Sunday, 17 June 2012

Dr Peter Jefferys and Barristers

Dr Peter Jefferys (top left), United Kingdom's Labour Party member, self-declared atheist, who has owed a home (converted church in Norfolk) has been a Fitness to Practice panelist since 2001 at the General Medical Council (GMC), regulator of medical profession in UK. He failed to declare all his conflicts of interests as required by GMC policy on declaration of interests. GMC has rules that panelists have to declare their interests and update them. He did not and GMC did not either for at least NINE YEARS and up to present day!

In 2002 Dr Peter Jefferys wrote to Simon Haywood, investigator at GMC stating his interest in Dr Helen Bright's case. Dr Jefferys complained to GMC that a Catholic nun was upset because Dr Bright stated that  uniforms are not worn in psychiatry by mental health workers, a true fact for most of UK.  At the time of his complaint UK was ruled by Labour Party with Mr Anthony Blair as Prime Minister. After leaving the government he declared himself as a Catholic.

GMC kept it secret from Dr Bright that Dr Jefferys declaration of interest in her case was late and contrary to GMC's policy for many years. GMC refused to comply with law and Dr Bright's request under section 7(1) of Data Protection Act 1998 to disclose information held on her by GMC. Quite simply, GMC misapplied section 31 of Data Protection Act to deny the information to Dr Helen Bright for years.

GMC continued to persecute Dr Bright and fix religiously biased Fitness to Practice Panels for many years. The head of empanelment was Ms Graziella Oragano (presumably from Catholic background if one can judge anything by names). She departed in April 2012 after complaints to Parliament for a couple years about the fixing of trials at GMC.

There is an interesting historical figure that of Hanging Judge Jefferys. Jefferys have been traditionally Catholic (see Hanging judge Jefferys picture bottom right, allow for age difference and whatever else is required and see the facial similarities, if any, between him and Dr Peter Jefferys). The relatives of "Hanging Judge" Jefferys were frightened of reprisals after he was imprisoned in London Tower when trying to escape. They found refuge in Catholic monasteries. Here is a bit of history:

Religion and politics were intertwined throughout James' public life. He openly opposed the Test Act of 1673, which barred all Catholics and Dissenters from holding administrative positions; James relinquished the post of Lord High Admiral and went abroad. The Whig Parliament of 1679 strove to exclude James from the succession, and failed only because Charles II dissolved Parliament. Within months of his accession, James had to crush a rebellion of Protestants who rallied around his nephew James, Duke of Monmouth and son of Charles II. The Protestants were easily defeated, and James exhibited little toleration: Monmouth was captured and beheaded. James appointed Judge Jeffries to preside over the "Bloody Assizes" which executed, tortured, or sent into slavery the Protestant rebels. James ambitiously appointed Catholics to high positions although loyal Tory councilors advised against it. As a result, both Tories and Whigs turned against him.

It is a historical fact that ladies in waiting made money from their sale of rebels into slavery.

In the time of Dr Peter Jefferys and his professional work with regulators it has been barristers who profited from injustice done to doctors, for example, by the fixing of Fitness to Practice Panels at GMC by Ms Oragano in such a manner that it was more or less guaranteed that doctor would lose. Injustice is really good for business. Dysfunctional units at their core have addiction to chaos and at least one person at GMC must have loved it. When doctors lost their Fitness to Practise cases, there would be appeals to superior courts and when doctors could no longer afford legal fees the modern day equivalent of "slavery" of bankruptcy, and low paid unprofessional work was an option if doctors stayed alive.

GMC grew millions (no need to pay tax as a charity) because of the Labour Party agreement to allow GMC to register as a charity (charities do not pay tax). This happened despite the High Court and Court of Appeal ruling to the contrary that GMC could not be a charity. Thus, money was made available to GMC to persecute doctors, dissidents of government policies which were breaking the EU law, for example, in return to the government for this favor of not paying the tax. It is not clear how many people died because of political persecutions but on the balance of probabilities many did. When competent doctors are eliminated and there is shortage of doctors, patients die, on the balance of probabilities. This is what happened after Dr Jefferys dimissed Dr Helen Bright from Northwick Park Hospital and he had no replacement for her. A couple of patients committed suicides. GMC covered up nicely for him since 2003 when they heard about it for the first time. Hospital is liable for such deaths when patients are under their care. It was in Dr Jefferys, personal interest to have Dr Bright's reputation smeared by allegations of bad behavior rather than any allegations that she harmed any patients. Dr Bright has never been found to be danger to any patients or public by any regulator. It was a brilliant and cunning plot by Dr Jefferys which GMC was keen to embrace because GMC themselves never managed to completely separate the politics and religion from their own interests. Patients and public interest are of course, completely irrelevant when it comes to real life, and power games as many doctors have learned by now.

