of deliberations between myself and Baroness Knight, together with contributions from the Medical Protection Society and the HCSA. The BMA also contributed to some extent.
The Bill was based largely on what the Scottish Parliament had done. The Scots had reacted to our second report on the money wasted on suspensions, by establishing a quick committee which then drew up a scheme which effectively almost eliminated suspensions in Scotland.
Baroness Knight’s Bill passed through the House of Lords where it had much cross party support but was killed in the House of. Commons by the Government who instead decided to set up the National Clinical Assessment Authority (NCAA).
Doctors initially attending the NCAA found the experience oppressive; extremely intrusive and fundamentally unfair. The attitude encountered was that they were the problem doctors and that their cases were essentially prejudged.
Meanwhile the National Audit Office (NAO) had decided to investigate the financial waste within the NHS. The SCP Study group, now transformed into the Suspended Doctors Group, contacted its active membership, who individually informed the National Audit Office about their treatments. That Office decided that the Suspensions Issue was worthy of a separate investigation on its own.
The financial details of the suspensions were verified by the NAO. In due course
they produced a damning report, almost twelve months ago. That report was
submitted to the Public Accounts Committee, which then cross examined the Chief
Executive and the Chief Medical Officer of the NHS on its contents.
By then there was a sea change in the NCAA, as it dawned on them that in the majority of cases of suspensions the doctor was not at fault, in terms of being either incompetent or guilty of professional misconduct. It became clear that doctors were being suspended over trifles, such as helping oneself to a handful of croutons at lunch time, or advising a patient to write a letter of complaint to her Member of Parliament!
The NCAA had set up a help line for Trusts to consult with them about suspending doctors and were almost overwhelmed by the demand. Half the hospital trusts in the country sought help within the first year. It was clear that hospital trusts had no idea what could justify suspending a highly and very expensively trained doctor, particularly as most of the cases did not involve risks to patients.
Whilst preparing its report by the Public Accounts Committee drafts were exchanged between that Committee and the NHS. It was very obvious that the committee report was going to be very critical of the NHS administration. Indeed when it was eventually published, almost a year after the NAO report had been published, its main critical comment was that suspensions were largely a result of maladministration. And it said that there racism was also a factor.
That confirmed that all that the Study Group had identified fifteen years earlier was proven to be justified.
At one meeting of the Suspended Doctors Group, a member reported that the NCAA was issuing instructions not to suspend doctors about whom there was a query, but that instead the doctor should be assigned to other duties; audit, teaching, or otherwise have his work schedule reduced where there was an element of possible risk to patients.
It had become very apparent to the group that this has been practiced for the last several months in that, whereas a year ago your secretary was receiving up to five contacts from newly suspended doctors a month, in the last five months he had received only two, and those were more that four months ago.
It would seem that our campaign has succeeded. It has taken a long time, and the cumulative cost at today’s prices approaches almost one BILLION pounds. But the victory is sweet nevertheless.
It is to be hoped that this will reduce the awful health consequences and mental suffering that wrongly suspended doctors experience.
It is my recommendation that the Suspended Doctors Group continues in action for the time being. There are two reasons for this, the first is that there is a small residua of suspended doctors whose cases are slowly evolving to a solution, but until those
cases are completed those doctors need support from the group.
The second reason to remain in existence is in case there is any backsliding by any hospital trust, so that we can bring much pressure to bear on that trust should the need arise.
My valedictory article for Hospital Doctor * celebrating our victory was featured on 9 December (pp.22-23). The victory is a great achievement of the Society of Clinical Psychiatrists of which the Society deserves to be very proud. The Society has single handedly taken on the might of the NHS and won.
I would add two personal things. I am not a psychiatrist. I have had to deal with many doctors severely disturbed as a consequence of their suspensions, and I am grateful to all those psychiatrists who came to my aid to help those doctors.
I would also add my thanks to the Executive Committee of the Society for not only giving me a free hand to organise the Suspended Doctors Group, but also for their unstinted backing whenever I embarked on yet another controversial move.
Peter J Tomlin