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Audio-recording your consultations with NHS doctors


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I couldn't agree with you more, T.a.i.

 

I think the post concerned represents one of the very lowest points in professional discussion of our topic, that I have been able to read at least, over the nearly 5 years this thread has been running.

 

Fortunately, I see that the rapid 'Responses' added to latest BMJ article which come from all round the globe, and are indeed available to all to read without registration here (click on the response tab):-

 

http://www.bmj.com/content/350/bmj.g7645

 

are predominantly of a different stamp. My favourite to date - from one Baptiste-Adams on 17 01 15 - reads:

 

" This is where educating our patients and not leaving them ignorant about their rights play a pivotal role. I embrace the idea of recording consultations. Too often the patients are not aware that they can do so, which usually leads to covert recording operations, where everything is not recorded and instead of working for the good of both patient and doctor, this turns out to be a complete disaster. The recorded consultation would help tremendously in health literacy, getting the patient to better understand his/her condition and what actions should be taken to better deal with the situation. The onus is upon us then, to inform them, let them know that it is quite alright. Many would feel too intimidated to ask, so we could suggest it to them. This could be a win/win situation for doctor and patient. "

 

Now that sounds a lot more like the notice described by T.a.i. as on his GPs surgery's wall.

 

Incidentally, caggers\viewers, it seems that you can vote to 'like' any of these responses at BMJ without being in any way 'logged in'. Offer some encouragement to the score of sane, perhaps?

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Albeit smoothed over by the bonhomie of publicly-aired quango debate, there was close to a 'dust-up' in yesterday's CQC Board meeting, on the score of surveillance in (principally) care homes and the long-awaited 'guidance' for the public.

 

Frankly, I fear that the result is still going to be a lemon, despite at least one board member fighting valiantly for concerned families wanting to record. The section of the board meeting runs approx:-

 

1:13 to 1:36 here:-

 

http://www.cqc.org.uk/content/care-quality-commission-board-meeting-21-january-2015

 

See what you think.

 

I realise that I am recommending quite a chunk of listening time, and not everyone shares my concerns on the subject – or not so strenuously, at any rate.

 

Perhaps take 3 mins to listen to a 'member of the public', David Hogarth, at the end of the meeting. He has been attending CQC board meetings 'from the auditorium', for a while – and he has insisted on getting his views across, and been completely clear and consistent in those views. Thoroughly good egg, in my book:

 

2:00 to 2:03 approx, same clip as linked above.

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I was refused the right to audio record a meeting with my Consultant recently. I was less than impressed, as one symptom of my illness is a loss of short term memory loss, so an audio recording would have helped me remember what he said. I honestly found it hard to understand why he refused, especially when he later 'tells me off' for not doing things. How can I if I've forgotten what he said?

 

Just a personal example, FWIW.

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Sorry to learn of such poor behaviour by a consultant, Coughdrop.

 

If you are inclined to challenge his\her decision you could always remind that you do not actually require a doctor's consent to record:-

 

Whilst it would be preferable for recordings to take place with the knowledge and consent of both parties, MPS reminds doctors that a patient does not require their permission to record a consultation."

 

( see e.g:-

http://www.thegoodhealthsuite.co.uk/GP/index.php/professional/155-mps-flags-up-doctors-concerns-about-patients-recording-consultations )

 

If not, covert recording by patients remains legal in this country. Good luck.

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Sorry to learn of such poor behaviour by a consultant, Coughdrop.

 

If you are inclined to challenge his\her decision you could always remind that you do not actually require a doctor's consent to record:-

 

Whilst it would be preferable for recordings to take place with the knowledge and consent of both parties, MPS reminds doctors that a patient does not require their permission to record a consultation."

 

( see e.g:-

http://www.thegoodhealthsuite.co.uk/GP/index.php/professional/155-mps-flags-up-doctors-concerns-about-patients-recording-consultations )

 

If not, covert recording by patients remains legal in this country. Good luck.

 

Thank you for that, though I won't appeal. I do wonder though if, had I done as you said and told him he couldn't stop me, whether he would have refused to go ahead with the consultation.

 

It is undoubtedly a strange area of law, and I'm not familiar with how the medical profession are performance checked - teachers, for example, have OFSTED to go in, and frequent internal observations. Do the medical profession have anything similar to ensure they are performing well, or indeed to ensure they have ongoing professional development?

