still time to put your words into practice and end the witch hunt against doctors
Dr Ros Jones, retired paediatrician and HART member
A few weeks ago, 80 health professionals wrote to Professor Carrie MacEwen, chairman of the General Medical Council, to express our concern at what would appear to be the use of GMC referrals against doctors speaking out about the poor safety profile of the Covid-19 vaccines. We were encouraged by her statement in the wake of the contaminated blood scandal in which she stated, “There is extensive commentary within the report about the importance of speaking up about both mistakes and near misses and a cautionary note about the need to protect those who do so from detriment to their career.” She was also quoted as saying “We are of course aware that referrals to us are sometimes used to intimidate. This is completely unacceptable, has significant consequences for doctors’ wellbeing and puts the safety of patients at risk.” Professor MacEwen also referenced “investigative media reports alleging that a number of NHS managers have taken actions to silence whistleblowers, including threatening referral to the GMC.”
In the letter, we urged:
- That the GMC apply the same protection to whistleblowers reporting Covid-19 vaccine harms that you have rightly observed were missing decades ago in the contaminated blood scandal.
- To call a moratorium on all GMC investigations which do not arise directly from complaints about actual patient care.
The full letter is available here.
We subsequently received two replies, one from the President of the Academy of Medical Royal Colleges: “While I am unable to enter into complex and clearly nuanced discussions about the appropriateness of the Covid-19 vaccine for some patients, I can respond to your more general point about freedom to speak out. In short, yes we agree with the right of doctors to speak out where the scientific or other provable evidence supports the claims being made.” So far, so good.
Meanwhile, Professor MacEwen responded: “Thank you for your latest letter raising concerns about protection for doctors engaged in whistleblowing, specifically relating to the Covid-19 vaccine.
“It is vital that healthcare has a culture that encourages and supports speaking up about patient safety concerns. This is why we continue to encourage doctors to speak up if they have any concerns, or if they are concerned that they may have experienced a retaliatory or threatening referral. Our Speaking up webpage has a range of resources and practical help for doctors, and our confidential helpline is always available for advice. Our whistleblowing guidance also sets out what doctors should do if they wish to raise a concern with the GMC as a whistle-blower.”
She went on to say, “Alongside our role in supporting doctors, we have a legal duty to protect the public, which includes maintaining and promoting public confidence in the profession. Members of the public are often at their most vulnerable when seeking and receiving healthcare. Trust and confidence in the profession is therefore essential so that individuals feel able to seek care and support, communicate honestly with their doctor and trust in the advice they are given. Where concerns are raised with us about a doctor’s conduct, we are therefore required to consider whether we need to investigate to determine if the behaviour undermines, or is capable of undermining, the trust and confidence that a fully informed and reasonable member of the public places in the profession. This may occur even where the behaviour is outside clinical practice, or the concerns raised do not involve patient care.”
Our full response is published here.
20th July 2024
Dear Professor MacEwen,
Many thanks for your detailed and helpful reply. I have taken a little time to reply while discussing the problems with several of my cosignatories. Despite the links and resources you have directed me to, a substantial number of doctors do not feel reassured that they are protected by the institutions to raise patient concerns as indicated by the number of doctors who signed our original letter to you.
We do understand that doctors have to behave responsibly on and off duty – clearly a doctor who commits a serious crime could potentially be a danger to patients and would expect to face restrictions.
The problem my colleagues and I have is the category of “bringing the medical profession into disrepute” and how such a concept can be defined. It could be argued that high profile doctors with significant conflicts of interest pushing Covid-19 vaccines, often with unsubstantiated and exaggerated claims of safety and efficacy, have contributed to the huge loss of trust in the medical profession. Also the large number of doctors telling patients with obvious adverse events that they are suffering from panic attacks or anxiety and failing to complete Yellow cards. We have also seen numerous examples of doctors telling their patients verbally that their symptoms are related to vaccine injury and yet refusing to put this in writing.
As we said in our previous letter, many of the doctors being hounded for speaking out on social media, far from bringing disrepute, are being repeatedly thanked by members of the public for their honesty and integrity and have been acting as support for the vaccine injured.
In a recent court case against the GMC, a doctor’s right to use social media was upheld. Yet this has not been seen as a precedent.
One doctor who has been under investigation by the GMC for over 2 years, with a catastrophic impact on his ability to obtain a job and hence his financial security, has received death threats on Twitter from an ex-colleague but neither the GMC nor the police thought this worthy of investigation. We have read Twitter posts by detractors discussing which doctor they will target next and what good sport it will be. We have several other extremely worrying examples of the hounding which is going on, for any doctors who are questioning the safety of the mRNA Covid-19 vaccines.
