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Replace the General Medical Council with a body that protects patients rather than the status quo

Comment 6th July 2010

The General Medical Council should be scrapped and replaced with a totally new body with a significantly different remit. That remit should of course put patient protection at its heart, but it should also recognise and protect the rights of patients to choose alternative approaches to the current mainstream 'best practice'. Protecting patients from harm does not just involve removing the Shipmans of this world, it must also involve recognising the importance of diversity of opinion in the medical profession. Without that diversity, flaws in current 'best practice' go unchallenged and patients are harmed as a result.

Why does this matter?

The General Medical Council supposedly exists to protect patients by regulating the activities of doctors in the UK. It is currently under attack from many quarters – both from within the medical profession and from patient groups. The acusation is that the GMC is acting to preserve the status quo at the expense of innovation and, in the process, is striking off or restricting the practice of doctors who represent the best hopes for innovation in various fields. This attempt to force doctors to stick to current 'best practice' represents a serious attack on truly evidence-based medicine.

A number of doctors have been either struck off or had restrictions placed on their practice in recent years despite massive campaigns from their patients to try to prevent this happening. Others have been forced to give up their registration as a result of not being able to finance the costs of fighting GMC cases. In each case, the doctor's 'crime' has been to use approaches for diagnosis and treatment that differ from what is currently deemed 'best practice'. These doctors typically have large numbers of loyal patients who can testify to the success of these alternative approaches. Often these patients have been failed by the 'best practice' approach for many years and are heavily reliant on these non-mainstream doctors for support in maintaining a reasonable quality of life (I speak from personal experience here).

It is innevitable that any doctor who investigates new approaches will attract criticism from the mainstream. The GMC should recognise the vital important of these doctors in pioneering new approaches and highlighting the flaws in current practice, but instead the GMC consistently finds in favour of the mainstream and against doctors who have highlighted real and serious flaws in current mainstream approaches.

A good example of this is Dr Sarah Myhill, who has championed the cause of patients with Chronic Fatigue Syndrome for many years. She has been able to clearly demonstrate that the current psychiatric model of the disease is deeply flawed and she has an unparalleled record of helping patients with CFS improve their health. She has published research work clearly demonstrating the physical nature of the disease and has contributed to the development of a blood test that helps to identify a key part of the condition in many of these patients. Her approach to treatment is based on good science and common sense and she has helped literally thousands of patients.

Dr Myhill has been in subject to GMC disciplinary procedures 7 times in the last 10 years. In the previous 6 cases, she was cleared of any wrong doing – but the cost to her and the impact on her patients of these cases has been massive. In the most recent case, she has had her right to prescribe suspended pending further investigations (which we are told may take 18 months). This is already causing harm to her patients – many of whom are not able to access the treatments they rely on. No evidence has been presented that a patient has been harmed by her approach and the complaints being considered have not come from her patients. One of the two complaints being considered has come from an anonymous internet source, the other from another doctor. Hundreds of patients have written to the GMC in support of Dr Myhill, but they are being ignored. Patient records have been used by the GMC in this case without the patient's consent – a clear breach of the data protection act. Key correspondence between Dr Myhill and the GMC has also been systematically removed from the file – something which the GMC has now apologised unreservedly for, but too late for the correspondence to be considered in the hearing that suspended her prescription rights making the outcome of that hearing unsafe. The actions of the GMC in the case of Dr Myhill demonstrate a complete disregard for the needs and rights of her patients and this one case alone (and there are many others) raises very serious concerns about the fitness of the GMC for its purpose.

Cases such as that of Dr Myhill are creating a climate of fear in the medical profession. I have been told by one doctor (a specialist in his field) that he didn't dare prescribe the treatment he considered best for me for fear of being hauled in front of the GMC. The result is that innovation is being stifled. Key innovators are being removed from the medical profession for no good reason and other potential innovators are sitting on their hands because they are too scared to stand up and point out the flaws in current 'best practice'.

We desperately need a GMC that exists to protect patients from harm both from rogue doctors but also from flaws in current 'best practice'. The current GMC puts the mainstream medical profession, right or wrong, ahead of the needs of patients and, as such, is not fit for purpose. It should be replaced with a body that truly protects patients.

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