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#924 is a fantastic post Nolegion. Very insightful. You cannot help but laugh at the likes of Dr Buckman with his weak reasoning in opposing audio recording. He's the King Canute in this field, but a reason why, at this time, I will never ask permission to record.

 

***

 

One reason given for Google Glass' failure was that people do not like being photographed, filmed or audio recorded without their consent. Really?! It seems to me that everyone is whipping out their smart phone for this purpose at every possible opportunity. It's not like Google Glass was in anyway covert.

 

 

***

 

I understand there is a phone-in on Radio 4 tomorrow with regards to surveillance. 12:15pm, if anyone is interested.

***

 

I listened to David's contribution to the CQC meeting (Who is David by the way)?! and agree that it would be a grave mistake for the CQC sit on the fence with regards to guidance on surveillance in care homes. The CQC needs to make the rules crystal clear for all parties. There cannot be any of the usual wooliness.

 

***

 

I wonder how effective these white noise generators actually are in practice? I would also question the legality of their existence in any setting where they are deliberately being used to hinder a perfectly legal audio recording - overtly or otherwise. Would a doctor/hospital really want to risk criminal charges?

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Many thanks for your kind words, Sali. I put a lot of effort into #924 and it's good to know it is appreciated.

 

I also listened, earlier today, to the R4 'You and Yours' on CCTV, at your prompting. Interesting mix of views but about two-thirds of the way through, I couldn't resist trying to put my oar in: quite a few comments made reference to the law but none to the wretched CJEU decision in Rynes. It was clearly news to the back-room boys, and they even rang me back to clarify a point about the case. All too late to make the cut, however.

 

The programme also said that this coming Thursday's edition will be about CCTV in care homes. They appeared confident that the CQC will have issued its guidance for the public, by then. My diary is incurably booked over the transmission time (12.15 to 1.00pm) so I won't get another chance to interpolate my matchless views, but it's definitely one for 'listen again'.

 

On the score of CQC, I don't know who David Hogarth is, but he is an assiduous attendee 'from the public' at CQC meetings, and his interest is focused on CCTV issues. He has said he has a relative in a care home and has been thinking of installing CCTV. So far he has always talked firm and clear common sense, in my view. Good man.

……………………………

 

I too would like to know about these supposed "anti-recording" devices. Do they work? Is their presence detectable at the time? Any techies out there who could wise us up?

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Yes, I noted that there was no mention of the Rynes case. Such a shame that you didn't get your view aired.

 

Overall the reaction to surveillance was positive. Perhaps we do need to sharpen up the law on home CCTV. To be able to position a camera that purposely overlooks a neighbour's property without restriction (the aggrieved would have to prove harassment) seems wrong to me.

 

I was also annoyed that the police used the data protection excuse (too many people resort to this to cover-up their own ignorance and/or incompetence) as a reason why the lady, whose car was keyed, was not allowed to review the footage, because they (the police) did not have the time. The camera was outside her flat with a view to the (public?) road. I was unsure who owned the camera. If run by the council and outside your own residence, I'm pretty sure you would have the right to view the footage, especially given the circumstances.

 

It was not a surprise, although somewhat shameful, that the Police and Crime Commissioner and the specialist selling bodycams, were not certain of the law in this area.

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Well, Winifred Robinson most definitely said that there would be discussion today on CCTV in carehomes, in connection with the guidance to be issued by the CQC for the public:-

 

http://www.bbc.co.uk/programmes/b05077kj

(Minute 38)

 

No such guidance was made available at the CQC website today - and the "You an Yours" programme made reference to Winterbourne View, but not to the issue as heralded.

 

I think it reasonable to guess that there's continuing "trouble at t' mill" - at the CQC's end of this. Earlier, the CQC said they would in any event aim to publish by the end of this month. We shall see, tomorrow, whether they are still in a mess about it.

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The 'medscape article', linked in #926 above, includes the following advice to (American) doctors:-

 

" You might also think about business considerations. If the patients prefer doctors who allow recording, they may seek out such practitioners. So allowing patients to tape may be a way to increase your patient base. "

 

and I just wonder whether this might reflect the first stirrings of true patient-power as regards the recording of consultations, in the USA.

 

Another way of putting that advice would be to consider whether refusing patients the right to record might become a way of losing 'business' – possibly quite fast.