GMC have never considered what impact it has on witnesses, for example, appearing before GMC FTP to know or not to know, as the case may be, that Dr Peter Jefferys sat on their regulatory bodies. At the last count Dr Peter Jefferys sat at regulatory bodies regulating at least eighteen different professions. There would have been so much opportunity for the vindictive side of his character to be put to use.

How would barristers feel making submissions at GMC and in superior courts knowing that Dr Jefferys worked and has connections with their regulatory body? Would the interests of their clients really come first? 

If they did not know, but their clients interests suffered anyway, as they would in the hands of unaccountable regulator's FTP panel fixer, where is justice?

Dr Peter Jefferys has worked as non-executive director of Norfolk and Waveney Mental Health Trust and now Norfolk and Suffolk NHS Foundation Trust.  AGAIN THERE IS NO DECLARATION THAT HE WAS A MEMBER OF PROFESSIONAL CONDUCT AND COMPLAINTS COMMITTEE OF BAR COUNCIL.This time his declared interests are:

Peter Jefferys joined the trust in September 2011, leaving London after 30 years as a consultant in the psychiatry of old age at Northwick Park Hospital, in Harrow, to live permanently in Norfolk. He has experience as medical director of a community and mental health trust, and has been involved in professional regulation with the General Medical Council, the Health Professionals Council, and the General Social Care Council.  He has also been involved in a wide range of associated clinical practice as a second opinion appointed doctor for the Care Quality Commission, and as clinical adviser to the Parliamentary and Health Services Ombudsman.

Dr Jefferys has reasons why he does not declare that he was a member of Professional Conduct and Complaints Committee of Bar Council just for one year. Normally, appointment is for several years. Barristers would be interested to know why he was there just for one year. Appointment at Professional Conduct and Complaints Committee of Bar Council would have been a useful to him in his case against his instructing solicitor Yvonne Hossack when he was her expert witness and complained about her to Law Society, after she complained about him first to GMC, for example.

Dr Peter Jefferys also worked as advisor to the Parliamentary and Health Services Ombudsman, yet another interest not to be found on GMC website today. Patients and relatives complain against doctors and to Parliamentary and Health Services Ombudsman as well as to GMC. Would the complainants know who assessed the validity of their complaints in different institutions?

No conflicts of interests, of course, not. it is not just that conflicts have to be declared but they have to be assessed. Willful blindness all around.

Remarkably, on oath when giving evidence against solicitor Yvonne Hossack at Solicitors Disciplinary Tribunal, Dr Peter Jefferys claimed that GMC have to have consent of patients for their identities to be disclosed to them. Since when did GMC get the consent of patients in Dr Harold Shipman's case? Or in the cases of those who are unable to give their consent because of fear or severity of dementia or where it would be unreasonable to seek their consent?

Dr Jefferys has regarded himself as the expert on mental capacity and has worked at GMC. However, none of these credentials are necessary to know some basic facts: GMC needs to have the names of patients in order to investigate the complaints properly should they feel the need to do so.


Thursday, 14 June 2012

Niall Dickson, CEO of the General Medical Council and Dr Richard Alexander Scott

In recognition of the importance of the case of Dr Richard Alexander Scott (decided by GMC's Investigation Committee on 14-6-2012)  Niall Dickson GMC's CEO (photograph above) has issued the following statement:

'Our guidance is clear -  doctors must not impose their own beliefs on their patients or cause them distress by inappropriately expressing their own views.

'In this case the panel gave careful consideration to the evidence given by Dr Scott and his patient. It concluded that Dr Scott had gone too far, trying to impose his own religious beliefs on a vulnerable individual. As this is a clear breach of our guidance, the panel concluded that we were right to issue Dr Scott with a warning.

"This is not about religion, it is about respecting patients and making sure doctors do not use the incredibly privileged position they hold to push their own beliefs, however strongly held they may be.

