Thursday, September 18, 2008

Letter to the Disability Rights Commission

To the Disability Rights Commission,

As a psychiatrist I am writing to express my strong concerns regarding the General Medical Councils approach towards doctor-patients who suffer from mental illness. I believe that their actions in these cases contravene the Disability Discrimination Act and as such are illegal.

I have been made aware of the following:-

1. Doctors who suffer from relapsing remitting conditions, for example bipolar affective disorder, are being prevented from working for protracted lengths of time (months-years) during periods when the doctor is fully well and able to function at work.

2. Doctors are called to GMC court hearings during which they are expected to justify behaviour that occurred when unwell and which is totally unrelated to their medical practice.

3. Doctors are expected to attend these hearings even when they are acutely unwell and would not be considered fit to plead in criminal proceedings.

4. Doctors are approached by the GMC by letters addressed to acute psychiatric wards while they are inpatients.

5. Doctors have been assessed by GMC appointed examiners for fitness to practice whilst acutely unwell and admitted formally under section 3 of the Mental health Act 1983 (i.e. sectioned).

The consequences of these actions are that doctors who suffer from mental illness are being forced to leave the medical profession. In addition I am aware of a number of doctors who have completed suicide whilst undergoing GMC health procedures.

I believe that the GMC procedures are an example of discrimination towards mental illness at the highest level within the medical profession.

I have contacted the Royal College of Psychiatrists expressing my concerns.

I would ask for your urgent advice and assistance in addressing these issues.

Many Thanks


XXXX killed herself sometime around Febuary the 12th 2008

XXXX was a fervent campaigner for the rights of people with mental health problems, specifically doctors. Doctors are important, not because doctors are somehow special people, but because of their influence in society. If we cannot get our act together as to how to handle mental health issues, what hope is there for everyone else with mental health who does not have our privileges?

Copyright (c) Dr. Liz Miller


peter a. said...

How do we get to the bottom of it, when these tangled webs, like nets, are embroidering our reality? What do the skeins of words say? Will they clothe a body, a meaning I can animate?

Anonymous said...

We're told the way the public uses words is the final judge of their meaning. Wee specialists can hang on like grim death to our apostrophe but if the people dump it or look strangely on the gay hussars now, well, it's the end. THEY have their ideas of what a doctor is, and I imagine the GMC is partly there to protect the integrity of the brand. If-you're-loopy-you-shouldn't-prescribe sort of thing.

Now, back to death. Suicide can be quite a statement. There is, unsurprisingly, a tendency to put down the motives of the successful as fickle in the extreme. (Quite whether the practitioners of this want to protect the vulnerable or deprive the desperate of a platform is a further matter -- just as officials not wishing to discuss individual cases is. Create an inquiry and put us off.)

England's the cradle of the language I love and I don't like to criticise it; but perhaps the behaviour of some... doesn't represent it well. Star Chambers and secret conclaves ought to be reading the writing on the wall. Comfy backwaters aren't good when fates are being decided.

As I said, the public aren't my first love. Unlike most of you I haven't taken any Hippocratic oath to cosset them at every opportunity. In fact most of the time I feel like giving them a good telling off for expecting poliiticians to do the impossible. Then again the politicians do rather ask for it (or have). I think they're regretting it now.

Royalism, though, keeping yourself at a distance, isn't the way for a committee supposedly serving the public to have gone. And it's unwise to carry it on -- in the days of bloggers. Don't let the bloggers grind you down? They probably will.

Anonymous said...

Suppose a category of person was attracted to a profession, as much as anything as a result of a vulnerability in their nature, a sympathetic way they have. Further suppose that the standard-setters they come up against one day are of the opposite disposition. Haven't we got a recipe for cruel outcomes in a closed kitchen?

If many aspiring to the profession can't speak the language of managers, but merely that of doctors, then a step toward conflict has already been made. For the moment push comes to shove, the language of right will go hand in hand with the already-existing might. And the humble doctors feel disowned.

There's a way with tribunals and lawyers where "less is more". Those who don't need, who are the very opposite of the usual carer, are held in high esteem: however that's not the same as medical ability. It's a troubling possibility.

Dr. Liz Miller said...

You are right, there is always the question of whether doctors are attracted to medicine, particularly psychiatry because of a need to sort themselves out, or an altruistic motive to help others. This question has to be included in debates about doctors mental health.

I asked a group of doctors with mental health problems, whether or not they thought medicine had caused their problems. One third thought that medicine had caused their problems, one third that it had contributed and one third that they would have been ill whatever they had done.

In my own case, medicine did make me ill, long hours, wrong sorts of stresses, bullying etc. I had not wanted to study medicine (I wanted to be an artist ;-). Personally, I believe that it was my lack of assertiveness that led to my breakdowns. Thus if I had been assertive enough not to do medicine, despite strong parental pressure, I would not have been ill. So although in one sense medicine "made me ill", it was not the root cause.

The root cause was, I believe, my inability to find something that better suited my nature! However after due trials and tribulations, I hope I now practice medicine in a way that I hope makes me and my patients happy!

Anonymous said...

I used a harsh-sounding word, "category", because I wanted to haul up for examination the absurdity of expecting just too much. You can be human, you can be an expert -- but can you keep in the back of your mind all the time how things can be portrayed in legal jargon?

Our family doctor during my childhood and teenage years was a rather wonderful Irishman who, sadly, liked the whisky too much. Yet he had earned the accolade of phrases like: "You can put your life in his hands." His partner in the practice was much more the gentleman, but not thought as clever.

To be analytical, about other people, can be god-like. And we've had so many hundreds of years of looking for saints or sinners, under our law. We ought to try to find no-fault or "lesser-fault" ways of dealing with things.

Yet there's this urge, I sense, to go backwards. People think they'd be better with the man-with-a-bow-tie no one can question. It won't be excellence that will come if the clock's turned back.

Being a mere member-of-the-public, one can't be struck off, but one can be struck down -- to the degree of finding oneself thought "the chief psychiatrist of the hospital in disguise:" which was what one fellow patient said to me. I suppose my psychiatrists found me unnerving in the opposite sense, since they knew I wasn't.

I think to be in one's twenties and to have had a nose in books for just long enough... is to still be a vulnerable child by today's standards. It's a crystal clear view of things we need.

Dr. Liz Miller said...

In the light of public disquiet concerning Debra Shepherd's, I made inquiries of the GMC, with respect of DNUK postings and GMC involvement with Debra in the month prior to her death.

I have received a letter from the GMC under FOI that contains the following information, if anyone would like a copy of the letter please get in touch

The letter confirms that the GMC did not have any communication with Debra Shepherd in the month prior to her death

The GMC do not hold any records of any postings of Dr Shephard from the DNUK, nor any correspondence between representatives of Doctors Net UK and the GMC in association with Dr Shepherd's Case