As reported here in October 2014, the General Medical Council (GMC) was due to publish a report on suicides of doctors going thought their Fitness to Practice Procedures in September last year; it was published in December and can be viewed in full here.
The review is titled: ‘Doctors who commit suicide while under GMC fitness to practise investigations’, which itself is a stigmatising and incorrect title, since suicide ceased to be a criminal act in England under the 1961 Suicide Act – and never was a criminal act in Scotland. The CEO of the GMC Niall Dickson is quoted as saying: ” We are determined to do everything we can to make sure we handle these cases as sensitively as possible, to ensure the doctors are being supported locally and to reduce the impact of our procedures.” We shall see – and increasing numbers are watching.
This report was commissioned by the GMC to review those cases where doctors have committed suicide while under the fitness to practise procedures between 2005 (when the GMC introduced electronic data systems) and 2013. The aim was to establish whether the GMC’s processes could be improved to reduce the impact on vulnerable doctors and whether there is more the GMC can do to prevent these tragedies from occurring. The report addresses lessons that can be learnt from these deaths, as well as any changes the GMC could make in the way it handles vulnerable doctors.
During the period under review there were 28 reported cases in the GMC’s records where a doctor committed suicide or suspected suicide while under their investigation procedures.
The case reviews showed that many of the doctors who committed suicide suffered from a recognised mental disorder, most commonly depressive illness, bipolar disorder and personality disorder. A number also had drug and/or alcohol addictions. Other factors that may have contributed to their deaths included marriage breakdown, financial hardship, the involvement of the police and the impact of the GMC investigation.
The review made the following recommendations for current GMC practice:
1 Doctors under investigation should feel they are treated as ‘innocent until proven guilty’
2 Reduce the number of health examiners’ reports required for health assessments
3 Appoint a senior medical officer within the GMC to be responsible for overseeing health cases
4 Introduce case conferencing for all health and performance cases
5 Set out pre-qualification criteria for referrals from NHS providers and independent employers
6 Make emotional resilience training an integral part of the medical curriculum
7 Expose GMC investigation staff to frontline clinical practice
8 Develop a GMC employee training package to increase staff awareness of mental health issues.
and recommendation for GMC stakeholders:
9 Establish a National Support Service (NSS) for doctors
Action for NHS Wellbeing welcomes the review as part of moving towards an increasing understanding (including by doctors and their regulators) that doctors are human too and obey the same laws of psychodynamcs as all other earthlings, with the same needs, hopes, desires and fears. Further that systemic and systematic training has to be a central part of all medical training and on-going practice and that compassionate and supportive policies and procedures are the way forward if we are not to drive increasing numbers of good people out of clinical care, with the huge financial costs and personal waste that result. In this sense, the GMC is truly a stake-holder.