'This case has been contentious and received a lot of comment - our aim throughout has been confined to make sure patients are protected and that our guidance is followed.'

We have been pessimistic that GMC would do the right thing in this case and it is reassuring that we have been proved wrong.

GMC does not have an easy job to do at the best of times and it would help if the political system outside GMC was up to date. UK is still in the process of moving on with times and lags behind other countries a lot in some respects. While many citizens can see the benefits of separating state and religion there is a lot of improvement that needs to be made in many British state institutions. Medical institutions themselves need not just to change but to lead the way when it comes to what must be done in public interest: separation of state and religion.
One cannot underestimate the power within population that has not been used yet to achieve true freedom for British citizens. Liberty requires sacrifices to be made at times and by many but one must never neglect defending it even after it appears to have been won. One only has to look at what happened in different countries that achieved secularism but then failed to defend freedom in times of economic turmoil.

Dr Richard Alexander Scott given warning by General Medical Council

The General Medical Council has today on 14th June 2012 issued a warning to Dr Richard Alexander Scott. This decision will be welcomed by many people (religious and not religious) who are able to distinguish between the human rights of patients and human rights of medical practitioners.

A patient attended his surgery in National Health Service GP practice in United Kingdom and following this consultation a complaint was made by his mother to medical regulator that it distressed him and that there was inappropriate discussion of Christian faith during medical consultation. 

This case is important one because UK has failed to ensure separation of state and religion leading to many problems including loss of lives in other cases. While GMC regulation imposes obligations on medical practitioners to put patients first this has not always happened. European Convention on Human Rights does state the limitations on the rights to religious expression but there are many issues that UK has not sorted out and Dr Scott case illustrates a lot more than this determination.

Investigation Committee (Oral hearing)
Dr Richard Alexander SCOTT

11-14 June 2012

3 Hardman Street, Manchester, M3 3AW

Dr Scott:

At this hearing, the Investigation Committee has carefully considered all the material before it, including the submissions made by Mr Hurst on behalf of the General Medical Council (GMC) and Mr Diamond on your behalf. The Committee has noted and accepted the advice of the Legal Assessor.

The Committee is aware that it must have in mind the GMC’s duty to act in the public interest, which includes the protection of patients, the maintenance of public confidence in the profession, and declaring and upholding proper standards of conduct and behaviour. In deciding whether to issue a warning the Committee must apply the principle of proportionality and weigh the interests of the public with those of the practitioner.

This case arises from a complaint made to the GMC on 14 August 2010 by Patient A’s mother about your conduct when her son consulted you on 4 August 2010. The complainant alleged that you abused your position as a medical practitioner to push your religion upon a vulnerable patient. It was alleged that you had belittled Patient A’s religion (which was not Christianity) and emphasised the importance of Christianity, stating that Jesus Christ could cure him.

At the request of the GMC, Patient A provided a written statement, dated 20 October 2010, detailing his recollection of the consultation, on which the factual allegations against you were based.
On 28 February 2011, following the completion of their investigation, the GMC wrote to you in accordance with Rule 7 of the General Medical Council (Fitness to Practise) Rules 2004 and invited you to comment upon the allegations.
On 25 March 2011 RadcliffesLeBrasseur wrote to the GMC, on your behalf, confirming that you did not accept that all of the individual phrases or words attributed to you were used during the consultation.  It was stated that you had read the GMC’s guidance in Good Medical Practice and the supplementary guidance ‘Personal Beliefs and Medical Practice’ and aim to follow that guidance in your consultations. You rejected any notion that the views you expressed were not directly relevant to Patient A’s clinical care and that you would have brought the discussion about faith to an immediate end if Patient A had indicated that he wished the conversation to stop.