We would also point out that it is often due to the very lack of interest doctors receive when expressing concerns through the official channels, that they resort to social media. For example, one doctor approached their local NHS whistleblowing department with her concerns about the vaccine harms she was witnessing in her patient group, but her concerns were never addressed and further emails received no reply.
So our questions to you are:
● what safeguards has GMC in place to ensure its investigations are proportionate to the actual risk to patients?
● How do you define what brings the profession into disrepute? If there is no clear definition, how can doctors ensure they comply with the requirement to highlight harms to patients and yet not find they have fallen foul of this very vague rule?
● Would you be willing as requested in our original letter to meet with a small group of us either in person or on line to discuss these issues further and hear some of our experiences first hand?
The current situation of self-censorship amongst doctors risks serious ongoing harms to patients and cannot continue.
Many thanks for your further advice and hopefully a chance to meet and contribute to your ongoing efforts to safeguard whistle blowers.
Yours sincerely
Dr Rosamond Jones, retired Consultant Paediatrician, convenor Children’s Covid Vaccines Advisory Council
Dr Ayiesha Malik, General Practitioner, co-founder, Doctors for Patients UK
Dr Clare Craig, diagnostic pathologist, co-chair, Health Advisory and Recovery Team
Dr Elizabeth Evans, retired doctor, CEO, UK Medical Freedom Alliance
16th August 2024: We have received another detailed reply from Dame Carrie McEwen:
“Dear Dr Jones
Thank you for your further letter and apologies for the time it has taken for me to respond. I am
sorry to hear that some of your colleagues and co-signatories do not feel reassured about the
safeguards and protections in place for those who raise legitimate patient safety concerns.
The information set out below describes our approach to investigations and how we assess the risk
to public protection. I hope this information provides greater clarity about our regulatory role and
how we consider fitness to practise concerns.”
She then went on to answer our first two specific questions, thus:
What safeguards has GMC in place to ensure its investigations are proportionate to the actual risk?
“As we explained in our previous letter, we have a legal duty under the Medical Act 1983 to protect
the public. The Act splits public protection into three distinct parts. It says that we must act in a way
that:
- protects, promotes and maintains the health, safety and wellbeing of the public
- promotes and maintains public confidence in the profession
- promotes and maintains proper professional standards and conduct for members of the
profession
…..In each case we will decide what action is required. Our decision makers are guided and trained to
take no more measures than are necessary to protect the public, and in a timely way. An investigation will only be opened if a concern is serious enough to raise a question about the doctor’s fitness to practise.
…..To ensure we only investigate where necessary, we have a process in place to swiftly gather
additional information where that is needed to help us assess whether opening a GMC investigation
would be a proportionate course of action. Under our provisional enquiry process, we gather one or
two pieces of information from different sources at an early stage in our process. This will typically
include obtaining details of any local investigations undertaken to consider the concerns raised
about a doctor, including any subsequent local actions taken to address these concerns. Where
appropriate, we may also decide to obtain an independent medical opinion on any clinical concerns
that have been raised in the referral. Details of the safeguards we have in place to protect doctors
who have raised patient safety concerns from retaliatory referrals were set out in our previous
letter.
Some concerns would not on their own raise a question about the doctor’s fitness to practise unless
they were to be repeated. To ensure we respond to such concerns in a proportionate way, we do not
open a full investigation but will disclose them to the doctor and their responsible officer so they can
reflect on the concerns as part of their appraisal and revalidation.
…It may reassure you to know that in 2022, 86% of the concerns we considered were closed at our
initial triage stage.”
How do you define what brings the profession into disrepute? If there is no clear definition, how
can doctors ensure they comply with the requirement to highlight harms to patients and yet not
find they have fallen foul of this very vague rule?
“Doctors hold a privileged and trusted position in society and it is important that they are aware of
the power they hold and do not abuse that trust. Trust in the profession is essential so that when
individuals need medical care, they have confidence in those that provide it and will not be put off
from seeking treatment.
We do not consider if ‘a doctor has brought the profession into disrepute’ – as you say in your letter,
instead we can take action if a doctor poses a risk to public confidence in the medical profession.
This threshold will be met where a doctor’s behaviour undermines, or is capable of undermining, the
trust and confidence that a fully informed and reasonable member of the public places in the
profession.
Our decision makers will consider the individual circumstances of a concern including how far the
doctor has departed from the professional standards set out in Good medical practice, along with
additional information about context and insight. It is unlikely however that highlighting harms to
patients would raise a risk to public confidence that would require us to investigate. A risk would
only be raised if a doctor was acting in bad faith and did not have a genuine concern, or was using
information they knew to be incorrect or misleading.
