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General Medical Council to investigate ‘culture of fear’ after doctor suicides

Health watchdog will ask if practitioners need better support during fitness-to-work reviews

The General Medical Council (GMC) is to re-examine the cases of a number of doctors who committed suicide while being investigated for their fitness to practise.

An internal review will consider whether the regulator could do more to “support vulnerable doctors” during their investigations, which one leading GP described as creating “a culture of fear”.

The decision comes after it emerged that 96 doctors have died while facing fitness-to-practise proceedings since 2004, following a freedom of information request to the regulator from the campaign group Doctors4Justice.

While it is not clear how many of these cases were suicides, and the GMC would not disclose how many cases it would be looking at, a report from the regulators’ chief executive Niall Dickson acknowledged that there were cases where a doctor had taken their own life while under investigation.

Sarndrah Horsfall, former interim chief executive of the National Patient Safety Agency, has been commissioned to look at the cases and will “consider whether [the GMC’s] current process for reviewing each of these cases can be improved.”

The GMC is responsible for investigating serious concerns about doctors and can take action to stop or restrict doctor’s practising medicine if they find evidence of serious wrongdoing, if a doctor is not keeping up to date with medical knowledge, or are too ill to work safely.

The regulator acknowledges that a referral to the GMC can be “one of the most stressful and painful times” of a doctor’s life.

“Some of the doctors are referred to us because they have serious mental health problems, including severe depression and various forms of addiction,” Mr Dickson said. “We recognise that these can be very vulnerable individuals and that being part of a fitness to practise investigation is almost always a stressful experience for everyone and especially for the doctor involved.”

Mr Dickson said the regulator had already introduced a programme to reduce the stress and anxiety for a doctor facing investigation. Doctors under investigation who have mental health problems have a supervising doctor in their workplace and are regularly examined by two practising psychiatrists, he said.

“Our priority though must always be to protect the public whilst at the same time being fair to the doctor - sometimes that does mean having to take immediate action when we believe patients may be at risk,” he added.  

The GMC carried out 3,465 investigations in 2011, and suspended 93 doctors.

Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, told the magazine Pulse that “the entire process” of fitness to practise investigations needed to be reviewed.

“It’s the smallest issue that can make a huge difference,” he said. “We need to look at the entire process, from the tone of letters to the fitness-to-practise hearing…Even the wording of a letter can have a dramatic impact on a doctor’s life.

“Most GPs live in fear of a GMC complaint,” he added. There’s a culture of fear. It’s important this review looks at the entire breadth of concerns.”