RadcliffesLeBrasseur submitted that there was no realistic prospect of a finding of impairment. A limited apology was provided stating that you were sorry, if on this occasion, the consultation had not gone well.
On 28 April 2011, the GMC wrote to you again in accordance with Rule 7 of the General Medical Council (Fitness to Practise) Rules 2004, and advised you that the Case Examiners had considered the allegations and the supporting information and decided that this was a case which they may conclude with a warning.
In a letter dated 20 May 2011 you wrote to the GMC confirming that you would not accept the warning therefore exercising your right under Rule 11 (3) of the Rules to an oral hearing before the Investigation Committee.
On 26 May 2011 the GMC received information from the National Secular Society which alleged that you had spoken on National media suggesting that your own faith had more to offer than that of Patient A. They provided the GMC with transcripts of two radio interviews in which you participated: The ‘Jeremy Vine Show’ aired on BBC Radio 2 on 23 May 2011 and BBC Radio 5 Live’s “Breakfast” show aired on 25 May 2011.
On 29 June 2011, the GMC wrote to you again in accordance with Rule 7 of the General Medical Council (Fitness to Practise) Rules 2004, and advised you that the Case Examiners had considered the additional evidence and confirmed that this remained a case that they may conclude with a warning.
In a letter dated 19 July 2011 you wrote to the GMC confirming that you wished to defend your position as a GP who cares for the whole patient, including the spiritual side, and therefore rejected the warning and wished to exercise your right to an oral hearing before the Investigation Committee.
At the opening of this hearing Mr Hurst, on behalf of the GMC, stated that this case did not constitute an attack on the Christian faith. GMC guidance acknowledges the role of faith issues in medical care and the right of doctors to raise such matters within the consultation provided that it is done with the patient’s consent and with sensitivity and respect for any faith they might have. Mr Hurst stated that on this occasion your behaviour in presenting your faith to Patient A had exceeded the boundaries set out in the guidance and, to use his words, “had gone too far.”
The Committee received oral testimony from you and Patient A. Patient A was permitted to give his evidence by telephone following the Committee’s earlier ruling. Patient A was supervised throughout his evidence by a GMC legal representative at the direction of the Committee. You were both subject to cross examination and were asked questions by the Committee. You each provided your own recollection of the consultation of 4 August 2010 and the Committee notes that there is a direct conflict of evidence between the accounts that you each gave of that consultation.
In providing oral evidence to the Committee you made a number of limited admissions during cross examination, but continued to assert that your actions were compliant with GMC guidance. You accepted that if you had acted in the way in which Patient A alleged this would be a significant departure from GMC guidance.

Mr Hurst submitted that it was both appropriate and proportionate to issue you with a warning. He stated that it was in the public interest to issue you with a warning, and that a warning would serve an important role in maintaining public confidence and high standards in the profession. He submitted also that a warning would act as a deterrent, reminding you that your behaviour had fallen below the standards expected and that repetition would likely result in a finding of impaired fitness to practise.

Mr Hurst submitted that your conduct amounted to a significant departure from the principles of Good Medical Practice and associated guidance; in particular paragraphs 33 of ‘Good Medical Practice’ and paragraph 19 of ‘Personal Beliefs and Medical Practice’ - supplementary guidance for doctors. He also submitted that your conduct ought to be marked by the issuing of a warning, to lay down a marker as to expected standards and to maintain public confidence in the profession.

Mr Diamond submitted on your behalf that your actions were appropriate in that you had acted at all times within these Guidelines; the issue was sensitively discussed and ceased upon request. He submitted further that a degree of deference should be given to an experienced GP who is embedded into the local community, particularly one who has a reputation for the care he provides to his patients.  

Mr Diamond drew the Committee’s attention to a considerable number of letters of support, testimonials and supportive recollections by your patients of occasions when matters of faith had been discussed to positive effect. The Committee noted also two witness statements that spoke of the help that had been received following discussions of faith with you and the regard in which you are held.

Mr Diamond submitted that a warning was neither appropriate nor proportionate.

In considering the facts of this case, the Committee noted that the GMC’s guidance confirms that discussing personal beliefs may, when approached sensitively, help to work in partnership with patients and allow doctors to address a patient’s treatment needs. As such the discussion of religion within consultations is not prohibited and this case relates to the manner in which religion was approached during the consultation with Patient A.

The Committee notes that there is clearly a conflict of recollection of what occurred in the consultation between the participants. In the Committee’s view both witnesses were honest and not trying to deceive. The Committee concluded that the differences were likely to be due to their differing perceptions.
Having made due allowance for the fact that Patient A gave his evidence by telephone and not in person, the Committee considers that it was able to obtain a sufficient impression of his truthfulness from the manner in which he gave his evidence and his response to questions. The Committee consider that Patient A gave credible evidence, direct answers and made all due allowances in your favour.