……Action we may take in public confidence cases
As with any fitness to practise concern, we will firstly consider if a doctor’s behaviour meets our
threshold for investigation, that is whether it poses a risk to public protection which includes
confidence in the profession. Examples of matters that may pose a risk to confidence in the
profession include dishonesty, violence or criminal conduct.”
This last point was interesting, given the recent Independent article “Doctors and nurses accused of rape left free to work in NHS”
The letter ended with:
“For further information, please see our guidance for GMC decision makers and Sanctions guidance
for MPTS.
I hope this additional information addresses your concerns.
Yours sincerely”
Perhaps not surprisingly, there was no reply to our request for a meeting.
It is hard to dispel the feeling among dissedent doctors that there is a target over their heads, with certain hostile actors itching to find any excuse for a GMC referral. HART wrote a year ago about the problems of self censorship and this still reads well now. Meanwhile, Pierre Kory and Paul Marik have finally lost their American Board of Internal Medicine certification, over 4 years after they founded the Front Line Covid-19 Critical Care Alliance (FLCCC).
Cosignatories to the letters
Professor Angus Dalgleish, MD, FRCP, FRACP, FRCPath, FMedSci, Emeritus Professor of Oncology, University of London; Principal, Institute for Cancer Vaccines & Immunotherapy
Professor Anthony J Brookes, Professor of Genomics and Health Data Science, University of Leicester
Professor David Livermore, BSc, PhD, Emeritus Professor of Medical Microbiology, University of East Anglia
Professor John A Fairclough, BM BS, BMedSci, FRCS, FFSEM(UK), Professor Emeritus, Honorary Consultant Orthopaedic Surgeon
Professor Martin Neil, BSc PhD, Professor of Computer Science and Statistics
Professor Roger Watson, FRCP Edin, FRCN, FAAN, Honorary Professor of Nursing, University of Hull
Lord Moonie, MBChB, MRCPsych, MFCM, MSc, retired member of House of Lords, former Parliamentary Under- Secretary of State 2001-2003, former Consultant in Public Health Medicine
Dr Alan Mordue, MBChB, FFPH, retired Consultant in Public Health Medicine & Epidemiology
Dr Ali Ajaz, Consultant Psychiatrist
Dr Alison Sabine, MBChB, MRCP, Consultant Rheumatologist
Dr Ancha Bala Joof, MBChB, MRCGP, General Practitioner
Dr Angela Musso, MD, MRCGP, DRCOG, FRACGP, MFPC, General Practitioner
Dr Branko Latinkic, BSc, PhD, Reader in Biosciences
Dr Carmen Wheatley, DPhil, Orthomolecular Oncology
Dr Caroline Lapworth, MBChB, General Practitioner
Dr Cathy Greig, MBChB (hons), General Practitioner
Dr Charles Forsyth, MBBS, FFHom, retired Integrative and Ecological Medicine Doctor
Dr Chris Newton, PhD, Biochemist working in immuno-metabolism
Dr Christopher Exley, PhD, FRSB, Bioinoganic Chemist
Dr Christina Peers, MBBS, DRCOG, DFSRH, FFSRH, Menopause Specialist
Dr Cordelia Phelan, Consultant Pathologist
Dr David Bell, MBBS, PhD, FRCP(UK), Public Health Physician
Dr David Cartland, MBChB, BMedSci, General Practitioner
Dr David Critchley, BSc, PhD, Clinical Pharmacologist, Children’s Covid Vaccines Advisory Council
Dr Dean Patterson, MBChB, FRCP, Consultant Cardiologist and General Physician
Dr Elizabeth Burton, MBChB, retired General Practitioner
Dr Emma Brierly, MBBS, MRCGP, General Practitioner
Dr Fatou Mbow, MD(Italy), MRCGP, DFFP, General Practitioner
Dr Felicity Lillingston, IMD DHS PhD ANP, Doctor, Urgent Care, Research Fellow
Dr Fiona Martindale, MBChB, MRCGP, General Practitioner
Dr Geoffrey Maidment, MD, FRCP, retired Consultant Physician
Dr Gillian Breese, BSc, MB ChB, DFFP, DTM&H, General Practitioner
Dr Greta Mushet, MBChB, MRCPsych, retired Consultant Psychiatrist in Psychotherapy