 

Here's a chap explaining how he views the situation:-

 

http://www.larryberkelhammer.com/self-efficacy-self-mastery/video-audio-recording-your-doctors-appointments

 

It's less than 2 minutes of video, and the very best of luck to him in his, continuing, approach.

 

Over here, I must admit, I don't offer doctors any wriggle room: I say, "I choose to inform you that I record…" (– but then I am old, mean, nasty and ugly etc. etc.).

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Still no announcement from the CQC about 'surveillance' by 'service users' in healthcare.

 

I suggest it remains enmired because it has 'progressed' - from not understanding what needs to be said, to not wanting to say what it has now understood.

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Dr Arun Kumar Singhal. (The one who told a patient to go kill herself.)

 

This GP was suspended from practice, for a mere 3 months, last September. He didn't bother to turn up to the tribunal hearing, and if it hadn't been for the fact that the patient had audio recorded how she was treated, it must seriously be doubted whether any action would have been taken at all. (Post #840, and subsequent, refer.)

 

Now, however, he has 'blown it.' He didn't bother to turn up the review hearing last month either, which might have entitled him to resume medical practice. So the tribunal banned him for a further 12 months. At his age, any resumption of practice after well over a year out in the cold is going to be difficult to justify. Good.

 

News story here:-

http://www.liverpoolecho.co.uk/news/liverpool-news/doctor-who-told-patient-kill-8404877

 

Full (further) MPTS report, which was made available on line yesterday, here:-

http://www.mpts-uk.org/static/documents/content/SINGHAL_6_January_2015.pdf

 

whence this summary of the original facts:

 

" Patient A attended a consultation with Dr Singhal on 21 December 2011 and during that consultation she made an audio recording which lasted approximately 2.5 minutes. During the consultation Dr Singhal had an exchange of words with Patient A and refused to provide her with a letter to excuse her attendance at Court on health grounds without her paying a private fee.

 

The previous Panel was satisfied that, in response to Patient A stating that she would commit suicide Dr Singhal said ‘you can go and jolly well do it now’ and ‘if you don’t know how to do it, it’s on the internet how to do it’. It was also found proved that in response to Patient A saying that Dr Singhal ‘was a disgrace for a doctor’ he replied ‘You know, you are a disgrace to be a patient."

 

And this conclusion:

 

" This Panel is concerned about Dr Singhal’s apparent lack of insight and lack of any evidence of remediation. It is also concerned that there is no information regarding his continuing professional development and that he has failed to engage with the processes of his regulatory body. The Panel considers that as Dr Singhal has demonstrated no insight he could potentially put vulnerable patients at risk of harm. "

 

That really was a very important 2 minutes and 30 seconds of audio-recording by the patient.

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With thanks to the viewer who sent me the link below.

 

Last month the Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland included a study about prostate cancer patients, from which:

 

" In 2012 we initiated consultation audio-recordings, where patients are given a CD of their consultation to keep and replay at home. We conducted a prospective non-randomised study of patient satisfaction, quality of life (QOL) and decision regret at 12 months follow-up…

 

…The study has shown that audio-recording clinic consultation reduces long-term decision regret, increases patient information recall, understanding and confidence in their decision. There is great potential for further expansion of this low-cost ntervention."

 

http://www.ncbi.nlm.nih.gov/pubmed/25636362

 

As my correspondent said, 'Sure thing, but…'

 

The 'but' is the phrase ' low-cost intervention'.

 

What about a 'no-cost non-intervention'?

 

In other words, back off and leave it to the patients - although a notice-board announcement welcoming such initiative would be essential, and saying that the medic would be happy to supply a recording, if you want one and don't happen to have something charged up and ready to go would no doubt be very useful.

 

(However, my children tell me CDs are heading ark-wise. Thank goodness I've still got all those cassettes.)

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Perhaps, Nolegion, Dr Arun Kumar Singhal has accumulated a maximum pension pot of £1.25 million (I think that's the figure) which means that he can snub the MPTS and give up the hard slog for good.

 

With regards to the RCS journal and low-cost intervention, I wonder how many patients would have taken the opportunity to record their consultation on their own devices if it were suggested to them beforehand. My feeling is not many at this time. Some patients will not have embraced the technology and others may feel it a kind of slur on the clinicians, an expression of mistrust, that could be to their detriment. What this study does prove (but we knew it anyway) is the usefulness of this process to the patient.

