Written: October 27, 2022
Recently I had a professional encounter with a GP at a local surgery. I run a Suicide Crisis Centre, and needed to talk to him in relation to a patient.
Later that day I discovered online press reports that showed he had inappropriately formed an emotional relationship with a vulnerable patient. She was vulnerable because of her mental health.
The General Medical Council (who investigate misconduct) had found that the doctor’s “misconduct involved very serious transgressions of professional boundaries over a lengthy period of time” and they concluded that “the patient suffered harm.”
However, the doctor was not suspended. The GMC report stated that the doctor had “learned much from the experience of this case”. The GMC placed some conditions on his practice, including a requirement to have a supervisor on site for forty per cent of his clinical time.
In the newspaper report, a senior partner at the GP surgery was quoted as saying that he was satisfied that the doctor “will continue to provide excellent care to all his patients at the surgery.”
Many of us find it hard to understand why such serious and damaging transgressions do not lead to suspension. And yet this is consistent with what we have seen in some other cases where doctors have harmed psychiatric patients.
I run a Suicide Crisis Centre, but there have been times when I have been a psychiatric patient, too. Sadly I encountered a psychiatrist whose behaviour had a damaging impact – not just on me, but on other patients, too.
An independent psychological report provided by a neighbouring NHS Trust concluded that his conduct had caused “highly significant harm” to me.
Subsequently I came into contact with other patients who had been affected by his conduct and actions, and bereaved families of loved ones who were under his care and who have tragically taken their own life.
The actions of the psychiatrist are now the subject of legal proceedings, and this limits what I can write about events. But I can say that one of the drivers of this legal action is a strong sense that it is the only route open to harmed patients and families. It is about seeking an acknowledgement of the impact of the psychiatrist’s actions – something many people feel the NHS management have never provided.
I understand that senior management have a duty to look after their staff’s wellbeing – including when staff are subject to investigations – but they also have a primary duty to protect patients under their care, and a duty towards patients who are harmed by their staff.
The psychiatrist took early retirement recently.
Complaints made by patients (or their families) about him were not upheld by the NHS Trust. However the Health Ombudsman (PHSO) became involved afterwards, and their investigations found that there had been significant failings. The Care Quality Commission and NHS Improvement became involved at this stage, at the Ombudsman’s request.
The Ombudsman can make recommendations, but it really needed the Care Quality Commission to take substantial action to protect future patients, not simply to accept the assurances of the NHS Trust that “learning has been taken”. Too often, the Care Quality Commission is failing to protect vulnerable patients. As we have seen from recent television documentaries, they have often failed to notice harmful practices or abuse in psychiatric services and services that support vulnerable adults, including Edenfield and Whorlton Hall. The Care Quality Commission had rated both of those services as “good”, based on its own inspections. It was undercover filming by television companies that provided evidence of harm.
Many of us are left feeling that there is no organisation protecting us. Even when there is evidence of misconduct and evidence of harm, doctors often appear to maintain the support of their colleagues and continue in their job – and often continue to be respected and admired by colleagues.
Senior management will often act to protect the reputation of their organisation. Expressing confidence in the doctor can be part of that. Additionally, management and colleagues may struggle with complex feelings including a sense of loyalty towards the doctor, who they may have previously respected and liked – perhaps even admired. It is so often the case that the doctor in question may have interacted completely differently with colleagues than with patients. Colleagues may not see or experience what some of their patients do. There is still often a sense of colleagues thinking “but they’re a great doctor”. They’re not a great doctor if they are harming patients. They should not be working with vulnerable psychiatric patients if they are harming them.
It’s important to emphasise that there are colleagues and clinicians who do take action to protect patients in these circumstances, for example by their courageous whistle blowing. It is often because of whistle blowers that abuse and malpractice are uncovered.
And it’s important to emphasise that the vast majority of clinicians would never knowingly harm patients.
But there is no statutory organisation consistently protecting or supporting psychiatric patients who experience harm from doctors – even when there is clear and objective evidence of harm having occurred. This is a significant gap. We cannot rely on the Care Quality Commission or the General Medical Council to take action to protect us. We need a statutory organisation that is specifically focusing on the harmed patients and their needs – and what needs to happen to protect future patients.
Those of us who are harmed by doctors need support afterwards. We are likely to need psychological treatment to recover – but few of us receive it. Far too often, there is no one supporting the harmed patients, or ensuring that their needs are met. That must change.
Joy Hibbins runs a Suicide Crisis Centre: https://www.suicidecrisis.co.uk
The patient safety charity AvMA (Action against Medical Accidents) can give advice on 0845 123 2352, if you have experienced harm from psychiatric or medical services: AvMA – The AvMA helpline
The charity Mind can provide information and signposting: Helplines – Mind
The Samaritans provides listening support: https://www.samaritans.org/