Dr Helen Westwood, MBChB, MRCGP, DCH, DRCOG, General Practitioner
Dr Ian Bridges, MBBS, retired General Practitioner
Dr Jenny Goodman, MA, MBChB, Ecological Medicine
Dr Jessica Robinson, BSc(Hons), MBBS, MRCPsych, MFHom, Integrative Medicine Doctor
Dr Jon Rogers, MBChB(Bristol), MRCGP, DRCOG, Retired NHS General Practitioner
Dr Jonathan Eastwood, BSc, MBChB, MRCGP, General Practitioner
Dr Jonathan Engler, MBChB, LlB (Hons), DipPharmMed
Dr Keith Johnson, BA, DPhil (Oxon), IP Consultant for Diagnostic Testing
Dr Livia Tossici-Bolt, PhD, retired Clinical Scientist
Dr Magdalena Stasiak-Horkan, MBBS, DCH, MRCGP (2003-2017), General Practitioner
Dr Marco Chiesa, MD, FRCPsych, Consultant Psychiatrist, Visiting Professor
Dr Mark A Bell, MBChB, MRCP(UK), FRCEM, Consultant in Emergency Medicine
Dr Matthew Dennison, MBBS, MRCGP, Dip IBLM, General Practitioner
Dr Michael Bazlinton, MBChB, MRCGP, DCH, General Practitioner
Dr Michael D Bell, MBChB, MRCGP, retired General Practitioner
Dr Noel Thomas, MA, MBChB, DObsRCOG, DTM&H, MFHom, Retired Doctor
Dr Peter Chan, BM, MRCS, MRCGP, NLP, General Practitioner, Functional medicine practitioner
Dr Rachel Nicoll, PhD, Medical researcher
Dr Renee Hoenderkamp, MBBS, General Practitioner
Dr Richard House, PhD, CPsychol, AFBPsS, CertCouns, Chartered Psychologist, former senior lecturer in Psychology (Roehampton) and Early Childhood (Winchester), retired psychotherapist
Dr Richard J O’Shea, MBBCh, BA(Hons), MRCGP, General Practitioner
Dr Rohaan Seth, BSc(hons), MBChB (hons), MRCGP, Retired General Practitioner
Dr Roland Salmon, MBBS, MRCGP, FFPH, Former Director, Communicable Disease Surveillance Centre Wales
Dr Salmaan Saleem, MBBS, BMedSci, RCGP(2019), co-founder Doctors for Patients UK
Dr Samuel White, MBChB, MRCGP, Functional Medicine Specialist, former General Practitioner
Dr Sarah Myhill, MBBS, Dip NM, retired GP, Independent Naturopathic Physician, UKMFA Director of Medical Ethics
Dr Scott McLachlan, Lecturer in Digital Technologies for Healthcare, School of Nursing, Midwifery and Palliative Care, King’s College London
Dr Scott Mitchell, MBChB, MRCS, Associate Specialist, Emergency Medicine
Dr Stefanie Williams, MD, Dermatologist
Dr Tanya Klymenko, PhD, FHEA, FIBMS, Senior lecturer in Biomedical Sciences
Dr Timothy Kelly, MBBCh, BSc, NHS doctor and Systems Analyst
Gayle Gerry, BSc(Hons), RGN, NHS Registered Nurse
James Cook, Bachelor of Nursing (Hons), Master of Public Health (MPH), NHS Registered Nurse
Julie Annakin, RN, Immunisation Specialist Nurse
Kaira McCallum, BSc, retired pharmacist, Director of strategy UKMFA
Katherine MacGilchrist, BSc(Hons), MSc, CEO/Systematic Review Director, Epidemica Ltd
Marco Tullio Suadoni, RN, BSc (Hons) Adult Nursing, MSc, Specialist Palliative Care Lead
Mr Angus Robertson BSc (Med. Sci.) MB ChB FRCS(Ed) FFSEM(UK) Consultant Orthopaedic Surgeon
Mr Anthony Hinton, MBChB, FRCS, Consultant ENT Surgeon, London
Mr David Halpin, MB BS, FRCS , Consultant Orthopaedic Surgeon, retired
Mr Ian F Comaish, MA, BM BCh, FRCOphth, FRANZCO, Consultant Ophthalmologist
Mr Ian McDermott MB BS, MS, FRCS (Tr & Orth), FFSEM (UK), Consultant Orthopaedic Surgeon | London Sports Orthopaedics, Honorary Professor Associate | Brunel University
Mr John Bunni, MBChB (Hons), Dip Lap Surg, FRCS [ASGBI Medal], Consultant Colorectal and General Surgeon
Mr T James Royle, MBChB, FRCS, MMedEd, Consultant Colorectal and General Surgeon
Natalie Stephenson, Audiologist
Sophie Gidet, RM,DTN, Midwife
Sorrel Scott, Physiotherapist
Rev Dr William J U Philip, MBChB, MRCP, BD, Senior Minister The Tron Church, Glasgow, formerly physician specialising in cardiology
Sue Parker Hall, CTA, MSc (Counselling & Supervision), MBACP, EMDR. Psychotherapist