Thursday, 23 August 2018

GMC Send Their Decision. It made no logical sense to me. Does it to you?

So on the 9th of February 2018 I sent a letter to the GMC in support of Dr Myhill's complaint.

I am not a Ms and the last paragraph I really object to, which I have addressed in my reply which I address in my next blog.

They say they oversee medical education... Err research forms medical understanding and education?Or am I missing something here?



Dear Ms Rodwell

Thank you for your correspondence sent via email which was received by the GMC on 9 February 2018, addressed to Sir Terence Stephenson. Your concern was passed to the Fitness to Practise section to look at the issues you had raised. We have now reviewed all of your correspondence, including the original concern from Dr Myhill.
In considering your concern, we looked at the doctors who were involved in conducting or publishing information relating to the PACE trial, who hold current registration with the GMC.

After careful consideration, we have decided that we will not be taking the matter any further at this time. We’re sorry if this is not the outcome that you were hoping for.
Concerns about staff involved in the PACE trial who are not registered doctors
There are a number of other researchers listed as authors of the PACE trial. However, as an organisation the GMC can’t investigate concerns which do not relate to registered doctors.

Our role
Our role is directly related to the registration of doctors. Our responsibilities are all connected to keeping the Medical Register. We oversee medical education; we give entry to the Register for those suitably qualified; we advise on good medical practice while registered; and we remove or restrict registration in response to fitness to practise concerns where there may be a risk to patient safety.

An investigation can only be opened if the concerns raised are so serious that the doctor’s fitness to practise medicine is called into question to such an extent that action may be required to stop or restrict the way in which they can work to protect future patient safety.

The purpose of an investigation is to determine if or to what extent we need to restrict the doctor from working. We are not a general complaints body and we have no legal powers to intervene in or resolve matters for individual patients.

Reasons for our decision

We are aware that many people have strong views on the PACE trial and concerns about the way the research was conducted, collated and published. As an organisation we don’t have any involvement in setting standards and protocols for clinical trials. However, we do appreciate that there has been significant academic debate about the trial and its methodology and that a number of criticisms have been made. We have reviewed an extensive amount of information about the concerns raised, before making our decision as to whether we can investigate.

In addition to all of the relevant documentation submitted to the GMC raising concerns about this research, we are also aware that there was a Parliamentary debate held on 21 June 2018 which discussed the matter of treatment and research relating to myalgic encephalomyelitis, in the UK.

Our considered view is that these concerns are part of an ongoing academic and scientific debate, rather than matters which would raise concerns about an individual doctor’s fitness to practice, in the absence of anything which demonstrates that they had acted dishonestly or with intent to be misleading. From the information provided, we haven’t identified any issues that would meet these criteria. As an organisation, we wouldn’t be in a position to comment on the research framework of the trial, and whether this was fair and robust, as this is outside our remit.

Whilst we do understand why you have significant concerns about this research and the impact it has had, overall, we are not of the view that this would require us to open an investigation with a view to restricting the medical registration of any of the doctors involved in carrying out this research.

Concerns about the standard of care provided

In your correspondence you have said that you are the mother of a 12 year old child, who has had ME since the age of 8. You have said that you were not given sufficient information by your son’s GP to allow you to consider the various treatment options available and you are concerned that appropriate investigations for your son were not always followed up. You have advised that your son also experienced severe headaches amongst other symptoms, however, you consider that the possibility of him experiencing migraines was not then discussed and investigated fully. You have advised that your concerns about his treatment were often dismissed, and you were made to feel irresponsible for wanting to discuss his treatment in detail.

You have said that your son was sent to a multidisciplinary team and advised to have CBT and GET. However, after having this treatment you found that his condition declined further. However, when you tried to raise your concerns about these matters and in relation to the issue of Post Exertional Neuro-immune Exhaustion (PEME), you said your views were dismissed even though his symptoms had become worse. You have also raised concerns about the delay involved in diagnosing your son as having coeliac disease. We can see that you have also found that you were not given sufficient support to help manage his pain and discomfort.

We’re sorry to hear of the difficulties you and your family have experienced. We appreciate that many ME and CFS patients might have had a negative experience in the NHS, and that they have concerns about the way their condition is diagnosed and managed. We don’t wish to undermine these concerns in any way, however we’re not able to look at the overall care a patient has received, only the issues raised about specific doctors. In addition, we can’t investigate concerns about the availability of funding or services available from the NHS. It’s useful to remember that we can only open an investigation where we’ve decided that we may need to place some kind of restriction on the doctor’s practice. We don’t have any powers to intervene in a particular patient’s care, or recommend a particular treatment or that a referral should be provided to a patient.

We do expect doctors to be respectful to patients and their families at all times. Whilst we’re sorry to hear about the attitude of some of the staff involved in your son’s medical care, issues such as you have described would not usually be a matter for the GMC to investigate as a medical regulator. However, you can of course complain about these matters to the relevant healthcare provider, if you’ve not already done so, to allow any concerns to be addressed at a local level.

We‘re aware there is a broad spectrum of opinion both among patients and doctors as to the correct method of diagnosis for people experiencing ME/CFS, and the way the condition should be managed. We also know that patients are individuals and respond differently to treatments, and as a result there is no single way of managing ME/CFS which will work for everyone. As an organisation we’re not able to get involved in endorsing or recommending particular methods of treatment, or endorsing particular theories or research about the illness, as this is not part of our statutory role.

We understand that there are concerns about the validity and quality of the guidance relating to patients who have ME/CFS which is used by other organisations such as the NHS and NICE, as well as non-health care bodies, like the Department for Work and Pensions and various insurance companies. We don’t have any role in regulating social security policies, and aren’t able to intervene to tell other organisations to amend any current guidance documents which they use. You might wish to raise any concerns you have with the relevant body.

If you feel that any GPs or consultants have failed to treat your son on specific occasions then this should be raised with their employers at the GP practice, NHS England or with the relevant hospital trust directly in the first instance. Local organisations are usually better placed to look into these types of issues and can provide explanations and offer apologies if this is appropriate.Thank you for bringing these matters to our attention. We hope this explains the reasons for our decision and the kind of issues we are able to look at. We’re sorry we cannot help you further at this time.

Yours sincerely
Ian McCann
Complaints and Correspondence Officer
On behalf of the Assistant Registrar
Fitness to Practise Directorate
Direct Dial: 0161 923 6344
Email: fpddecisions@gmc-uk.org

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