The Committee considered that while you sought to answer questions truthfully a number of your responses were in conflict with the evidence. Specifically, the Committee noted that it is unlikely that the very full record of the consultation which you made would have omitted mention of the treatment plan if it had been discussed - since this would have happened before the discussion about religion. The Committee regards it as unlikely that the discussion of your faith lasted only two and a half minutes as you contended, bearing in mind the breadth of material covered during your discussion. Furthermore, regrettably, at times you appeared to be evasive when answering questions.

The Committee went on to consider each of the allegations in turn. The Committee notes that you admitted paragraphs 1 to 3, at the outset of your cross-examination, and therefore commenced its consideration at paragraph 4.

Paragraph 4:
    During the consultation of 4 August 2010, you:

Paragraph 4(a):
    “continuously asked Patient A about his religion”
Has not been found proved

During oral testimony it was neither asserted by you nor Patient A that you had continuously asked Patient A about his religion. The evidence presented suggested that the contrary was true and that very little time had been spent on Patient A’s own religion.

Paragraph 4(b) During the consultation, you told Patient A that (or words to the effect that):

Paragraph 4(b)(i):
    “you were not going to offer him any medical help or tests or advice”
Has been found proved

The Committee notes that there is a direct conflict in recollection between yourself and Patient A on this matter. While you stated in your own evidence that you did not tell Patient A that you were not going to offer him any medical help, the Committee considers that Patient A’s account is more probable, since there is no mention in the notes of the medical treatment which you say that you offered.

Paragraph 4(b)(ii):
“you had something to offer Patient A which would cure him for good and that this was his one and only hope in recovery.”
Has been found proved in part

You acceded to the first half of this paragraph during your oral testimony, accepting that you had informed Patient A that you had something to offer which would cure him. The Committee has not found proved that you said that what you had to offer was his one an only hope of recovery as this was not borne out in your testimony or that of Patient A.

Paragraph 4(b)(iii):
“if Patient A did not turn towards Jesus and hand Jesus his suffering, then Patient A would suffer for the rest of his life.”
Has been found proved

The Committee considered that whilst you may not have said the exact words as stated within this paragraph, you did say words to that effect. It was confirmed in both your own testimony and that of Patient A that you had used phrasing similar to that in the allegations.

Paragraph 4(b)(iv):
“his own religion could not offer him any protection and that no other religion in the world could offer Patient A what Jesus could offer him.”
Has been found proved

The Committee considered that whilst you may not have said the exact words as stated within this paragraph, you did say words to that effect. During your testimony you conceded that you had said “you may find that Christianity can offer you something that your current faith can’t” and that you had told Patient A that his faith was not helping him. While you tried to justify your comments by saying that Patient A had walked away from his own religion, the Committee is satisfied that your words were sufficiently similar to find this paragraph proven.

Paragraph 4(b)(v):
“until he was ready to turn to Jesus that he would eternally suffer.”
Has not been found proved

You agreed in cross examination that you told Patient A that he would continue to suffer for a long time if he did not turn to Jesus, but did not talk about eternal suffering. Patient A did not make this claim in his oral evidence. The Committee does not consider that suffering for a long time is sufficiently similar to ‘eternal suffering’ to be able to find this paragraph proven.

Paragraph 4(b)(vi):
“the devil haunts people who do not turn to Jesus and hand him their suffering.”
Has been found proved

During your testimony you accepted that you had made reference to the Devil during the consultation. Whilst you do not accept using the term ‘haunt’ the Committee considers that your words were sufficiently similar to find this paragraph proven.

Paragraph 4(b)(vii):
“when pointing to a large picture frame on the wall, all the happy people he could see in those pictures all used to be addicts like Patient A until they turned to Jesus and now they are cured.”
Has been found proved

Whilst agreeing to the substance of this paragraph you stated that you had not referred to Patient A as an addict, as you do not consider him to be one. The Committee considers that your words were sufficiently similar to find this paragraph proven.

Paragraph 4(c):
“were told by Patient A that he had not come to a doctor to talk about religion and that he had come to the Practice because he was unwell and desperately needed help, or words to that effect.”
Has been found proved

You agreed, during your oral testimony, that Patient A did say this towards the end of the consultation.