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I suspect you are right about Singhal and his pension pot, Sali. Still, I hope it will give the patient some grim satisfaction if it is actually her recording that eventually leads to his being struck off in a year's time for 'failing to engage with his regulatory body.'

 

As regards doctors actually offering recordings to patients - well these are the good guys, of course, and best of luck to them. What makes me raise a slightly sardonic smile, though, is the ease with which even the good guys slide perilously close to Buckman-world when they describe their actions. If recording is seen as a medically-initiated 'intervention' (by 'we doctors') for those hapless, stressed-out cancer patients, it becomes a 'good thing'.

 

When the patient initiates the process, not because they are stressed out or lacking mental faculties - but just because they find it thoroughly useful, ah, then there is a problem...

 

Now I'll go and wash my mouth out with soap and water for having mentioned the 'B' word.

 

(Below is why I refer to him as 'Chuckles' B*ckman)

 

 

 

drbuckman.jpg

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When I first started reading the discussion from the link below, sent to me this morning, I thought it would just be another example of American doctors whipping themselves up into a self-righteous fury because of horrible patients who want to record how they are treated and advised.

 

But, in fact, it didn't all go 'SouthernSurgeon's' way in the end. Far from it:-

http://forums.studentdoctor.net/threads/patients-recording-videoing-you.1120550/

 

See what you think.

 

It's true that some same ol' (B*ckman-level-brainless) tripe is trotted out, but if you compare the contributions to those of enraged baby-medics at the same site 4 years 11 months ago (linked way back at post #16 ), I think some improvement can be discerned – and the good Prof. Elwyn gets a reference.

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  • 2 weeks later...

"If it considers that a decision made by a fitness to practise panel is unduly lenient, the Professional Standards Authority for Health and Social Care has the power to refer the decision to the High Court or Court of Sessions. The Professional Standards Authority has 28 days to refer a decision following the doctor's 28 day appeal period."

 

From:-

http://www.gmc-uk.org/concerns/doctors_under_investigation/a_guide_for_referred_doctors.asp

 

I have just read a truly extraordinary case report concerning GP Dr Farzana Bhatia, posted at the mpts website today.

 

Bearing in mind that, in my view disgracefully, the mpts took NO action against this doctor we must be careful what we say defamation-wise, but the reason I quote the (relatively–recently-formalised) independent appeal route above is because I think that if ever a case called out for being appealed over the GMC's head (to the High Court), this has to be one glaring example of such.

 

A seventy-year old woman who had had cancer and a stroke, and was acknowledged to be a vulnerable patient who could get very confused, was treated by a GP's practice in a fashion which I believe most normal people would describe as obscene, unforgivable, bullying.

 

The only reason we know about the behaviour for sure is because her daughter, whom Dr Bhatia had required leave the consultation (before he 'set about' the 70yr old), left her handbag in the room – with her mobile phone in it recording what then happened behind closed doors.

 

The following are amongst the panel's findings of fact:-

 

"The Panel considered that the key unifying factor underpinning these matters was that you persisted in your questioning long after you should have desisted. The Panel considered that your individual questions, taken in isolation may not have been inappropriate but, taken cumulatively, they became so. In this regard the Panel took account of the following surrounding circumstances pertaining throughout the consultation: the fact that Patient A was becoming visibly more distressed; she was repeatedly pleading with you to stop; she was repeatedly asking that her daughter return to the room and had been told by you to sit down, which the Panel concluded indicated an attempt by her to stand up from her chair in order to leave the room. In all these circumstances the Panel considered that your continuing to question Patient A, set against this scene, was both repeated and inappropriate."

 

"Stated to Patient A that you would be unable to continue acting as her doctor if a complaint were made against you.

Admitted and found proved"

 

"You persisted in questioning Patient A about the complaint, despite being asked by her on at least eight occasions to desist from doing so;

Admitted and found proved"

 

"You failed to ask B to return to the consultation room despite Patient A asking for her to return on at least eleven occasions during the consultation;

Admitted and found proved "

 

Yet, as I say, despite all this, and the undeniable evidence from the recording on which the admissions and findings are clearly based, no disciplinary penalty was imposed – not even a warning. I think this emits a stench of partiality, and it is my personal, but wholly un-provable, suspicion that the panel's dislike of the way the evidence was obtained - which it nonetheless could not ignore - may well have played role in such lunatic leniency

 

I know very little about the Professional Standards Authority, but their policy about members of the public "raising concerns" specifically extends to:-

 

"Decisions by a final fitness to practise hearing which you consider to be unduly lenient. We will consider these concerns under our powers of appeal."

 

From (p 4 of):-

http://www.professionalstandards.org.uk/docs/psa-library/raising-concerns-policy

 

So, I've just winged a fruity missive to them about this case, telling them to get on and appeal the decision, via their advertised contact email address:-

[email protected]

 

I wonder if, after forming their own opinion of the case:-

http://www.mpts-uk.org/static/documents/content/BHATIA_6_February_2015.pdf

 

anyone else here would care to do the same?

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Don't it always seem to go...

 

My email to the Professional Standards Authority bounced back as 'undeliverable'. The polite chap on their swithboard with whom I have just spoken on the phone says that they are having some 'technical difficulties' with that email address at the moment but one can use:-

 

[email protected]

 

instead, and it will be redirected internally to the right department.

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You can still count the number of tweets I have ever sent on the fingers of one hand. Nevertheless, I am very pleased to have been sent this morning details of a twittershpere event, apparently known as a 'tweet chat,' scheduled for the week after next, on Friday 13th of March at 2.00pm USA eastern time, which I think translates as 7.00pm UK time on that day (corrections most welcome).

 

Basically, the good Prof. Elwyn is starting a varied, monthly, one-hour, 140 character, discussion forum, with the subject of patients recording their clinical encounters. Good topic choice.

 

Further details here:-

http://tdchcds.dartmouth.edu/research/patientpref-tweet-chat

 

I usually have commitments at that time of day on a Friday, but, if I can re-arrange them, I will certainly be trying to get in a clumsy word or two under an oh-so-witty tweeting-name: "Legion Jones", that would be me (because I am so often mistaken for Harrison Ford, of course). I hope I might meet others who follow this thread on occasion, as well.

 

……………………………………………………………………………

 

As regards Dr Bhatia, I have to say you can't fault the Professional Standards Authority for courtesy and speed of response. They tell me that they review all mpts decisions and they will expect to have reached a decision in this matter by the end of the appeal period which they calculate as 16th March and, they say, they will notify me thereafter of that decision.

 

Courtesy aside, it seems from my reading of the case reports that the number of times this authority actually gets round to appealing mpts decisions is tiny – and I deny that that is because the underlying quality of the jurisprudence doesn't deserve frequent and vigorous challenge.

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Thanks to the viewer who sent me the link below, to a recent altercation with an American doctor:-

 

http://www.kmov.com/news/investigates/Caught-on-tape-Swansea-doctor-cusses-out-care-provider-in-front-mentally-challenged-patient-291339521.html

 

The deletion of the swear words rather reduces the impact of what is, not surprisingly, a somewhat incoherent recording in any event, but having listened to the clip a few times I am on the side of the patient and her relative.

 

I think the allegation (of an allegation) of racism is probably a red-herring. Seems to me that the real issue is that this doctor doesn't like treating the poor, and was prepared to let his contempt show when he thought he was safe behind closed doors.

 

The attempt by the other member of staff to deny the behaviour of the doctor dissolves like snow when she realises there was a recording, and the weaselly lawyer doesn't exactly help his medical company client much either.

 

I would be interested in whatever anyone else thought.

 

Note. The recording took place in Swansea, Illinois, which is a 'one-party state' and therefore the recording was legal, as it would be in the UK, even though the doctor (presumably) didn't appreciate it was taking place:-

 

http://www.notalldadsaredeadbeats.com/recording-laws

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Dr Bhatia #946

 

A very unsavoury case.

 

I think, considering the circumstances, Dr X should have been required to record the telephone conversation with Patient A, where the outcome was the cancellation of the meeting on the following day, as should the 'phone conversation between Ms D, Mrs B and Patient A. I completely understand Mrs B's request for the practice to put everything in writing.

 

Patient A's health and mental capacity (to allow her daughter to represent her interests in the complaint), should, in my view, have been carried out by an independent doctor with no links to the practice. It seems to me that Dr Bhatia harangued Patient A in an attempt to get the desired answer (she did not want Mrs B to make a complaint). Hardly a professional approach considering the patient's medical history and obvious distress.