Paragraph 4(d):
“told Patient A that you were not offering him anything else because there is no other answer and that he will keep suffering until he is ready to hand his suffering to Jesus.”
Has been found proved

The Committee considered that whilst you may not have said the exact words as stated within this paragraph, you did say words to that effect. You confirmed in your oral testimony that you had said that Patient A’s condition was not amenable to standard medical treatment. This is supported by Patient A’s own testimony.

Paragraph 5:
“You knew or ought to have been aware that your views expressed at 4(b) and 4(d) above:”

Paragraph 5(a):
“were not directly relevant to Patient A's clinical care.”
Has been found proved.

The Committee does not consider that matters of faith are irrelevant to clinical care, and accepts that there are many circumstances in which spiritual assistance is valuable. The Committee noted that you were not Patient A’s GP, that you had not previously met him and that the appointment had been made at the request of Patient A’s mother to consider her urgent concerns about Patient A. The Committee considers that you must have been aware that the manner in which your views were expressed during the consultation were not directly relevant to Patient A’s clinical care at that time.

Paragraph 5(b):
“could potentially cause distress to Patient A.”
Has been found proved.

The Committee notes your oral evidence in this regard, specifically that you accept that you were taking a risk in raising religion in the way that you did. Whilst you perceived that it was you who were bearing the risk, in that the GMC may receive a complaint about your actions, the Committee considers that the true risk of your actions would be that Patient A may be distressed.

Paragraph 6:
Following the consultation of 4 August 2010, you did not arrange any further referral to the local psychiatric services for Patient A.
Has not been found proved.

The Committee accept that you had already referred Patient A to the local psychiatric service on 2 August 2010 and therefore a further referral was not required.

Paragraph 7:
“Your actions and/ or omissions at 4(a), 4(b), 4(d), 5 and 6 above were:

  1. inappropriate
  2. clinically not in Patient A’s best interests”

The Committee consider that your actions in relation to those elements found proved within 4b, 4d and 5 were both inappropriate and clinically not in the Patient A’s best interest. The Committee consider that you went beyond the limit of such spiritual guidance as would have been appropriate. Your actions caused some distress to Patient A, which was foreseeable. He said that he felt abused. This is plainly inappropriate and not in his best interests.

Paragraph 8:
“On 24 May 2011, you stated on national radio that during the consultation at 2 above you had told Patient A that he may find Christianity offers him something more than his current faith does in his current situation, or words to that effect.”
Has been found proved.

The Committee notes that during cross examination you admitted making the comments, as alleged.

Having made its determination on the facts the Committee went on to consider whether your actions constituted a significant departure from Good Medical Practice and supplemental guidance. Given your own admission that a significant departure would have occurred if Patient A’s recollection was correct, and in exercising its own judgement, the Committee considers your actions do constitute a significant departure.

Furthermore, based on the facts found proved, your actions meet the threshold set out in paragraph 13 of the GMC’s Guidance on Warnings. In the Committee’s view, having taken all the circumstances into consideration, your actions did fall just below the threshold for a finding of impaired fitness to practise.

In the absence of insight and given your strongly expressed views during this hearing the Committee is not satisfied that repetition of the concerns is unlikely. It notes that although this was a single incident, if there had been more the case would undoubtedly have been referred to a Fitness to Practise panel.

We have noted the excellent testimonials presented on your behalf, which speak of the esteem in which you are held and the dedicated care you offer to your patients. Some of them say you did not press your faith on them when they resisted. There have been no previous complaints about you to the GMC.

This case however is different, because on this occasion you caused the patient distress which you should have foreseen. While the allegations relate to what occurred on a single occasion your actions nevertheless constitute a significant departure from the principles in Good Medical Practice. The Committee considers that it is appropriate, proportionate and in the public interest for the protection of the reputation of the profession to issue you with a warning.

The Committee directs that the following warning be attached to your registration:

“During a consultation with a patient in August 2010 you expressed your religious beliefs in a way that distressed your patient.

You subsequently confirmed, via National media, that you had sought to suggest your own faith had more to offer than that of the patient.

In this way you sought to impose your own beliefs on your patient. You thereby caused the patient distress through insensitive expression of your religious beliefs.

Your actions were in direct conflict with the GMC’s supplementary guidance: Personal Beliefs and Medical Practice. This states in paragraph 19 that:

‘You must not impose your beliefs on patients, or cause distress by the inappropriate or insensitive expression of religious, political or other beliefs or views’.

Your actions also contravened Paragraph 33 of Good Medical Practice:

‘You must not express to your patients your personal beliefs including political, religious or moral beliefs, in ways that exploit their vulnerability or that are likely to cause them distress.’

Your actions do not meet with the standards required of a doctor. You are hereby formally warned as to your future conduct. Further serious or persistent failure to follow GMC guidance will put your registration at risk.”

This warning will be published on the List of Registered Medical Practitioners (LRMP) for five years and will be disclosed to any person enquiring about your fitness to practise history during that period. After five years, the warning will cease to be published on the LRMP. However, it will be kept on record and disclosed to employers on request, indefinitely.

You will be notified in writing of this decision in the next two working days. That concludes the determination of the Investigation Committee in this case.

Tuesday, 12 June 2012

GMC and Dr Richard Alexander Scott

Dr Richard ScottDr Richard Alexander Scott, ex Christian missionary, and a General Medical Practitioner allegedly asked one of his patients if he had considered faith in Jesus during his consultation in National Health Service surgery. Patient was allegedly distressed by this and his mother wrote a complaint to General Medical Council, the regulator of medical profession.

Setting a disciplinary Fitness to Practice  hearing was a bit problematic for GMC but eventually, GMC offered telephone evidence by patient and in private hearing by GMC Investigation Committee.

 Dr Scott's barrister, Mr Diamond objected on the grounds that body language of the witness needs to be seen by FTP panel members and others present. We are not aware that Mr Diamond, GMC or High Court are keen on televised record in that case and not just transcripts. Surely, fairness principles should apply to appeals as well and to all doctors.

Considering vulnerability of patient it may feel right to GMC to offer evidence by telephone, but giving evidence via video link is another possibility.

Of course, journalists can be present in family courts which are rather private and non-disclosure of identity to public can be assured. Assuring a degree of privacy does not mean that there should be no public scrutiny at all.

In ASIC v Rich [2004] 467 judge evaluated arguments for the way evidence can be given and concluded that it depended on circumstances of the particular case:

Good luck if you can find where it is. The case is probably the biggest in Australian history and there were many interlocutory judgments and in different countries, some not cited.


Investigation Committee - Determination on Defence application to adjourn proceedings - 12 June 2012
Dr Richard Alexander SCOTT (2890748)

Mr Hurst:

The Committee has considered your application, on behalf of the General Medical Council (GMC), to hear a witness, Patient A, via telephone and in private. You provided the Committee with a witness statement from Patient A in which he stated that he was unable to attend the hearing as a result of both his physical and mental health. Patient A believed that his health would be negatively affected if he were to give evidence by any other means than by telephone and in private. Patient A stated further that he did not wish his identity to be revealed to the public and if he were to be identified this may negatively affect his job.
In addition to the witness statement of Patient A the Committee was provided with an email from Patient A’s GP, dated 11 June 2012, in which it was confirmed that attending the hearing in person, or by way of video link, would have a very serious adverse effect upon Patient A’s mental and physical health.

In response to the points raised within the Defence’s skeleton argument, you referred the Committee to the case of R (Thompson) v Law Society [2004] which you submitted demonstrated that a decision by a regulator to reprimand a professional person, does not amount to a determination of that person’s civil rights. As the Investigation Committee does not have the power to make determinations adverse to a Doctor’s fitness to practice, the Investigation Committee is not empowered to determine “civil rights and obligations” so as to engage Article 6 of the Human Rights Act.
You submitted, therefore, that the consideration for the Investigation Committee was one of proportionality. You brought the Committee’s attention to the case of R (Bonhoeffer) v General Medical Council (2010) which you submitted demonstrated that even in cases that have the possibility of impacting on civil rights, the need for the attendance of the complainant is not absolute. You submitted that the principle of a fair hearing is not limited to fairness to the doctor, and that as Patient A was the only other person who was present at the consultation in question, his evidence is highly relevant and should be admitted accordingly.
You additionally submitted that even if Patient A was unable to attend, even by telephone, his written evidence could properly be admitted as hearsay evidence in accordance with Rule 11(7)(a) and determined in the round by the Committee; assessing the appropriate weight to be accorded to it.