 

I guess in the case of Dr Bhatia, it shows what a good brief can do for you, effectively outmanoeuvring Mrs B and Patient A. Clearly Dr Bhatia's threats about the ability to continue to act as the patient's GP is not seen as an offence that the MPTS sees as even worthy of a warning.

 

C'est toujours la meme chose.

 

***

 

Cussing Doctor post #949

 

So I'm assuming there was no formal appointment process at the centre, which would show if the patient was bumped on purpose because of the alleged (overheard) 'phone call.

 

I thought the police interviewer was asking leading questions of the witness over the racism accusation. I don't think this was about race.

 

Personally, I saw one angry and vocal carer (and who hasn't felt like that when they've been sitting for ages in a waiting room) and a doctor reacting (unprofessionally) to, what he considered to be, a relative's ungratefulness for the 'free'treatment. I think the patient's carer could have been a little (actually a lot) more diplomatic in her complaint, but most of us would be mortified if we were made to feel like an unworthy charity case. I would have walked out too.

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Since that last post of Sali's sums up the situations concerned in ways I wholly agree with, perhaps I ought just to move on.

 

But that Farzana Bhatia case really bugs me. The emphasis in the extracts (from the case report) below is entirely mine.

 

Extract 1

 

"[Charge]… d. Stated to Patient A that you would be unable to continue acting as her doctor if a complaint were made against you

 

44. According to the transcript [i.e from the covert recording] of your consultation with Patient A, you told her that if she made a complaint against you, you could not continue to be her doctor. In evidence you accepted that it was untrue. However, you said that you had tried to explain to Patient A that if she made a complaint about a doctor to the GMC then it would be very difficult for that doctor to keep seeing her. Nevertheless, your motive or intention does not render an untrue statement true. Therefore the Panel finds this paragraph of the allegation proved."

 

Extract 2

 

"[Charge]… b. Inappropriately attempted to convince Patient A to withdraw her consent for B to make a complaint about Dr X on her behalf

 

41. During the consultation you told Patient A that if she made a complaint she would be involved in the investigation of that complaint and would have to attend meetings and answer questions. In your evidence, you said that you were trying to explain to Patient A the consequences of making a complaint and what she could expect her involvement to be in that process. After being questioned on this point, you did not seek to evade the question. You conceded that, with hindsight, your remarks could have been misinterpreted and that it could be inferred that you were trying to convince Patient A to withdraw her consent for Mrs B to make complaint against Dr X. However, as set out in the Panel’s reasoning above, it accepts your evidence that your primary motivation was not to get Mrs B's complaint withdrawn but rather to establish whether Patient A had the requisite capacity and consent given your concerns. Part of that was your attempt to explain the process of what that complaint might entail in line with the advice you had received from the MPS. In these circumstances, the Panel did not find this charge proved."

 

Anybody can form their own view from the full case report linked earlier. In my view, the contortions of logic that the panel indulged in to produce these two conflicting parts of the judgment reveal incompetence, bias, or both.

 

None of this would ever have reached the panel at all, I suggest, unless the audio-recording had been made. The mpts has then twisted itself into knots to avoid marking undeniable and gross lack of professionalism with appropriate disciplinary action.

 

And just in case any viewer should be in doubt, please let me stress that it is specifically part of 'Good Medical Practice' as stated by the GMC that doctors must NOT decline to treat patients simply because they are maintaining a complaint against them.

 

This is a rare example of undeniable evidence of bullying, involving precisely the threat of what is forbidden, being in front of the mpts. If they are allowed wholly to excuse a doctor in the teeth of such evidence, what hope has any complainant treated in the same way but lacking such a recording?

 

I'm still trying to digest the information stemming from the Morecambe Bay enquiries e.g., today:-

 

"Inquiry chair Bill Kirkup said: “There was a disturbing catalogue of missed opportunities, initially and most significantly by the trust but subsequently involving the North West [strategic Health Authority], the CQC, Monitor, the Parliamentary Health Service Ombudsman and the Department of Health."

 

http://www.thecommissioningreview.com/article/kirkup-calls-nhs-trusts-face-new-openness-duties

 

The GMC and the mpts are missing from the list, and when – who doubts it – the Professional Standards Authority does absolutely nothing about the Bathia case, let's add that body in as well.

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