Following questions from the Committee you confirmed that you do not seek to rely upon Rule 36 of the General Medical Council (Fitness to Practise) Rules 2004 as you do not believe Patient A’s circumstances allow for him to be classified as a vulnerable witness. However, you submitted that Rule 36 was of use to the Committee as it demonstrated that it is appropriate to take into account the circumstances of witnesses.

Mr Diamond, counsel on behalf of Dr Scott opposed your application and indicated that evidence via telephone is less than optimal in comparison to having witnesses give live evidence, or at least see the witness on a video link.  He submitted that he would not be able to see the witness or regard his demeanour if he was to give evidence via telephone.

Mr Diamond submitted further that to accept evidence by way of telephone would be in breach of Dr Scott’s rights under Article 6 and the Common Law. The basic position under both Article 6 and the Common law is that the Defendant in a criminal trial should be confronted by his accusers in order that he may cross examine them and challenge their evidence. Evidence by telephone does not constitute confrontation and fails to accord the right to a fair trial to Dr Scott. The Committee were referred to the cases of R v Davies [2008], Luca v Italy(2003) and  PS v Germany (2001).
Mr Diamond submitted further that the defence did not accept the evidence put forward by Patient A’s GP and would have questions to ask this witness. It was submitted that the defence believed Patient A to be well enough to attend.

The Committee has accepted the advice of the Legal Assessor including his advice that the previous Committee made no final decision on the question whether Patient A should be required to attend, but only required the GMC to make further attempts to secure Patient A’s attendance.

The Committee has been satisfied that the GMC has made adequate attempts, since the previous hearing, to secure Patient A’s attendance and has received no evidence to suggest that this is not the case.

In reaching its decision, the Committee has considered all the circumstances. These included:

  • the willingness and ability of the witness to attend in person,
  • the impact upon the witness if he were to attend,
  • the importance of the witness’s evidence to the proceedings, and
  • fairness to all parties.

The Committee in determining this matter have accepted the content of the email from Patient A’s GP which confirms that attendance at this hearing would have a very serious adverse effect upon Patient A’s mental and physical health. The Committee has no reason to doubt the information provided by Patient A’s registered GP and furthermore does not consider it necessary for the GP to be present at this hearing. The Committee considers the medical evidence to be clear.

The Committee considers that this matter ought to be heard and dealt with now in fairness both to the doctor and Patient A and in the public interest. The only way in which this can be achieved is by hearing and weighing Patient A’s evidence by telephone or by excluding it. The Committee considers that it would be better for it to hear the evidence than not to. Mr Diamond will be able to cross examine Patient A. The evidence adduced as to the patient’s health and circumstances has satisfied the Committee that it would be inappropriate for Patient A to be required to attend this hearing.

Having taken all factors into account the Committee has determined to accede to your application and hear the evidence of this witness via telephone.

When considering whether the evidence should be heard in private the Committee notes that the disputed facts relate to a medical consultation between Patient A and the doctor which, in itself, attracts a certain level of confidentiality. Furthermore, the Patient’s religious beliefs and current health are likely to be discussed in significant detail which all attracts a level of confidentiality. The Committee considers that it would not be possible to separate out the public and private aspects of Patient A’s evidence and accordingly has decided that his oral evidence shall be heard in private.

On a final point the Committee also wishes to stress the importance of maintaining Patient A’s anonymity and requests that both Counsel continue to exercise great caution when speaking in public session.

The Committee will, of course, when weighing up Patient A’s evidence, bear in mind that he gave his evidence via telephone and will, in due course, receive any relevant submissions from the parties.

Finally, the Committee is mindful that certain safeguards should be put in place to ensure the quality of Patient A’s evidence is protected. As such, the Committee has determined that Patient A must be accompanied by an employee of the General Medical Council, or an independent solicitor or legal executive, whilst giving evidence. This individual will be relied upon to:
  • verify Patient A’s identity;
  • administer the oath or affirmation;
  • provide Patient A with copies of documents referred to during his evidence;
  • ensure Patient A is not prompted or coached during his evidence,
  • ensure Patient A does not breach his oath during any breaks to be taken.

The Committee is mindful that it is not in a position to dictate how long the GMC will require to put in place such safeguards and therefore invite you to address the Committee on this matter once initial enquiries have been made.